Factors affecting masticatory function of community-dwelling older people: Investigation of the differences in the relevant factors for subjective and objective assessment

OBJECTIVE

This study aimed to examine relevant factors for subjective and objective assessment of masticatory functions and elucidate any differences between the two methods.

BACKGROUND

Previous studies have reported that the results of subjective and objective assessment of masticatory function in older people do not necessarily agree.

MATERIALS AND METHODS

This study included 487 community-dwelling Japanese older people (205 male and 282 female; mean age 74.1±6.3 years) who participated in a comprehensive geriatric health examination. Basic information (gender and age), higher level of competence in daily living, depression, subjective masticatory function (SMF) and objective masticatory function (OMF) assessments, cognitive function, skeletal muscle mass, handgrip strength, gait speed and oral status (number of remaining and functional teeth, mouth dryness and occlusal force) were recorded.

RESULTS

Multiple logistic regression analysis showed that depression (odds ratio [OR]: 1.181, 95% confidence interval [CI]: 1.094-1.275), mouth dryness (OR: 2.037, CI: 1.212-3.423) and occlusal force (OR: 0.997, CI: 0.996-0.999) were significantly associated with SMF, whereas higher level of competence in daily living (OR: 0.730 CI: 0.586-0.910), skeletal muscle mass (OR: 0.521 CI: 0.283-0.960), number of functional teeth (OR: 0.862 CI: 0.775-0.959), number of remaining teeth (OR: 0.868 CI: 0.810-0.930) and occlusal force (OR: 0.994, CI: 0.991-0.998) were associated with OMF.

CONCLUSION

Subjective masticatory functionSMF and OMF were associated with different factors, suggesting that both mental and physical factors should be taken into consideration when treating decreased masticatory function.

Ear Acupuncture for Immediate Pain Relief-A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective

To systematically review the literature on the effectiveness of ear acupuncture (EA) for immediate pain relief.

Data sources

AMED, CINAHL, Cochrane Reviews, Embase, PsycINFO, PubMed, Scopus Web of Science, from inception through March 2015.

Study selection

English publications, randomized controlled trials on human subjects involving EA as a treatment for pain, with outcomes recorded within 48 hours.

Data extraction and design

Two authors independently assessed trial eligibility, quality, results, and side effects, and extracted data; a third author checked final data. Effect size (d), mean difference (MD), and 95% confidence interval (CI) were calculated. The Physiotherapy Evidence Database (PEDro) scoring system was used to assess study quality. Meta-analysis was performed for two primary outcomes measures-pain intensity score and analgesic requirements.

Results

Ten studies met inclusion criteria. Quality per PEDro scores: four excellent, four good, two fair. Based on their primary outcome measures, six studies showed EA being superior to its comparator, three showed no difference to comparators (which in all cases were analgesics), and one study showed significant pain decrease at the first time point and no significant decrease at the second. Meta-analysis was completed for the three studies that evaluated pain intensity as a primary outcome measure, and EA was superior to comparator (MD = -0.96, 95% CI = -1.82- -0.11), but the MD was small. Meta-analysis was completed for the six studies that evaluated analgesic requirements, and EA was superior (MD = -1.08, 95% CI = -1.78- -0.38]), again with a small MD. Six studies reported side effects; all were minor and transient.

Conclusions

Ear acupuncture may be a promising modality to be used for pain reduction within 48 hours, with a low side effect profile. Rigorous research is needed to establish definitive evidence of a clinically significant difference from controls or from other pain treatments.

Boosting laser-ion acceleration with multi-picosecond pulses

Using one of the world most powerful laser facility, we demonstrate for the first time that high-contrast multi-picosecond pulses are advantageous for proton acceleration. By extending the pulse duration from 1.5 to 6 ps with fixed laser intensity of 1018 W cm-2, the maximum proton energy is improved more than twice (from 13 to 33 MeV). At the same time, laser-energy conversion efficiency into the MeV protons is enhanced with an order of magnitude, achieving 5% for protons above 6 MeV with the 6 ps pulse duration. The proton energies observed are discussed using a plasma expansion model newly developed that takes the electron temperature evolution beyond the ponderomotive energy in the over picoseconds interaction into account. The present results are quite encouraging for realizing ion-driven fast ignition and novel ion beamlines.

Pregnancies with factor V deficiency: a case report and review of the literature

CASE REPORT

A 30-year-old Japanese nulliparous woman visited for pregnancy at 33 weeks with a massive ovarian tumor located in the pouch of Douglas. By preoperative screening, her prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged, and her FV activity was significantly decreased to 4.8%. After prophylactic FFP 20 ml/kg was administered and her FV factor was 19.3%, cesarean delivery was performed, and her perioperative course was uneventful. One year later, she underwent a dilatation and evacuation because of a missed abortion, although prophylactic FFP was not administered. During a third pregnancy, after prophylactic FFP 20 ml/kg was administered and FV activity increased to 21.1%, elective cesarean delivery was performed, and her postoperative course was uneventful.

CONCLUSION

For surgical therapy or delivery, the goal of therapy is to maintain FV activity above 20%. It is particularly useful to administer prophylactic FFP.

The relationship between lip-closing force and dental arch morphology in patient with Angle Class I malocclusion

Dental arch morphology and tooth position are affected by lip-closing force (LCF). This study aimed to quantitatively evaluate the relationships between the horizontal or vertical balance of the LCF generated during maximum voluntary pursing-like movements and dental arch length (DAL) or width (DAW) or the lingual inclination of the upper or lower 1st molars (LIUM, LILM) in patients with Angle Class I malocclusion. Sixteen subjects with Angle Class I malocclusion (median age: 23·4 ± 5·9 years) who had never undergone orthodontic treatment were randomly selected. LCF was measured in eight directions during maximum voluntary pursing-like lip-closing movements. Dental arch models were scanned and analysed to obtain DAW, DAL, LIUM and LILM measurements. Mandibular deviation was measured on posteroanterior cephalograms. A significant negative correlation was detected between maxillary DAL and upper LCF. Maxillary DAL, DAW and the DAL/DAW ratio displayed significant negative correlations with total LCF and upper LCF. However, no significant correlations were detected between any mandibular dental arch morphological parameter and LCF. The difference in the LIUM between the deviation and non-deviation sides exhibited a significant positive correlation with the difference in upper LCF between the deviation and non-deviation sides and was significantly negatively correlated with the difference in lower LCF between the deviation and non-deviation sides. These results suggest that upper LCF is related to maxillary DAL, and the horizontal balance of the LCF of the upper and lower lips is related to the LIUM during pursing-like lip-closing movements in patients with Angle Class I malocclusion.

Complementary activities of DOT1L and Menin inhibitors in MLL-rearranged leukemia

Chromosomal rearrangements of the mixed lineage leukemia (MLL/KMT2A) gene leading to oncogenic MLL-fusion proteins occur in ~10% of acute leukemias and are associated with poor clinical outcomes, emphasizing the need for new treatment modalities. Inhibition of the DOT1-like histone H3K79 methyltransferase (DOT1L) is a specific therapeutic approach for such leukemias that is currently being tested in clinical trials. However, in most MLL-rearranged leukemia models responses to DOT1L inhibitors are limited. Here, we performed deep-coverage short hairpin RNA sensitizer screens in DOT1L inhibitor-treated MLL-rearranged leukemia cell lines and discovered that targeting additional nodes of MLL complexes concomitantly with DOT1L inhibition bears great potential for superior therapeutic results. Most notably, combination of a DOT1L inhibitor with an inhibitor of the MLL-Menin interaction markedly enhanced induction of differentiation and cell killing in various MLL disease models including primary leukemia cells, while sparing normal hematopoiesis and leukemias without MLL rearrangements. Gene expression analysis on human and murine leukemic cells revealed that target genes of MLL-fusion proteins and MYC were suppressed more profoundly upon combination treatment. Our findings provide a strong rationale for a novel targeted combination therapy that is expected to improve therapeutic outcomes in patients with MLL-rearranged leukemia.

Relationship Between Frailty and Oral Function in Community-Dwelling Elderly Adults

OBJECTIVES

To determine the standard values of and age-related changes in objective oral function of healthy older people; compare oral function of robust, prefrail, and frail older people; and determine the association between oral function and frailty.

DESIGN

Cross-sectional analysis.

SETTING

General community.

PARTICIPANTS

Elderly adults (≥65) from the Obu Study of Health Promotion for the Elderly were included and assigned to the robust, prefrail, and frail groups (N = 4,720).

MEASUREMENTS

Each participant underwent detailed physical testing to assess frailty. The frailty phenotype was defined according to the presence of limitations in three or more of the following five domains: mobility, strength, endurance, physical activity, and nutrition. The numbers of present teeth and functional teeth were counted, and occlusal force, masseter muscle thickness, and oral diadochokinesis (ODK) rate were measured, along with sociodemographic and functional status, comorbidities, and blood chemistry.

RESULTS

The number of present teeth, occlusal force, masseter muscle thickness, and ODK rate decreased with age. The frail group had significantly fewer present teeth (women aged ≥70), lower occlusal force (women aged ≥70; men aged ≥80), lower masseter muscle thickness, and lower ODK rate than the robust group. Multivariate analysis indicated that age, Geriatric Depression Scale score, skeletal muscle mass index, Mini-Mental State Examination score, hypertension, diabetes mellitus, albumin and triglyceride levels, and oral function were significantly associated with frailty.

CONCLUSION

Age-related differences in oral function were found in older adults. Moreover, frail older individuals had significantly poorer oral function than prefrail and robust individuals. The risk of frailty was associated with lower occlusal force, masseter muscle thickness, and ODK rate.

Clinical Value of Pet with 18F-Fluorodeoxyglucose and L-Methyl-11C-Methionine for Diagnosis of Recurrent Brain Tumor and Radiation Injury

We studied 15 patients clinically suspected to have recurrent brain tumor or radiation injury, using positron emission tomography (PET) with 18F-fluorodeoxyglucose (18FDG) and L-methyl-11C-methionine (11C-Met). PET with 11C-Met (Met-PET) clearly delineated the extent of recurrent brain tumor as focal areas of increased accumulation of 11C-Met, and was useful for early detection of recurrent brain tumor. PET with 18FDG (FDG-PET) showed focal 18FDG-hypermetabolism in one patient with malignant transformation of low grade glioma, and demonstrated its usefulness for evaluation of malignant transformation. 18FDG-hypometabolism was observed in all patients with radiation injury, but was also found in one patient with recurrent malignant brain tumor. 11C-Met uptake in 3 patients with radiation injury was similar to that of the normal cortical tissue. FDG-PET can be used to initially exclude recurrent brain tumor which is seen as 18FDG-hypermetabolism. The combined use of Met-PET in addition to FDG-PET can improve the accuracy of differentiation of recurrent brain tumor with 18FDG-hypometabolism from radiation injury.