METHODS: Tooth wear status of NPC survivors were clinically assessed using the Exact Tooth Wear Index. A tooth was graded to have severe wear when more than one-third of its buccal/occlusal/lingual surface had dentine loss. At the subject-level, percentages of anterior/posterior/all teeth with severe wear were calculated. Age, number of teeth, flow-rate/buffering capacity/pH of stimulated whole (SWS) and parotid (SPS) saliva's were collected. Correlation and multiple-linear regression tests were performed at the significance level α = 0.05.
RESULT: Sixty-eight participants (mean age of 60.0 ± 8.9), 697 anterior and 686 posterior teeth were examined with a mean of 10-years post-radiotherapy. Severe tooth wear was found in 63 (92.6 percent) participants, 288 anterior and 83 posterior teeth. The mean percentage of anterior/posterior/all teeth with severe wear were 42.3 ± 28.1, 14.5 ± 19.9 and 30.0 ± 21.7. Anterior teeth, particularly the incisal surface of central incisors were most affected. The mean flow-rate of SWS and SPS were 0.1 ± 0.1 ml/min and 0.03 ± 0.07 ml/min respectively. Thirty (44.1 percent) and 48 (70.6 percent) participants were found to have low/no buffering capacity of SWS and SPS respectively. Multiple-regression analyses revealed the SWS flow-rate was associated with the percentage of anterior teeth with severe wear (p=0.03).
CONCLUSION: Anterior tooth wear is a significant dental problem among NPC survivors and was associated with hypo-salivation.
CLINICAL SIGNIFICANCE: Patients with hypo-salivation should be being monitored for tooth wear particularly on the anterior teeth.
AIMS: This study aims to evaluate the clinical outcomes and practicality of immediately transferring stable STEMI patients back to their originating hospitals within 2 h postprimary PCI, within the Serdang STEMI Network. Specifically, it seeks to assess the in-hospital mortality rate and 30-day major adverse cardiac events (MACE) among these patients to determine the safety and feasibility of this novel early transfer strategy.
METHODS: This retrospective cohort study involved 1374 STEMI patients participating in the Serdang STEMI network from May 2015 to December 2022, including 570 patients admitted directly to Hospital Sultan Idris Shah, Serdang (HSIS) and 804 transferred from non-PCI centers.
RESULTS: Of the 804 transferred patients, 415 (52%) were transferred back to referring hospitals within 2 h of PPCI. These patients met specific criteria including hemodynamic stability, absence of procedural complications, and fit for transfer at the discretion of the attending cardiologist. The primary outcomes measured were in-hospital and 30-day mortality rates, as well as major adverse cardiac events (MACE). MACE was defined as a composite of death, myocardial infarction, stroke, or repeat revascularization. In the early return group, there was no in-hospital or 30-day mortality. No patient required repeat revascularization or readmission within 30 days.
CONCLUSIONS: Our results indicate that carefully selected patients can be safely returned to their originating hospitals very early following successful PPCI. These findings have important implications for large regional STEMI networks worldwide, particularly in areas where PPCI centers may have limited resources to handle high STEMI volumes.