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The Effect of Er:YAG Laser Therapy as an Adjunct to Surgical Treatment Compared to Latter Alone in Managing Medication-Related Osteonecrosis of the Jaw: A Randomised Controlled Clinical Trial.

OBJECTIVE: The aim of this double-blind randomised controlled clinical trial was to assess the effectiveness of the Er:YAG laser as an adjunct to conventional surgical treatment compared to surgical treatment alone in managing medication-related osteonecrosis of the jaw (MRONJ). METHODS: Sixty-five patients diagnosed with stage II or III MRONJ were randomly allocated into 2 groups: a control group (n = 30) treated using conventional surgery alone and a test group (n = 35) treated using conventional surgery with adjunctive Er:YAG laser. All patients received 3-day preoperative and 14-day posto

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… For patients allergic to penicillin, clindamycin (600 mg every 12 hours) was prescribed. Antibiotic therapy began 3 days preoperatively and continued for 14 days postoperatively. …

Non-Interventional Prospective Observational Study of Platelet Rich Fibrin as a Therapy Adjunctive in Patients with Medication-Related Osteonecrosis of the Jaw.

BACKGROUND: Medication-related osteonecrosis (MRONJ) of the jaw is a severe and feared side effect of antiresorptive therapy in the oncological setting. With growing evidence that impaired angiogenesis may represent a key factor in pathogenesis, the aim of this study was to evaluate an autologous platelet concentrate as a possible additive in surgical therapy to optimize vascularization and, subsequently, resolution rates. MATERIAL AND METHODS: A non-interventional, prospective, multicenter study was conducted, and all patients with stage I-III MRONJ, undergoing antiresorptive therapy for an

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… The interventions were all conducted under general anesthesia; all patients received perioperative antibiotic therapy with ampicillin/sulbactame 3 g i.v. 1-1-1 (or in case of penicillin allergy: Clindamycin 600 mg p.o. 1-1-1) as well as tube feeding until the 5th postoperative day. …

A multicenter case registry study on medication-related osteonecrosis of the jaw in patients with advanced cancer.

PURPOSE: This observational case registry study was designed to describe the natural history of cancer patients with medication-related osteonecrosis of the jaw (ONJ) and evaluate the ONJ resolution rate. METHODS: Adults with a diagnosis of cancer and with a new diagnosis of ONJ were enrolled and evaluated by a dental specialist at baseline and every 3 months for 2 years and then every 6 months for 3 years until death, consent withdrawal, or loss to follow-up. The primary endpoint was the rate and time course of ONJ resolution. Secondary endpoints included frequency of incident ONJ risk facto

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… Table 6 Antibiotic regimens and duration of treatment Antibiotic class/category | Courses, n (%) | Average duration, d Extended-spectrum penicillin | 212 (25.2) | 48.8 Amoxicillin-clavulanic acid | 175 (20.8) | 26.6 Tetracyclines | 119 (14.2) | 10.4 Clindamycin | 99 (11.8) | 11.1 Metronidazole | 96 ( …

A Systematic Review of Laser Photobiomodulation Dosimetry and Treatment Protocols in the Management of Medications-Related Osteonecrosis of the Jaws: A Rationalised Consensus for Future Randomised Controlled Clinical Trials.

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating adverse effect of bisphosphates, antiresorptive therapy or antiangiogenic agents that can potentially increase oxidative stress, leading to progressive osteonecrosis of the jaws. Despite the large number of published systematic reviews, there is a lack of potential MRONJ treatment protocols utilising photobiomodulation (PBM) as a single or adjunct therapy for preventive or therapeutic oncology or non-oncology cohort. Hence, this systematic review aimed to evaluate PBM laser efficacy and its dosimetry as a monotherapy or comb

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… Study Reference | Type of Antibiotics and Antiseptic Mouthwash | Pre- and Post-op | Pre-op | Post-op | Dose | Route of Administration | Frequency | Duration (Day) [ 103 ] | Antibiotics | NA Antiseptics | NA [ 104 ] | Antibiotics | Amoxicillin clavulanate | | x | | | 1000 mg | Po | BD | 7 Clindamycin … Ceftriaxone | x | x | | | 1 g | IM | OD | 7 Metronidazole | x | x | | | 500 mg | Po | BD | 7 Antiseptics | Chlorhexidine | x | x | | | NM | Mouth rinse | NM | NM [ 107 ] | Antibiotics | Amoxicillin clavulanate | x | x | | | 2 g | Po | OD | 14 Metronidazole | x | x | | | 500 mg | Po | OD | 14 Clindamycin …

Clinical Performance of Implant-Supported Prostheses in the Rehabilitation of Patients Previously Treated for Medication-Related Osteonecrosis of the Jaws (MRONJ): A Systematic Review.

There is a lack of consensus on managing resultant bone and soft tissue defects or on restoring oral function and aesthetics following medication-related osteonecrosis of the jaws (MRONJ) lesion healing. This clinical challenge presents a dilemma for practitioners. Removable prostheses pose a recurrence risk if poorly fitted and may inadequately restore function or aesthetics in cases of significant bone defect. Dental implant-supported prostheses could enhance function and quality of life, though their risks and indications are not well-defined. This systematic review examines the clinical ou

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… If penicillin allergy, 300 mg clindamycin capsules (thrice daily) | No 6 | Mean: 74 (range: 57-88) | NA* | 0 Lee et al., 2023 [ 56 ] | 1 | 80 | Female | 11 | One week before and one week after surgery. amoxicillin–clavulanic acid and zaltoprofen | No (switch to non-BP therapy using raloxifene) Caldroney …

Nutritional Status in Patients with Medication-Related Osteonecrosis of the Jaw (MRONJ).

Medication-related osteonecrosis of the jaw (MRONJ) is a potentially severe side effect of mostly antiresorptive drugs. The aim of this prospective clinical study was to evaluate the nutritional status in MRONJ patients scheduled for surgical treatment (intraoral soft tissue closure). The following parameters were evaluated: body weight, body height, BMI, nutritional risk index (NRI), bioelectric impedance analysis (BIA), vitamins A, B12, D3, E, K1, folic acid, iron, total protein, transferrin, ferritin, prealbumin, albumin, and zinc. All subjects were admitted to hospital four to five days be

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… In case of a known allergy to penicillin, clindamycin (Pfizer, New York City, NY, USA) was used. Patients were sip-fed with two drinks of Nutritia Fortimel Compact Protein (18 g, 300 kcal) in addition to regular oral food intake. …

Preoperative Vitamin D as Predictor of MRONJ: A Retrospective Multivariate Analysis.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a grave complication in patients with cancer treated with antiresorptive agents, particularly after invasive dental procedures. Identifying reliable clinical factors to assess MRONJ risk remains a clinical challenge. Methods: The retrospective observational study comprised 61 oncologic patients undergoing dental extractions during antiresorptive therapy. Preoperative serum levels of 25-hydroxyvitamin D and β-C-terminal telopeptide cross-link (β-CTx), along with relevant clinical variables, were measured. The analyses included c

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… Patients allergic to beta-lactams were prescribed clindamycin (600 mg every 8 h). Dental extractions were conducted using techniques designed to minimize trauma. A single surgeon used standard oral surgery methods to reduce variations that could affect the outcome. …

Metagenomic Profiling of Oral Microbiome Dynamics During Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma Patients.

BACKGROUND: We explored the interaction between the oral microbiome and the development of radiation-induced mucositis in patients with head and neck squamous cell cancer (HNSCC) undergoing chemoradiotherapy (CRT). We prospectively studied the oral microbiome and compared it to healthy controls. Additionally, we compared patients with low-grade (LGM) vs. high-grade mucositis (HGM). METHODS: Ten HNSCC patients scheduled for CRT were included. Saliva samples were characterized prior to, during, and nine months after CRT using metagenomic sequencing. We similarly characterized samples from seven

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… Abbreviations: ABT = antibiotic therapy, C = clindamycin, D = doxycycline, F = fluoroquinolones, U = unacid, V = vancomycin. a Sixth cycle not administered (infection), aCRT = adjuvant chemoradiotherapy, dCRT = definitive chemoradiotherapy. b During follow‐up. …

How we manage medication-related osteonecrosis of the jaw.

Bone-modifying agents (BMAs) are integral to managing patients with advanced cancer. They improve quality of survival by reducing skeletal-related events, treating hypercalcaemia and chemotherapy-induced bone loss (Coleman in Clin Cancer Res 12: 6243s-6249s, 2006), (Coleman in Ann Oncol 31: 1650-1663, 2020). Two decades ago, medication-related osteonecrosis of the jaw (MRONJ) was first reported following BMA therapy (Marx in J Oral Maxillofac Surg 61: 1115-1117, 2003). The risk of MRONJ extends over a decade following BMA treatment with bisphosphonates, complicating dental care such as extract

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… Penicillin-based antibiotics (amoxicillin ± clavulanic acid) or clindamycin in patients with penicillin allergies are recommended [ 4 , 85 , 90 , 96 ]. Do drug holidays work? …

Advanced biomaterial-based approaches for medication-related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating adverse effect linked to anti-resorptive and anti-angiogenic therapies, with an incidence of 4.34 % (6.22 % in oncology patients and 0.59 % in osteoporosis patients) based on a pooled analysis of 92 observational studies (2015-2020), characterized by persistent bone exposure and poor healing. Conventional treatment modalities often yield suboptimal outcomes, with recurrence and procedural morbidity. In recent years, biomaterial-based strategies have emerged as promising alternatives by targeting MRONJ's complex pathophysiolo

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… , vascular endothelial growth factor; PBM hydrogel, poly (ethylene glycol)-bovine serum albumin/arginylglycylaspartic acid-magnesium oxide hydrogel; CMCS-PMCM-41-NMCM-41, carboxymethyl chitosan-plasma-treated mesoporous silica nanoparticles-amine-functionalized mesoporous silica nanoparticles; CDM, clindamycin … Thavornyutikarn et al. exemplified this strategy by engineering a dual-drug delivery platform combining two types of MSNs, plasma-treated particles loaded with hydrophilic clindamycin (CDM) and amine-functionalized MSNs loaded with hydrophobic geranylgeraniol (GGOH). …

Neurology

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… meningoencephalitis affecting gray and white matter is seen with occasional periventricular involvement. 32 Necrosis may be severe, especially in congenital infections, and organisms may be visualized at the margins of lesions, within macrophages, and in tissue cysts. 32 Treatment may yield a favorable response, and clindamycin …

Безопасность и эффективность добавки корма, состоящей из Enterococcus lactisNICIMB 10415 (Cylactin) для всей птицы, предназначенной для жирения или выращивания для слоения/бридинга и декоративных птиц, для всех суидов, телят и других видов червей, предназначенных для сжижения или выращивания (DSM Dutal Products Ltd).

По просьбе Европейской комиссии ЕФСА было предложено представить научное заключение по оценке Цилактин в качестве зоотехнической добавки. Активным агентом присадки является Enterococcus lactis NCIMB 10415, и three Разрешенные в настоящее время составы присадок: Cylactin (LBC G35), Cylactin (LBC ME10) и Cylactin (LBC ME20) плюс. В настоящее время эта добавка разрешена в ЕС для использования в птице (цыплятах и мелких видах птицы для жиров, цыплят и мелких видов, выращиваемых для стирания), телятах и детях для выращивания и жирения, свиней, кормовых и откормленных поросят и свиней для откорма. В

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… The MIC values for all antibiotics tested were below the EFSA cut‐off values except for erythromycin and clindamycin (8 mg/L) and kanamycin (2048 mg/L), that exceeded the cut‐off values by one dilution. …

Prevention and treatment of oral adverse effects of antiresorptive medications for osteoporosis - A position paper of the Brazilian Society of Endocrinology and Metabolism (SBEM), Brazilian Society of Stomatology and Oral Pathology (Sobep), and Brazilian Association for Bone Evaluation and Osteometabolism (Abrasso).

Antiresorptive therapy is the main form of prevention of osteoporotic or fragility fractures. Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare but severe adverse reaction to antiresorptive and antiangiogenic drugs. Physicians and dentists caring for patients taking these drugs and requiring invasive procedures face a difficult decision because of the potential risk of MRONJ. The aim of this study was to discuss the risk factors for the development of MRONJ and prevention of this complication in patients with osteoporosis taking antiresorptive drugs and requiring invasiv

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… For patients allergic to penicillin, clindamycin may be prescribed. A systematic review has reported different prophylactic regimens starting 48 to 72 hours before the procedure and maintained for 1 to 3 weeks after the procedure ( 45 ). …

Respiratory Tract Infections: Sinusitis, Bronchitis, and Pneumonia

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… Oral atovaquone, primaquine plus clindamycin, and parenteral pentamidine may be given to patients who are intolerant of sulfa-containing regimens. …

Mesenchymal stem cells in the treatment of osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) has recently associated to the increase in antiresorptive and anti-angiogenic drugs prescriptions in the treatment of oncologic and osteoporotic patients. The physiopathogenesis of MRONJ remains unclear and available treatments are unsatisfactory. Newer pharmacological treatments have shown good results, but are not curative and could have major side effects. At the same time as pharmacological treatments, mesenchymal stem cells (MSCs) have emerged as a promising therapeutic modality for tissue regeneration and repair. MSCs are multi-potentia

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… The protocol involves the use of chlorhexidine mouthwashes and antibiotics (amoxicillin-clavulanate, clindamycin, or levofloxacin), while re-evaluating the patient every 15 days. …

Peritonsillar abscess: clinical aspects of microbiology, risk factors, and the association with parapharyngeal abscess.

PTA is a collection of pus located between the tonsillar capsule and the pharyngeal constrictor muscle. It is considered a complication of a … of FN in PPA. Based on our findings suggesting that FN is a frequent pathogen in PTA, we recommend clindamycin instead of a macrolide in penicillin-allergic patients with PTA. Furthermore, cultures made from PTA aspirates should include a selective FN-agar plate in order to identify growth of this bacterium. Recent studies of sore throat patients document an …

Infections associated with CAR-T cell therapy in patients with relapsed refractory multiple myeloma: Risks and prevention strategies.

BackgroundChimeric antigen receptor T (CAR-T) cell therapy has emerged as a potent treatment for relapsed or refractory multiple myeloma, demonstrating significant clinical efficacy. Despite these advances, treatment-related toxicities, particularly infections, pose a significant challenge to patient safety.MethodsThis review synthesizes current knowledge on the mechanisms underlying post-CAR-T therapy infections, focusing on the interplay between immune dysfunction, host factors, and treatment-induced toxicity. It provides a comprehensive analysis of the temporal and individual variability in

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… associated risk of Pneumocystis jiroveci pneumonia (PJP), it is recommended that all patients use co‐trimoxazole for PJP prophylaxis when tolerated. 21 , 71 In cases where patients exhibit an allergic reaction to co‐trimoxazole, an alternative prophylactic regimen comprising atovaquone, primaquine, and clindamycin …

Miscellaneous Spinal Cord Diseases

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… Clindamycin (12.5 mg/kg PO q12h for 4 weeks) is recommended for treatment of CNS toxoplasmosis. 23 An alternative drug therapy is trimethoprim-sulfonamide (15 mg/kg PO q12h). 23 One author reported a fair to good outcome in three cats treated for Toxoplasma -induced myelitis. 5 Clinical signs can be …

Chronic pruritus: a narrative review.

Chronic pruritus encompasses a manifestation of several cutaneous, allergic, infectious, neurological, psychological, and systemic conditions, whose etiological investigation and therapeutic strategy can be challenging. This comprehensive review aims to enhance the understanding of pruritus by highlighting important elements in its pathogenesis, including keratinocytes, Merkel cells and mast cells, nerve fibers, histaminergic and nonhistaminergic pathways, and the interaction of itch signals with the central nervous system. Diagnostic evaluation of chronic pruritus may require a meticulous app

Evaluation and Management of Bacterial and Fungal Infections Occurring in Patients with a Hematological Malignancy: A 2011 Update

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… The combination of vancomycin or clindamycin plus ciprofloxacin may be a suitable alternative for β-lactam-allergic patients [ 66 ]. Double β-lactam regimens are discouraged due to concerns about increased expense and toxicity, and the lack of consistent added clinical benefit [ 128 , 129 ]. … The present data suggest that if an oral regimen is considered then the combination of a fluoroquinolone (ciprofloxacin) and an agent with enhanced gram-positive activity (amoxicillin/potassium clavulanate [Augmentin] or clindamycin) is recommended [ 11 , 13 ]. …