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Cho EP, Hwang SJ, Clovis JB, Lee TY, Paik DI, Hwang YS. Enhancing the quality of life in elderly women through a programme to improve the condition of salivary hypofunction. Gerodontology 2011; 29:e972-80. [PMID: 22126433 DOI: 10.1111/j.1741-2358.2011.00594.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The purposes of this study were to examine the effects of oral exercise intended to improve the function of the oral cavity in the elderly and their quality of life to pave the way for the development of oral-health promotion programmes geared towards the elderly. METHODS The subjects were 78 female Koreans who resided in Seoul and were aged 65 years and older. During a 3-month period, an oral function promotion programme was conducted twice a week, between 10.00 am and 12.00 pm, applying oral exercise suggested by a Japanese public health centre. A survey was conducted by interviewing the selected women to determine the state of their subjective dry mouth, quality of life related to oral health and jaw functional limitation. Their opening, unstimulated whole saliva and pronunciation speed were measured before and after the oral function exercise programme. RESULTS The subjects showed a significant improvement in subjective dry mouth symptoms, relevant behaviour, the level of discomfort caused by dry mouth and subjective jaw functional limitation during mastication and swallowing and emotional expression after receiving the oral exercise. After the oral exercise, there was a significant increase in mouth opening, unstimulated whole saliva and speaking speed ('patakala' pronunciation) after oral exercise. There was also significant progress in their quality of life related to oral health. Overall improvement in subjective dry mouth symptoms and relevant behaviour over time after oral exercise had a positive correlation with the level of improvement in discomfort triggered by dry mouth and mastication. The level of improvement in OHIP-14 had a positive correlation with the level of overall improvement in dry mouth symptoms and behaviour, the level of improvement in discomfort by dry mouth and that in mastication and swallowing. CONCLUSION This study showed the effects of the oral function promotion programme and correlation of oral condition and oral health-related quality of life. It is suggested that this oral function promotion programme has positive effects on both objective and subjective oral conditions. It is strongly recommended that this programme, along with other oral health promotion programmes, be implemented to improve oral function and oral health-related quality of life for the elderly.
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Affiliation(s)
- Eun-Pyol Cho
- Oral Health Service Team, Korea Health Promotion Foundation, Seoul, Korea
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152
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Deschasse G, Steenpass V, Couturier P, Diot E, Maillot F, Maruani A. Sicca Syndrome in Hospitalized Older Adults: Prevalence and Comparison of Objective and Subjective Symptoms. J Am Geriatr Soc 2011; 59:2178-9. [DOI: 10.1111/j.1532-5415.2011.03639.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Veronika Steenpass
- University Clinic of Geriatric Medicine; University Hospital; Grenoble; France
| | - Pascal Couturier
- University Clinic of Geriatric Medicine; University Hospital; Grenoble; France
| | - Elisabeth Diot
- Internal Medicine; CHRU de Tours; Université François Rabelais; Tours; France
| | - François Maillot
- Internal Medicine; CHRU de Tours; Université François Rabelais; Tours; France
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153
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Johansson AK, Johansson A, Unell L, Ekbäck G, Ordell S, Carlsson GE. Self-reported dry mouth in Swedish population samples aged 50, 65 and 75 years. Gerodontology 2011; 29:e107-15. [PMID: 22050189 DOI: 10.1111/j.1741-2358.2010.00420.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Reduced salivary flow may have a negative impact on general well-being, quality of life and oral health. OBJECTIVES To examine xerostomia in 50-, 65- and 75-year-olds, background factors and effect on Oral Impacts on Daily Performances (OIDP). METHODS In 1992, a questionnaire was sent to all 50-year-old persons (n = 8888) in two Swedish counties. In 2007, the same questionnaire was sent to all 65-year-olds (n = 8313) in the two counties and to all 75-year-olds (n = 5195). Response rate was for the 50, 65 and 75 year olds 71.4, 73.1 and 71.9%, respectively. RESULTS Xerostomia was higher in women than in men in all age groups. There was higher prevalence of xerostomia with increasing age in both sexes and it was more frequent at night than during daytime. 'Often mouth dryness' was 2.6-3.4 times more prevalent in those who reported an impact from OIDP. The highest odd ratios were for daytime xerostomia and for the variables burning mouth (17.1), not feeling healthy (4.5), daily smoking (4.4), and medication (4.1). CONCLUSIONS The dramatic increase of xerostomia between age 50 and 75, especially amongst women, needs to be considered in the management of this age group.
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Affiliation(s)
- Ann-Katrin Johansson
- Department of Clinical Dentistry-Cariology, Faculty of Medicine and Odontology, University of Bergen, Bergen, Norway.
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154
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Abstract
Dry mouth can be caused by medication, CPAP use, radiation treatment and a variety of connective tissue diseases, with the prevalence increasing with age. In most individuals, daytime dryness is easily managed. However, except for a new product tested in this study, there is no product lasting longer than an hour that can be used at night to reduce the perception of oral dryness while sleeping. The purpose of this study was to assess whether a self-adhering, slowly dissolving disc that time-releases 500 mg of xylitol, cellulose gum (lubricant and humectant) and mild mint flavour (XyliMelts for Dry Mouth, OraHealth Corp.) used during sleep would reduce perceived morning oral dryness and discomfort. Fifteen subjects self-identified as having morning oral dryness were evaluated first without treatment and again with the use of XyliMelts for Dry Mouth. Measures of initial morning discomfort and perceived wetness demonstrated significant improvement. Perceived oral wetness scores increased more than threefold with the use of XyliMelts for Dry Mouth while sleeping. These findings suggest that XyliMelts for Dry Mouth may be an effective strategy for managing oral dryness that occurs at night.
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Affiliation(s)
- J Burgess
- Oral Care Research Associates, Seattle, WA 98115, USA.
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155
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López-Jornet P, Camacho-Alonso F, Rodriguez-Aguado C. Evaluation of the clinical efficacy of a betaine-containing mouthwash and an intraoral device for the treatment of dry mouth. J Oral Pathol Med 2011; 41:201-6. [PMID: 21950587 DOI: 10.1111/j.1600-0714.2011.01088.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE An evaluation is made of the efficacy and safety of an intraoral device with a betaine (BET)-containing mouthwash in treating xerostomia. METHODS A total of 105 patients with dry mouth (xerostomia) were included in a randomized, non-blinded, parallel-group, controlled clinical trial. The patients were assigned to one of the three groups: A (night guard), B (mouthwash), or C (night guard and mouthwash). A xerostomia questionnaire was administered, and unstimulated salivary flow was measured. The Oral Health Impact Profile (OHIP) - 14 was assessed. All measurements were taken before and after treatment, which had a duration of 4 weeks. The patients in turn completed a treatment satisfaction questionnaire. RESULTS Ninety patients (eight men and 82 women) completed the study. All three treatments alleviated the symptoms of xerostomia, with improvement in the OHIP-14 scores and sialometry findings. There were no adverse effects. Patient satisfaction with the treatment received showed no statistically significant differences among the three groups; though, the patients in group A considered treatment to have been extremely beneficial in 10% of the cases, while 43% considered it to have been beneficial. CONCLUSIONS The daily use of a night guard and BET-containing mouthwash was seen to improve dry mouth during the 4-week duration of the study.
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Affiliation(s)
- Pia López-Jornet
- Department of Oral Medicine, University of Murcia, Murcia, Spain.
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156
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Tada A, Miura H. Prevention of aspiration pneumonia (AP) with oral care. Arch Gerontol Geriatr 2011; 55:16-21. [PMID: 21764148 DOI: 10.1016/j.archger.2011.06.029] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 06/22/2011] [Accepted: 06/23/2011] [Indexed: 10/17/2022]
Abstract
AP is a major cause of morbidity and mortality in elderly patients, especially frail elderly patients. The aim of this article is to review effect of oral care, including oral hygiene and improvement of oral function, on the prevention of AP among elderly people in hospitals and nursing homes. There is now a substantial body of work studying the effect of oral care on the prevention of respiratory diseases. Oral hygiene, consisting of oral decontamination and mechanical cleaning by dental professionals, has resulted in significant clinical effects (decreased incidence of pneumonia and decreased mortality from respiratory diseases) in clinical randomized trials. Moreover, studies examining oral colonization by pneumonia pathogens have shown the effect of oral hygiene on eliminating these pathogens. In addition, swallowing training has been shown to improve the movement and function of swallowing-related muscles, also resulting in decreased incidence of pneumonia. These findings support the contention that oral care is effective in the prevention of AP.
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Affiliation(s)
- Akio Tada
- Department of Health Science, Hyogo University, 2301 Shinzaike Hiraoka-cyo, Kakogawa, Hyogo 675-0195, Japan.
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157
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Quandt SA, Savoca MR, Leng X, Chen H, Bell RA, Gilbert GH, Anderson AM, Kohrman T, Arcury TA. Dry mouth and dietary quality in older adults in north Carolina. J Am Geriatr Soc 2011; 59:439-45. [PMID: 21391935 DOI: 10.1111/j.1532-5415.2010.03309.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To quantify prevalence of dry mouth, association between dry mouth and beverage intake and dietary quality, and association between dry mouth and self-reported dietary accommodations to oral health deficits. DESIGN Cross-sectional study; data from self-reports. SETTING Rural North Carolina counties with substantial African-American and American Indian populations. PARTICIPANTS Six hundred twenty-two participants aged 60 and older. MEASUREMENTS Data included the 11-item Xerostomia Inventory (higher scores connote greater effect from dry mouth), a food frequency questionnaire (converted into Health Eating Index-2005 scores), and survey items on foods modified before consumption or avoided because of oral health problems. RESULTS Dry mouth was associated with being female, lower education, and income below the poverty level. Although overall beverage consumption did not vary with dry mouth, consumption of certain sugar-sweetened beverages was positively associated with dry mouth. Overall dietary quality did not differ with dry mouth, but more-severe dry mouth was associated with lower intake of whole grains and higher intakes of fruits. Dry mouth was strongly associated with self-reported modification and avoidance of foods. Those in the highest tertile of dry mouth were more likely to modify several foods than those in the lowest tertile and were more likely to avoid three or more foods. CONCLUSION Older adults appear to modify foods or selectively avoid foods in response to perceived dry mouth. Despite these behaviors, dry mouth does not result in poorer dietary quality.
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Affiliation(s)
- Sara A Quandt
- Department of Epidemiology and Prevention, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
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159
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Lončar B, Mravak Stipetić M, Baričević M, Risović D. The Effect of Low-Level Laser Therapy on Salivary Glands in Patients with Xerostomia. Photomed Laser Surg 2011; 29:171-5. [DOI: 10.1089/pho.2010.2792] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Božana Lončar
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Croatia
| | | | - Marinka Baričević
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Croatia
| | - Dubravko Risović
- Molecular Physics Laboratory, Institute Rudjer Bošković, Zagreb, Croatia
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160
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Abstract
The oral cavity of the hospitalized or bedridden elderly is often a reservoir for opportunistic pathogens associated with respiratory diseases. Commensal flora and the host interact in a balanced fashion and oral infections are considered to appear following an imbalance in the oral resident microbiota, leading to the emergence of potentially pathogenic bacteria. The definition of the process involved in colonization by opportunistic respiratory pathogens needs to elucidate the factors responsible for the transition of the microbiota from commensal to pathogenic flora. The regulatory factors influencing the oral ecosystem can be divided into three major categories: the host defense system, commensal bacteria, and external pathogens. In this article, we review the profile of these categories including the intricate cellular interaction between immune factors and commensal bacteria and the disturbance in homeostasis in the oral cavity of hospitalized or bedridden elderly, which facilitates oral colonization by opportunistic respiratory pathogens.
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Affiliation(s)
- Akio Tada
- Department of Oral Health, National Institute of Public Health, Wako, Saitama, Japan.
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161
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Abstract
Saliva plays an important protective role in the oral environment, and reductions in saliva quantity are known to increase the risk of oral diseases. Importantly, xerostomia or the perception of a dry mouth is now being recognized as an important risk factor for dental diseases. Furthermore, the subjective sensation of a dry mouth is a debilitating condition in itself that impacts on the quality of life of sufferers. With approximately 1 in 5 people reporting some form of dry mouth, and an increasing prevalence in the elderly, it is important for clinicians to have a thorough understanding of this problem. The aim of this paper is to review some of the literature relating to xerostomia in order to provide an evidence based update for clinicians.
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Affiliation(s)
- M S Hopcraft
- Cooperative Research Centre for Oral Health Sciences, Melbourne Dental School, The University of Melbourne, Victoria.
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162
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Kharevich O, Shipman B, Goldman BM, Nahon M. Salese to Buffer Saliva in Elderly Patients with Xerostomia: a Pilot Study. J Prosthodont 2011; 20:135-8. [DOI: 10.1111/j.1532-849x.2010.00680.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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163
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Featherstone JDB, Singh S, Curtis DA. Caries Risk Assessment and Management for the Prosthodontic Patient. J Prosthodont 2011; 20:2-9. [DOI: 10.1111/j.1532-849x.2010.00596.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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164
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Marsicano JA, Grec PGDM, Belarmino LB, Ceneviva R, Peres SHDCS. Interfaces between bariatric surgery and oral health: a longitudinal survey. Acta Cir Bras 2011; 26 Suppl 2:79-83. [DOI: 10.1590/s0102-86502011000800015] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE: To evaluate oral changes, such as dental caries, periodontal disease, dental wear and salivary flow in bariatric patients. Fifty four obese patients who underwent bariatric surgery were studied before (n=54), up after 3 months (n=24) and 6 months (n=16). METHODS: Indices for evaluating oral conditions were: DMFT, CPI, DWI and salivary flow. OIDP questionnaire was used to assess the impact of oral health on quality of life. ANOVA and Spearman correlation were used (p<0.05). RESULTS: DMFT was 17.6±5.7, 18.4±4.1 and 18.3±5.5 (P>0.05), presence of periodontal pockets in 50%, 58% and 50% of patients (p>0.05), tooth wear in dentin present in 81.5%, 87.5% and 87.5% before, 3 and 6 months after surgical treatment respectively. There were differences between the three periods for prevalence and severity of dental wear (p = 0.012). Salivary flow was 0.8±0.5 ml/min before surgery, 0.9±0.5 ml/min for 3 months and 1.1±0.5m/min for 6 months (p>0.05). The impact of oral health on quality of life decreased with time after bariatric surgery (p= 0.029). CONCLUSION: The lifestyle changes after bariatric surgery and these changes may increase the severity of pre-existing dental problems. However, these alterations in oral health did not influence the quality of life.
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165
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Brukienė V, Aleksejūnienė J, Gairionytė A. Salivary factors and dental plaque levels in relation to the general health of elderly residents in a long-term care facility: a pilot study. SPECIAL CARE IN DENTISTRY 2010; 31:27-32. [PMID: 21235611 DOI: 10.1111/j.1754-4505.2010.00172.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The goal of this study was to examine salivary factors and formation of dental plaque in elderly subjects who were institutionalized and to relate these factors to general health and medication use. This cross-sectional study consisted of 50 elderly individuals who were institutionalized and 25 healthy young volunteers who served as a reference group. For each subject, salivary flow rates, salivary pH, and buffering capacity were assessed. Baseline Plaque Index and Plaque Formation Rate Index were used as a measure of oral hygiene. Information on each patient's general health and medication use was acquired from the institution. An evaluation of the results of this study suggests that salivary protective qualities and dental plaque levels in the elderly subjects who were institutionalized were worse than in healthy young individuals. An association between the general health of the elderly and salivary flow rate was found.
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Affiliation(s)
- Vilma Brukienė
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
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166
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Syrjälä AMH, Raatikainen L, Komulainen K, Knuuttila M, Ruoppi P, Hartikainen S, Sulkava R, Ylöstalo P. Salivary flow rate and periodontal infection - a study among subjects aged 75 years or older. Oral Dis 2010; 17:387-92. [DOI: 10.1111/j.1601-0825.2010.01764.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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167
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Ohara Y, Hirano H, Yoshida H, Suzuki T. Ratio and associated factors of dry mouth among community-dwelling elderly Japanese women. Geriatr Gerontol Int 2010; 11:83-9. [DOI: 10.1111/j.1447-0594.2010.00647.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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168
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Kim SY, Guevara JP, Kim KM, Choi HK, Heitjan DF, Albert DA. Hyperuricemia and coronary heart disease: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 2010; 37:185-93. [PMID: 20191515 DOI: 10.1111/j.1365-2842.2009.02037.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The role of serum uric acid as an independent risk factor for cardiovascular disease remains unclear, although hyperuricemia is associated with cardiovascular disease such as coronary heart disease (CHD), stroke, and hypertension. METHODS A systematic review and meta-analysis using a random-effects model was conducted to determine the risk of CHD associated with hyperuricemia in adults. Studies of hyperuricemia and CHD were identified by searching major electronic databases using the medical subject headings and keywords without language restriction (through February 2009). Only prospective cohort studies were included if they had data on CHD incidences or mortalities related to serum uric acid levels in adults. RESULTS Twenty-six eligible studies of 402,997 adults were identified. Hyperuricemia was associated with an increased risk of CHD incidence (unadjusted risk ratio [RR] 1.34, 95% confidence interval [95% CI] 1.19-1.49) and mortality (unadjusted RR 1.46, 95% CI 1.20-1.73). When adjusted for potential confounding, the pooled RR was 1.09 (95% CI 1.03-1.16) for CHD incidence and 1.16 (95% CI 1.01-1.30) for CHD mortality. For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR for CHD mortality was 1.12 (95% CI 1.05-1.19). Subgroup analyses showed no significant association between hyperuricemia and CHD incidence/mortality in men, but an increased risk for CHD mortality in women (RR 1.67, 95% CI 1.30-2.04). CONCLUSION Hyperuricemia may marginally increase the risk of CHD events, independently of traditional CHD risk factors. A more pronounced increased risk for CHD mortality in women should be investigated in future research.
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Affiliation(s)
- Seo Young Kim
- Brigham and Women's Hospital, Boston, Massachusetts, USA.
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169
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Leal SC, Bittar J, Portugal A, Falcão DP, Faber J, Zanotta P. Medication in elderly people: its influence on salivary pattern, signs and symptoms of dry mouth. Gerodontology 2010; 27:129-33. [PMID: 20337727 DOI: 10.1111/j.1741-2358.2009.00293.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To compare stimulated and non-stimulated salivary flow, pH, buffering capacity and presence of signs and symptoms of hyposialie and xerostomia in elderly patients, with senile dementia using medication and healthy elderly subjects not using medication. METHODS Forty individuals (mean age: 68.5 years) were divided into two groups, according to the use (G1) or non-use (G2) of medication and the presence (G1) or absence (G2) of senile dementia. Data with reference to the general health condition, use of medication and the patient's complaints were collected during anamnesis. Clinical examination identified signs associated with hyposialie and xerostomia. Stimulated and non-stimulated saliva flow, pH and buffering capacity were verified. RESULTS The stimulated saliva flow in both groups was below normal parameters. The drugs used by individuals in G1 showed xerostomic potential. Individuals with a higher consumption of xerostomic medication presented with dry and cracked lips. A significant negative relationship was found between drugs consumption and the buffering capacity (p < 0.001), and the resting saliva flow rate (p = 0.002). CONCLUSION The use of medication increases the chance that an elderly person may present signs related to xerostomia and alterations in stimulated saliva flow and buffering capacity.
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Affiliation(s)
- Soraya Coelho Leal
- Dental School, Faculty of Health Science, University of Brasília, Brasília-DF, Brazíl.
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170
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Laudenbach JM, Epstein JB. Treatment strategies for oropharyngeal candidiasis. Expert Opin Pharmacother 2010; 10:1413-21. [PMID: 19505211 DOI: 10.1517/14656560902952854] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Oropharyngeal candidiasis (OPC) is a common oral disease that may cause oral symptoms, lead to regional infection (e.g., esophageal candidiasis) and increase the risk of systemic fungal infection in the compromised host. OBJECTIVE Critical review of the literature of prevention and therapy. METHODS The literature was reviewed using PubMed, and specific keywords from the MeSH Database were used. RESULTS/CONCLUSION Management of OPC requires that the underlying risk factors of infection be diagnosed and managed whenever possible. Antimicrobials may be provided as topical or systemic therapy. Topical therapies may provide effective management for candidiasis in the non-compromised host and increase the control of colonization in the compromised host. Advances in prevention and management include new agents and improved mechanisms of topical drug delivery.
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Affiliation(s)
- Joel M Laudenbach
- University of Illinois at Chicago College of Dentistry, Department of Oral Medicine and Diagnostic Sciences, 801 South Paulina Street (MC 838), Rm 554A, Chicago, IL 60612, USA.
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171
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GLAZAR I, UREK MM, BRUMINI G, PEZELJ-RIBARIC S. Oral sensorial complaints, salivary flow rate and mucosal lesions in the institutionalized elderly. J Oral Rehabil 2010; 37:93-9. [DOI: 10.1111/j.1365-2842.2009.02027.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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172
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Park MS, Ryu SA. Degree of Dry Mouth and Factors Influencing Oral Health-related Quality of Life for Community-Dwelling Elders. J Korean Acad Nurs 2010; 40:747-55. [DOI: 10.4040/jkan.2010.40.5.747] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Myung Sook Park
- Assistant Professor, Department of Nursing, Sun Moon University, Asan, Korea
| | - Se Ang Ryu
- Assistant Professor, Department of Nursing, Dongshin University, Naju, Korea
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173
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Bergqvist M, Ulfvarson J, Karlsson EA. Nurse-led medication reviews and the quality of drug treatment of elderly hospitalized patients. Eur J Clin Pharmacol 2009; 65:1089-96. [PMID: 19798491 DOI: 10.1007/s00228-009-0728-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 08/29/2009] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate if nurses after receiving training in clinical pharmacology can improve the quality of the drug therapy in elderly hospitalized patients. METHODS Nurses were given a 1-day training in clinical pharmacology to identify drug-related problems (DRPs).All patients admitted to the ward aged 65 or more were studied. Patients at the same ward before the intervention were considered as control group. Outcome variables were re-hospitalized 3 months from discharge, drug-related readmissions, the proportion of inappropriate drug use (IDU), and DRPs found by the nurses. RESULTS Of 460 patients (250 intervention group and 210 in the control group) 38 and 36%, respectively, had at least one re-admission to hospital (p=0.86) and 24% of the patients died. Eighteen and 17% (43/37), respectively, used one or more inappropriate drug (p 0.90). The nurses found 86 clinically significant DRPs not detected by the usual care. A substantial part of the DRPs detected by the nurses were revealed with assistance of Symptoms Assessment Form (SYM). There were no statistical difference in the number of drug-related re-admissions between the groups, 14/16, respectively, (p=0.40). CONCLUSIONS Nurses are able to detect a high proportion of clinically relevant DRPs not detected by the usual care and thereby increase the quality of the drug treatment in elderly hospitalized patients. Our study showed no effect on re-hospitalization or IDU. By using a SYM nurses can find DRPs that computer-based decision support systems miss.
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Affiliation(s)
- Monica Bergqvist
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
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174
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Arisco AM, Brantly EK, Kraus SR. Oxybutynin extended release for the management of overactive bladder: a clinical review. Drug Des Devel Ther 2009; 3:151-61. [PMID: 19920931 PMCID: PMC2769230 DOI: 10.2147/dddt.s3370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Overactive bladder (OAB) is a common condition which negatively impacts the quality of life of afflicted patients. This can result in alterations in social interactions at home, in the workplace and in the community, often leading to depression and poor self esteem as well as loss of productivity. Traditional mainstays of treatment include both behavioral therapy and pharmacotherapy. Oxybutynin immediate release (IR) represents the first such medication approved by the FDA specifically for treatment of OAB in 1975. Nevertheless, bothersome side effects in addition to thrice daily dosing often led to treatment cessation which raised the question that patients may actually prefer to live with their OAB symptoms rather than incur side effects or complex dosing schemes. Pharmacological advances ultimately led to development of a long-acting formulation of oxybutynin in the form of oxybutynin extended release (ER) with the hope that this drug would maintain efficacy while decreasing bothersome side effects and improve compliance with the convenience of once daily dosing regimen. This paper will review the major clinical studies involving oxybutynin ER as well as its role in different patient populations and potential concerns with its use.
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Affiliation(s)
- A M Arisco
- University of Texas Health Science, Center at San Antonio, Department of Urology, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
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Kanehira T, Yamaguchi T, Takehara J, Kashiwazaki H, Abe T, Morita M, Asano K, Fujii Y, Sakamoto W. A pilot study of a simple screening technique for estimation of salivary flow. ACTA ACUST UNITED AC 2009; 108:389-93. [DOI: 10.1016/j.tripleo.2009.04.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 04/06/2009] [Accepted: 04/09/2009] [Indexed: 10/20/2022]
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176
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Sprenger N, Julita M, Donnicola D, Jann A. Sialic acid feeding aged rats rejuvenates stimulated salivation and colon enteric neuron chemotypes. Glycobiology 2009; 19:1492-502. [PMID: 19696237 DOI: 10.1093/glycob/cwp124] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Old age is linked to numerous changes of body functions such as salivation, gastrointestinal motility, and permeability all linked to central and enteric nervous system decline. Thus, gut motility and barrier functions suffer. Sialic acid plays a key role in the nervous system at large and for many receptor functions specifically. Decreased sialylation in the elderly suggests an endogenous sialic acid deficit. We used a rat model of aging, to ask whether sialic acid feeding would affect (i) stimulated salivation, (ii) gut functions, and (iii) sialic acid levels and neuronal markers in brain and gut. We observed reduced levels of pilocarpine-stimulated salivation in old versus young rats and restored this function by sialic acid feeding. Brain ganglioside bound sialic acid levels were found lower in aged versus young rats, and sialic acid feeding partly restored the levels. The hypothalamic expression of cholinergic and panneuronal markers was reduced in aged rats. The expression of the nitrergic marker nNOS was increased upon sialic acid feeding in aged rats. Neither fecal output nor gut permeability was different between young and aged rats studied here, and sialic acid feeding did not alter these parameters. However, the colonic expression of specific nervous system markers nNOS and Uchl1 and the key enzyme for sialic acid synthesis GNE were differentially affected in young and aged rats by sialic acid feeding indicating that regulatory mechanisms change with age. Investigation of sialic acid supplementation as a functional nutrient in the elderly may help those who suffer from disorders of reduced salivation. Further research is needed to understand the differential effects of sialic acid feeding in young and aged rats.
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Affiliation(s)
- Norbert Sprenger
- Nestlé Research Center, Vers-chez-les-Blanc, Lausanne 26, CH-1000 Switzerland.
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177
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Napeñas JJ, Brennan MT, Fox PC. Diagnosis and treatment of xerostomia (dry mouth). Odontology 2009; 97:76-83. [DOI: 10.1007/s10266-008-0099-7] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Accepted: 12/18/2008] [Indexed: 10/20/2022]
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178
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Leao JC, Ribeiro CMB, Carvalho AAT, Frezzini C, Porter S. Oral complications of HIV disease. Clinics (Sao Paulo) 2009; 64:459-70. [PMID: 19488613 PMCID: PMC2694251 DOI: 10.1590/s1807-59322009000500014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 02/18/2009] [Indexed: 12/13/2022] Open
Abstract
Oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). A better understanding of the oral manifestations of AIDS in both adults and children has implications for all health care professionals. The knowledge of such alterations would allow for early recognition of HIV-infected patients. The present paper reviews epidemiology, relevant aspects of HIV infection related to the mouth in both adults and children, as well as current trends in antiretroviral therapy and its connection with orofacial manifestations related to AIDS.
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Affiliation(s)
- Jair C Leao
- Departamento de Clinica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, PE, Brazil.
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179
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Johansson AK, Johansson A, Unell L, Ekbäck G, Ordell S, Carlsson GE. A 15-yr longitudinal study of xerostomia in a Swedish population of 50-yr-old subjects. Eur J Oral Sci 2009; 117:13-9. [DOI: 10.1111/j.1600-0722.2008.00597.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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180
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Thelin WR, Brennan MT, Lockhart PB, Singh ML, Fox PC, Papas AS, Boucher RC. The oral mucosa as a therapeutic target for xerostomia. Oral Dis 2008; 14:683-9. [DOI: 10.1111/j.1601-0825.2008.01486.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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