Factors associated with prolonged hospitalizations from odontogenic infections in children

OBJECTIVE

Oro-facial infections are common pathologies comprising a substantial health concern in the pediatric population. Incorrect or late treatment may lead to serious and possibly life-threatening complications. The aim of this study is to analyze variables associated with prolonged length of hospital stays (LOS) due to odontogenic infections in children.

STUDY DESIGN

Data was collected from the records of patients (age <15 years) hospitalized due to odontogenic infections at Poriya Medical Center during the period of 1/2010-12/2015. Patients with oro-facial infections originating from other organs were excluded from the study as well as children with underlying systemic medical conditions that may affect recovery.

RESULTS

A total of 411 patients (mean age 6.5 ± 2 years) were included in this study, with 58.4% being male. There were significantly higher (p < 0.05) values of white blood cell (WBC) counts in patients with >3 days LOS. Patients with >3 days LOS were also significantly older (8.4 vs. 6.3 years). There were no significant differences in sex distribution or other clinical or laboratory parameters between the groups.

CONCLUSION

Older child age and higher WBC counts on admission are indicators for prolonged LOS.

Clinical and Prognostic Significance of the Eighth Edition Oral Cancer Staging System

Objectives: The most notable changes in the eighth edition of the AJCC Cancer Staging System include incorporating the depth of invasion (DOI) into T staging and extranodal extension (ENE) into N staging. In this study, we retrospectively assessed the prognostic and clinical implications of the eighth TNM staging system. Materials and Methods: Patients with Oral Squamous Cell Carcinoma (OSCC) who were treated surgically between 2010 and 2017 were retrospectively reviewed. Tumors were first staged according to the seventh edition and restaged using the eighth edition. The prognostic value of the resultant upstaging was evaluated. Results: Integrating the DOI into the T classification resulted in the upstaging of 65 patients, whereas incorporating ENE into the N staging resulted in the upstaging of 18 patients (p < 0.001). Upstaging due to DOI integration had no significant effect on OS or DSS (p > 0.05). Conclusion: Our results demonstrate the importance of incorporating ENE into nodal staging and considering adjuvant therapy when ENE is present.

Does fasting during Ramadan increase the risk of the development of sialadenitis?

BACKGROUND

Ramadan is a month within the Islamic lunar calendar when Muslims are required to fast (abstain from food and drink) during the daytime (from sunrise to sunset) for the entire month. Due to the established connection between fasting and dehydration and acute sialadenitis, the aim of this study is to determine if there is a higher frequency of sialadenitis among the Muslim population during Ramadan than during other months of the year.

METHODS

We conducted a retrospective study using the medical records of 120 Muslim patients admitted to the emergency room (ER) and diagnosed with acute sialadenitis over a 5-year period at the Baruch Padeh Medical Center, Poriya, and St. Vincent de Paul (French) Hospital, Nazareth, both located in Israel. The study group were Muslim patients, with the aforementioned diagnosis, admitted during Ramadan, while the control group included patients diagnosed with sialadenitis during the rest of the year. We analyzed overall admission frequency as well as descriptive and diagnostic data, including age, sex, gland involved and several blood test results.

RESULTS

During the month of Ramadan, the admission of Muslims with a diagnosis of acute sialadenitis was more than double that during the other months of the year - a difference that was found to be statistically significant (p = 0.001). Additionally, we found that Ramadan sialadenitis patients had significantly higher leukocyte numbers at admission (p = 0.0085) and, importantly, a significantly higher level of dehydration (blood urea nitrogen (BUN)/creatinine ratio) than non-Ramadan sialadenitis patients (p = 0.0001).

CONCLUSION

There is evidence that fasting in Ramadan may increase the risk for the development of acute sialadenitis. Our results suggest that this may be the result of dehydration.