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Wada E, Ito C, Shinohara M, Handa S, Maetani M, Yasugi M, Miyake M, Sakamoto T, Yazawa A, Kamitani S. Prunin Laurate Derived from Natural Substances Shows Antibacterial Activity against the Periodontal Pathogen Porphyromonas gingivalis. Foods 2024; 13:1917. [PMID: 38928857 PMCID: PMC11202431 DOI: 10.3390/foods13121917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/03/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Periodontal disease is an inflammatory disease caused by infection with periodontopathogenic bacteria. Oral care is essential to prevent and control periodontal disease, which affects oral and systemic health. However, many oral hygiene products currently on the market were developed as disinfectants, and their intense irritation makes their use difficult for young children and older people. This study investigated the antibacterial effects of prunin laurate (Pru-C12) and its analogs on periodontopathogenic bacteria, Porphyromonas gingivalis (P. gingivalis). Pru-C12 and its analogs inhibited in vitro bacterial growth at more than 10 μM and biofilm formation at 50 µM. Among its analogs, only Pru-C12 showed no cytotoxicity at 100 µM. Three of the most potent inhibitors also inhibited the formation of biofilms. Furthermore, Pru-C12 inhibited alveolar bone resorption in a mouse experimental periodontitis model by P. gingivalis infection. These findings may be helpful in the development of oral hygiene products for the prevention and control of periodontal disease and related disorders.
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Affiliation(s)
- Erika Wada
- Nutrition Support Course, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 583-8555, Osaka, Japan (A.Y.)
| | - Chiharu Ito
- Division of Clinical Nutrition, School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 583-8555, Osaka, Japan (M.M.)
| | - Mai Shinohara
- Nutrition Support Course, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 583-8555, Osaka, Japan (A.Y.)
| | - Satoshi Handa
- Graduate School of Agriculture, Osaka Metropolitan University, Sakai 599-8531, Osaka, Japan; (S.H.); (T.S.)
| | - Miki Maetani
- Division of Clinical Nutrition, School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 583-8555, Osaka, Japan (M.M.)
| | - Mayo Yasugi
- Graduate School of Veterinary Science, Osaka Metropolitan University, Izumisano 598-8531, Osaka, Japan; (M.Y.); (M.M.)
| | - Masami Miyake
- Graduate School of Veterinary Science, Osaka Metropolitan University, Izumisano 598-8531, Osaka, Japan; (M.Y.); (M.M.)
| | - Tatsuji Sakamoto
- Graduate School of Agriculture, Osaka Metropolitan University, Sakai 599-8531, Osaka, Japan; (S.H.); (T.S.)
| | - Ayaka Yazawa
- Nutrition Support Course, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 583-8555, Osaka, Japan (A.Y.)
- Division of Clinical Nutrition, School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 583-8555, Osaka, Japan (M.M.)
- Department of Nutrition, Graduate School of Human Life & Ecology, Osaka Metropolitan University, Habikino 583-8555, Osaka, Japan
| | - Shigeki Kamitani
- Nutrition Support Course, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 583-8555, Osaka, Japan (A.Y.)
- Division of Clinical Nutrition, School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 583-8555, Osaka, Japan (M.M.)
- Department of Nutrition, Graduate School of Human Life & Ecology, Osaka Metropolitan University, Habikino 583-8555, Osaka, Japan
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De Almeida Mello J, Reynaert L, Frites H, Vandenbulcke P, Vandamme K, Duyck J. Evaluation of the extent of plaque removal and users' experience of alternative toothbrushes: A randomized single-blind crossover study. Int J Dent Hyg 2024. [PMID: 38798071 DOI: 10.1111/idh.12825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION In residential care, tooth brushing with a manual toothbrush can be challenging because of technical difficulties, time consumption and poor patient cooperation, resulting in a sub-optimal cleaning. The study aimed at comparing the efficiency in plaque removal, brushing time and users' experience between three toothbrushes: a single-headed conventional manual toothbrush, a triple-headed manual toothbrush and a U-shaped electric toothbrush. METHODS This was a single-blind crossover study with three pre-post-test conditions. Participants were 26 dental students divided into fixed pairs to play the role of caregivers and care receivers. Pre/post plaque scores were determined by two independent investigators according to the Quigley-Hein Plaque Index (QHI). Questionnaires evaluated participants' experiences. Statistical tests of significances of differences and ANOVA were performed. RESULTS Results showed that plaque removal was more effective for the manual toothbrush and the triple-headed toothbrush compared to the U-shaped electric toothbrush (p < 0.001). Brushing time was the longest for the single manual toothbrush (149 s). The U-shaped electric toothbrush showed significantly better results for aspects related to comfort and salivation. The manual and triple-headed toothbrush showed better results for aspects related to cleanliness and motivation to use. CONCLUSION Notwithstanding its favourable comfort, tooth plaque removal is not enhanced by a U-shaped electric toothbrush. The triple-headed and single-headed toothbrushes reduced plaque more substantially than the U-shaped toothbrush. In addition, the triple-headed manual toothbrush was not only effective in plaque removal, but also had a shorter brushing time and was easy to use, being an adequate alternative for care-dependent patient groups.
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Affiliation(s)
- Johanna De Almeida Mello
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
- LUCAS-Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Louise Reynaert
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Hicham Frites
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | | | | | - Joke Duyck
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
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Zhang K, Wu B, Tsay RM, Wu LH, Zhang W. The Moderating Role of Self-Rated Oral Health on the Association Between Oral Health Status and Subjective Well-Being: Findings From Chinese Older Adults in Hawai'i and Taiwan. Res Aging 2024; 46:3-14. [PMID: 36825677 DOI: 10.1177/01640275231158771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
This paper aims to address the research questions of whether individual's oral health status is associated with subjective well-being, as well as if there is possible moderating role of self-rated oral health among two groups of Chinese older adults (≥55 years old) in Honolulu, Hawai'i and Taichung, Taiwan. Using survey data collected in 2018 (N = 430, Honolulu) and in 2017 (N = 645, Taichung), ordinary least square regressions were applied. Results showed that, for both samples, oral health status was negatively and significantly associated with subjective well-being, and both associations were moderated by self-rated oral health. In addition, the moderating effects were more salient for the Honolulu sample, who enjoyed higher levels of self-rated oral health and life satisfaction. These results suggest the significant associations of both oral health status and self-rated oral health on individual health and well-being for Chinese older adults residing in different cultural contexts.
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Affiliation(s)
- Keqing Zhang
- School of English and International Studies, Beijing Foreign Studies University, Beijing, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- NYU Aging Incubator, New York University, New York, NY, USA
| | - Ruey-Ming Tsay
- Department of Sociology, Tunghai University, Taichung, Taiwan
| | - Li-Hsueh Wu
- Department of Sociology, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Wei Zhang
- Department of Sociology, University of Hawai'i at Mānoa, Honolulu, HI, USA
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Hunting A, Steffanoni B, Jacques A, Miles A. Accumulated Secretions and Associated Aerodigestive Function in Patients With Dysphagia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2691-2702. [PMID: 37696043 DOI: 10.1044/2023_ajslp-23-00118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
PURPOSE Accumulated pharyngo-laryngeal secretions are associated with dysphagia, aspiration, and poor health outcomes. Despite ongoing developments in the evaluation of pharyngo-laryngeal secretions, understanding of the underlying mechanisms is limited. Pathophysiology associated with accumulated secretions is needed to guide tailored, targeted treatment pathways. This study reports the prevalence of accumulated pharyngo-laryngeal secretions in a large acute care caseload and explores the relationship between secretions and aerodigestive function. METHOD Consecutive inpatients (N = 222) referred for flexible endoscopic evaluation of swallow (FEES) with suspected dysphagia following assessment by a speech-language pathologist were recruited (43% neurological, 22% neurosurgical, 20% critical care, 15% other), and 250 standardized FEES were completed (222 first FEES, 28 repeat FEES). The assessment protocol included secretion assessment using the New Zealand Secretion Scale (NZSS), pharyngeal squeeze maneuver, laryngeal motor and sensory assessment, Penetration-Aspiration Scale, and Yale Pharyngeal Residue Severity Rating Scale. Urge-to-clear ratings were collected during endoscopy. Cough peak expiratory flow and swallow frequency measures were also collected, as well as clinical outcomes at time of discharge. RESULTS There was a high incidence of accumulated secretions, with 77% of inpatients having elevated NZSS (Mdn = 3, range: 0-7) and 37% with pooled laryngeal secretions. Accumulated secretions were associated with reduced swallow frequency, reduced laryngeal adductor reflex, impaired pharyngeal squeeze maneuver, and peak expiratory flow. NZSS scores also correlated with swallow measures (Penetration-Aspiration Scale and Yale Pharyngeal Residue Severity Rating Scale) and patient outcomes including diet recommendations at discharge and pneumonia during admission. CONCLUSIONS This large study contributes to evidence associating both sensory and motor impairments with secretion accumulation and aspiration risk. Further exploration of the key physiological mechanisms contributing to accumulated secretions will serve as markers to provide proof of principle for targets for secretion management protocols. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24101667.
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Affiliation(s)
- Alexandra Hunting
- Speech Pathology Department, Sir Charles Gairdner Hospital, Perth, Australia
| | | | - Angela Jacques
- Institute for Health Research, The University of Notre Dame Australia, Fremantle
- Department of Research, Sir Charles Gairdner Hospital, Perth, Australia
| | - Anna Miles
- Department of Speech Science, The University of Auckland, New Zealand
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Ball L, Meteyard L, Powell RJ. Predictors of aspiration pneumonia: developing a new matrix for speech and language therapists. Eur Arch Otorhinolaryngol 2023; 280:5101-5114. [PMID: 37543958 DOI: 10.1007/s00405-023-08153-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION The contributing factors of aspiration pneumonia have been well documented. However, there are gaps in the literature regarding identifying the weight associated with each factor and the relationship between factors. METHOD In this study, 20 potential predictors of aspiration pneumonia (with four additional variables) have been applied to historic Speech and Language Therapy records to greater understand the significance of each contributor of aspiration pneumonia. 152 cases with an oropharyngeal dysphagia, and a Speech and Language Therapy recommendation of eating and drinking with known aspiration and the associated potential risk of developing an aspiration pneumonia, were included in the data. These were inpatients and outpatients, and had various diagnoses but all had had a videofluoroscopy. RESULTS Logistic regression analysis found seven factors that were individually significant in predicting the development of aspiration pneumonia with 84.93% sensitivity and 91.03% specificity DISCUSSION: Logistic regression and random forest analyses led to the proposal of a new matrix of predictors of aspiration pneumonia with respective scoring weights for individual and cumulative contributors (a direction for future research).
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Affiliation(s)
- Laura Ball
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
| | - Lotte Meteyard
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Roy J Powell
- NIHR Research Design Service-SW, Exeter, UK
- University of Exeter Medical School, Exeter, UK
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Ren Y, Liang J, Li X, Deng Y, Cheng S, Wu Q, Song W, He Y, Zhu J, Zhang X, Zhou H, Yin J. Association between oral microbial dysbiosis and poor functional outcomes in stroke-associated pneumonia patients. BMC Microbiol 2023; 23:305. [PMID: 37875813 PMCID: PMC10594709 DOI: 10.1186/s12866-023-03057-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Despite advances in our understanding of the critical role of the microbiota in stroke patients, the oral microbiome has rarely been reported to be associated with stroke-associated pneumonia (SAP). We sought to profile the oral microbial composition of SAP patients and to determine whether microbiome temporal instability and special taxa are associated with pneumonia progression and functional outcomes. METHODS This is a prospective, observational, single-center cohort study that examined patients with acute ischemic stroke (AIS) who were admitted within 24 h of experiencing a stroke event. The patients were divided into three groups based on the occurrence of pneumonia and the use of mechanical ventilation: nonpneumonia group, SAP group, and ventilator-associated pneumonia (VAP) group. We collected oral swabs at different time points post-admission and analyzed the microbiota using 16 S rRNA high-throughput sequencing. The microbiota was then compared among the three groups. RESULTS In total, 104 nonpneumonia, 50 SAP and 10 VAP patients were included in the analysis. We found that SAP and VAP patients exhibited significant dynamic differences in the diversity and composition of the oral microbiota and that the magnitude of this dysbiosis and instability increased during hospitalization. Then, by controlling the potential effect of all latent confounding variables, we assessed the changes associated with pneumonia after stroke and explored patients with a lower abundance of Streptococcus were more likely to suffer from SAP. The logistic regression analysis revealed that an increase in specific taxa in the phylum Actinobacteriota was linked to a higher risk of poor outcomes. A model for SAP patients based on oral microbiota could accurately predict 30-day clinical outcomes after stroke onset. CONCLUSIONS We concluded that specific oral microbiota signatures could be used to predict illness development and clinical outcomes in SAP patients. We proposed the potential of the oral microbiota as a non-invasive diagnostic biomarker in the clinical management of SAP patients. CLINICAL TRIAL REGISTRATION NCT04688138. Registered 29/12/2020, https://clinicaltrials.gov/ct2/show/NCT04688138 .
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Affiliation(s)
- Yueran Ren
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingru Liang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Li
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yiting Deng
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Sanping Cheng
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiheng Wu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei Song
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan He
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiajia Zhu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaomei Zhang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongwei Zhou
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Jia Yin
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Desai JP, Nair RU. Oral Health Factors Related to Rapid Oral Health Deterioration among Older Adults: A Narrative Review. J Clin Med 2023; 12:jcm12093202. [PMID: 37176641 PMCID: PMC10179735 DOI: 10.3390/jcm12093202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Older adults who face systemic health issues and lack adequate social support are at risk for oral health deterioration. How rapidly such changes take place depends on the severity of their medical condition and their ability to access oral health services in a timely manner. The management of dental caries and periodontal disease in this cohort is made complex by the interaction of local and host factors such as the presence of dry mouth, involvement of root surfaces, and altered wound healing. in addition to enhanced maintenance needs to avoid recurrence or progression. Tooth replacement can be beneficial in restoring oral function, allowing patients to enjoy a healthy and nutritious diet but requires careful consideration to avoid further damage to remaining dental units. Establishing a dental home for the older adult can facilitate routine surveillance, disease prevention, and patient/caregiver education to achieve oral health goals commensurate with overall health. This narrative review details oral health factors that are related to rapid oral health deterioration among older adults.
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Affiliation(s)
- Jhanvi P Desai
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
| | - Rohit U Nair
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
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Zhang J, Wu Y, Liu J, Yang Y, Li H, Wu X, Zheng X, Liang Y, Tu C, Chen M, Tan C, Chang B, Huang Y, Wang Z, Tian G, Ding T. Differential Oral Microbial Input Determines Two Microbiota Pneumo-Types Associated with Health Status. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2203115. [PMID: 36031410 PMCID: PMC9661847 DOI: 10.1002/advs.202203115] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/02/2022] [Indexed: 05/09/2023]
Abstract
The oral and upper respiratory tracts are closely linked anatomically and physiologically with the lower respiratory tract and lungs, and the influence of oral and upper respiratory microbes on the lung microbiota is increasingly being recognized. However, the ecological process and individual heterogeneity of the oral and upper respiratory tract microbes shaping the lung microbiota remain unclear owing to the lack of controlled analyses with sufficient sample sizes. Here, the microbiomes of saliva, nasal cavity, oropharyngeal area, and bronchoalveolar lavage samples are profiled and the shaping process of multisource microbes on the lung microbiota is measured. It is found that oral and nasal microbial inputs jointly shape the lung microbiota by occupying different ecological niches. It is also observed that the spread of oral microbes to the lungs is heterogeneous, with more oral microbes entering the lungs being associated with decreased lung function and increased lung proinflammatory cytokines. These results depict the external shaping process of lung microbiota and indicate the great value of oral samples, such as saliva, in monitoring and assessing lung microbiota status in clinical settings.
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Affiliation(s)
- Jingxiang Zhang
- Department of Immunology and MicrobiologyZhongshan School of MedicineSun Yat‐sen UniversityGuangzhou510080China
- Key Laboratory of Tropical Diseases Control (Sun Yat‐sen University)Ministry of EducationGuangzhou510080China
| | - Yiping Wu
- Department of Immunology and MicrobiologyZhongshan School of MedicineSun Yat‐sen UniversityGuangzhou510080China
- Key Laboratory of Tropical Diseases Control (Sun Yat‐sen University)Ministry of EducationGuangzhou510080China
| | - Jing Liu
- Department of Respiratory MedicineThe Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhai519000China
| | - Yongqiang Yang
- Department of Immunology and MicrobiologyZhongshan School of MedicineSun Yat‐sen UniversityGuangzhou510080China
- Key Laboratory of Tropical Diseases Control (Sun Yat‐sen University)Ministry of EducationGuangzhou510080China
| | - Hui Li
- Department of Immunology and MicrobiologyZhongshan School of MedicineSun Yat‐sen UniversityGuangzhou510080China
- Key Laboratory of Tropical Diseases Control (Sun Yat‐sen University)Ministry of EducationGuangzhou510080China
| | - Xiaorong Wu
- Department of Immunology and MicrobiologyZhongshan School of MedicineSun Yat‐sen UniversityGuangzhou510080China
- Key Laboratory of Tropical Diseases Control (Sun Yat‐sen University)Ministry of EducationGuangzhou510080China
| | - Xiaobin Zheng
- Department of Respiratory MedicineThe Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhai519000China
| | - Yingjian Liang
- Department of Respiratory MedicineThe Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhai519000China
| | - Changli Tu
- Department of Respiratory MedicineThe Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhai519000China
| | - Meizhu Chen
- Department of Respiratory MedicineThe Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhai519000China
| | - Cuiyan Tan
- Department of Respiratory MedicineThe Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhai519000China
| | - Bozhen Chang
- Department of Immunology and MicrobiologyZhongshan School of MedicineSun Yat‐sen UniversityGuangzhou510080China
- Key Laboratory of Tropical Diseases Control (Sun Yat‐sen University)Ministry of EducationGuangzhou510080China
| | - Yiying Huang
- Department of Respiratory MedicineThe Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhai519000China
| | - Zhengguo Wang
- Department of Respiratory MedicineThe Fifth Affiliated Hospital of Sun Yat‐sen UniversityZhuhai519000China
| | - Guo‐Bao Tian
- Department of Immunology and MicrobiologyZhongshan School of MedicineSun Yat‐sen UniversityGuangzhou510080China
- Key Laboratory of Tropical Diseases Control (Sun Yat‐sen University)Ministry of EducationGuangzhou510080China
- School of MedicineXizang Minzu UniversityXianyangShaanxi712082China
| | - Tao Ding
- Department of Immunology and MicrobiologyZhongshan School of MedicineSun Yat‐sen UniversityGuangzhou510080China
- Key Laboratory of Tropical Diseases Control (Sun Yat‐sen University)Ministry of EducationGuangzhou510080China
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Starikova EV, Galeeva JS, Andreev DN, Sokolov PS, Fedorov DE, Manolov AI, Pavlenko AV, Klimina KM, Veselovsky VA, Zaborovsky AV, Evdokimov VV, Andreev NG, Devkota MK, Fomenko AK, Khar'kovskii VA, Asadulin PO, Kucher SA, Cheremushkina AS, Yanushevich OO, Maev IV, Krikheli NI, Levchenko OV, Ilina EN, Govorun VM. [Composition of oropharyngeal microbiota in patients with COVID-19 of different pneumonia severity]. TERAPEVT ARKH 2022; 94:963-972. [PMID: 36286976 DOI: 10.26442/00403660.2022.08.201780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
AIM To identify features of the taxonomic composition of the oropharyngeal microbiota of COVID-19 patients with different disease severity. MATERIALS AND METHODS The study group included 156 patients hospitalized with confirmed diagnosis of COVID-19 in the clinical medical center of Yevdokimov Moscow State University of Medicine and Dentistry between April and June 2021. There were 77 patients with mild pneumonia according to CT (CT1) and 79 patients with moderate to severe pneumonia (CT2 and CT3). Oropharyngeal swabs were taken when the patient was admitted to the hospital. Total DNA was isolated from the samples, then V3V4 regions of the 16s rRNA gene were amplified, followed by sequencing using Illumina HiSeq 2500 platform. DADA2 algorithm was used to obtain amplicon sequence variants (ASV). RESULTS When comparing the microbial composition of the oropharynx of the patients with different forms of pneumonia, we have identified ASVs associated with the development of both mild and severe pneumonia outside hospital treatment. Based on the results obtained, ASVs associated with a lower degree of lung damage belong predominantly to the class of Gram-negative Firmicutes (Negativicutes), to various classes of Proteobacteria, as well as to the order Fusobacteria. In turn, ASVs associated with a greater degree of lung damage belong predominantly to Gram-positive classes of Firmicutes Bacilli and Clostridia. While being hospitalized, patients with severe pneumonia demonstrated negative disease dynamics during treatment significantly more often. CONCLUSION We have observed differences in the taxonomic composition of the oropharyngeal microbiota in patients with different forms of pneumonia developed outside hospital treatment against COVID-19. Such differences might be due to the presumed barrier function of the oropharyngeal microbiota, which reduces the risk of virus titer increase.
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Affiliation(s)
| | - J S Galeeva
- Research Institute of Systemic Biology and Medicine
| | - D N Andreev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - P S Sokolov
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - D E Fedorov
- Research Institute of Systemic Biology and Medicine
| | - A I Manolov
- Research Institute of Systemic Biology and Medicine
| | - A V Pavlenko
- Research Institute of Systemic Biology and Medicine
| | - K M Klimina
- Federal Scientific and Clinical Center for Physical and Chemical Medicine
| | - V A Veselovsky
- Federal Scientific and Clinical Center for Physical and Chemical Medicine
| | - A V Zaborovsky
- Yevdokimov Moscow State University of Medicine and Dentistry, Moscow
| | - V V Evdokimov
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - N G Andreev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - M K Devkota
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - A K Fomenko
- Yevdokimov Moscow State University of Medicine and Dentistry
| | | | - P O Asadulin
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - S A Kucher
- Yevdokimov Moscow State University of Medicine and Dentistry
| | | | - O O Yanushevich
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - I V Maev
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - N I Krikheli
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - O V Levchenko
- Yevdokimov Moscow State University of Medicine and Dentistry
| | - E N Ilina
- Research Institute of Systemic Biology and Medicine
| | - V M Govorun
- Research Institute of Systemic Biology and Medicine
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10
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Müller F, Srinivasan M, Krause K, Schimmel M. Periodontitis and peri-implantitis in elderly people experiencing institutional and hospital confinement. Periodontol 2000 2022; 90:138-145. [PMID: 35916869 PMCID: PMC9804296 DOI: 10.1111/prd.12454] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
An increasing number of elderly people retain their natural teeth into old age and further, the prevalence of endosseous implants for supporting oral prosthesis is ever increasing. These teeth and implants now present a considerable challenge in terms of maintenance, especially when patients become dependent on care. Periodontal and peri-implant diseases are more prevalent in elderly than in younger age cohorts. There are distinct differences related to the inflammatory response between periodontal and peri-implant tissues, both in young and old age. The age-related reasons for the increase in periodontal infections may be related to poor oral hygiene because of a loss of dexterity or vision, but also to immunosenescence. This term describes the aging of the immune system and the decline of its effectiveness with age. Low-grade infections, like chronic periodontitis, may cause low-grade inflammation and subsequently increase the likelihood of developing chronic diseases. In return, treatment of periodontitis may improve general health, as demonstrated for diabetes. A second mechanism illustrating how poor oral health translates into systemic disease is the risk of developing aspiration pneumonia. The treatment options in old age should be evaluated with regard to the issues of general health and maintenance. Systematic periodontal maintenance therapy, as performed in younger age cohorts, may be difficult to implement in elderly people experiencing institutional or hospital confinement because of logistics, barriers related to patients and caregivers, or cost. The scale of periodontal disease in old age represents a public health issue.
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Affiliation(s)
- Frauke Müller
- Division of Gerodontology and Removable ProsthodonticsUniversity of GenevaGenevaSwitzerland,Department of Rehabilitation and GeriatricsUniversity Hospitals of GenevaThônexSwitzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable ProsthodonticsUniversity of GenevaGenevaSwitzerland,Clinic for General, Special Care and Geriatric DentistryCenter of Dental Medicine, University of ZürichZürichSwitzerland
| | - Karl‐Heinz Krause
- Department of Pathology and ImmunologyUniversity of GenevaGenevaSwitzerland,Department of Genetic and Laboratory MedicineGeneva University HospitalsGenevaSwitzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable ProsthodonticsUniversity of GenevaGenevaSwitzerland,Department of Reconstructive Dentistry and GerodontologySchool of Dental Medicine, University of BernBernSwitzerland
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11
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Remijn L, Sanchez F, Heijnen BJ, Windsor C, Speyer R. Effects of Oral Health Interventions in People with Oropharyngeal Dysphagia: A Systematic Review. J Clin Med 2022; 11:jcm11123521. [PMID: 35743591 PMCID: PMC9225542 DOI: 10.3390/jcm11123521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
People with oropharyngeal dysphagia (OD) are at risk of developing aspiration pneumonia. However, there is no “best practice” for oral health interventions to improve swallowing-related outcomes, the incidence of aspiration pneumonia, and oral health in people with OD. Systematic literature searches were conducted for oral health interventions in OD in PubMed, Embase, CINAHL, and PsycINFO until July 2021. Original articles published in English and reporting pre- and post-intervention measurements were included. The methodology and reporting were guided by the PRISMA checklist. The methodological quality of the eight included studies was rated using the QualSyst critical appraisal tool. The oral health interventions in people with OD were diverse. This study shows little evidence that regular oral care and the free water protocol or oral disinfection reduced the incidence of aspiration pneumonia in people with OD. Oral cleaning, twice a day with an antibacterial toothpaste in combination with intraoral cleaning or the free water protocol, proved to be the most promising intervention to improve oral health. The effect of improved oral health status on swallowing-related outcomes could not be established. Increasing awareness of the importance of oral health and implementing practical oral care guidelines for people involved in the daily care of people with OD are recommended.
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Affiliation(s)
- Lianne Remijn
- Academy of Health, HAN University of Applied Sciences, 6525 EN Nijmegen, The Netherlands
- Correspondence: ; Tel.: +31-24-353-1500
| | - Fabiola Sanchez
- Pedagogical Professional Team District Frogner, 0201 Oslo, Norway;
- Department Special Needs Education, Faculty of Educational Sciences, University of Oslo, 0318 Oslo, Norway; (C.W.); (R.S.)
| | - Bas J. Heijnen
- Department Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, 2300 RC Leiden, The Netherlands;
| | - Catriona Windsor
- Department Special Needs Education, Faculty of Educational Sciences, University of Oslo, 0318 Oslo, Norway; (C.W.); (R.S.)
| | - Renée Speyer
- Department Special Needs Education, Faculty of Educational Sciences, University of Oslo, 0318 Oslo, Norway; (C.W.); (R.S.)
- Department Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, 2300 RC Leiden, The Netherlands;
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
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12
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Lin TH, Yang CW, Chang WK. Evaluation of Oropharyngeal Dysphagia in Older Patients for Risk Stratification of Pneumonia. Front Immunol 2022; 12:800029. [PMID: 35185865 PMCID: PMC8847226 DOI: 10.3389/fimmu.2021.800029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Nasogastric tube (NGT) and percutaneous endoscopic gastrostomy (PEG) are widely used techniques to feed older patients with oropharyngeal dysphagia. Aspiration pneumonia is the most common cause of death in these patients. This study aimed to evaluate the role of oropharyngeal dysphagia in older patients on long-term enteral feeding for risk stratification of pneumonia requiring hospitalization. Methods We performed modified flexible endoscopic evaluation of swallowing to evaluate oropharyngeal dysphagia in older patients and conducted prospective follow-up for pneumonia requiring hospitalization. A total of 664 oral-feeding patients and 155 tube-feeding patients were enrolled. Multivariate Cox analysis was performed to identify risk factors of pneumonia requiring hospitalization. Results Multivariate analyses showed that the risk of pneumonia requiring hospitalization significantly increased in older patients and in patients with neurological disorders, tube feeding, and oropharyngeal dysphagia. Subgroup analysis revealed that the risk of pneumonia requiring hospitalization was significantly lower in patients with PEG than in those with NGT among the patients with oropharyngeal dysphagia (adjusted hazard ratio 0.26, 95% confidence interval: 0.11–0.63, P = 0.003). Conclusions For older patients with oropharyngeal dysphagia requiring long-term enteral tube feeding, PEG is a better choice than NGT. Further research is needed to elucidate the role of oropharyngeal dysphagia in enteral feeding in older patients.
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Affiliation(s)
- Tai-Han Lin
- Department of Pathology and Graduate Institute of Pathology and Parasitology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Wei Yang
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Kuo Chang
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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13
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Tang X, Shen Y, Pan X, Liao J, Xu Y, Luo W, Zhang X, Li C, Wan Q, Cai X, Zhang X, Wang T, Zhang G. Oral care for intensive care unit patients without mechanical ventilation: protocol for a systematic review and meta-analysis. Syst Rev 2022; 11:5. [PMID: 34986878 PMCID: PMC8734315 DOI: 10.1186/s13643-021-01878-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/26/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Infection is a common problem and a major cause of morbidity and mortality for patients in intensive care units (ICUs). According to published meta-analyses, oral care has been found to reduce the risk of nosocomial pneumonia, and has been recommended to improve the oral environment for patients in ICUs. However, relatively little information is available about the effects of oral care in patients without ventilatory support in ICUs. Therefore, this review proposes to evaluate the effectiveness of oral care in preventing pneumonia in non-ventilated ICU patients. METHODS Eight databases will be searched for relevant literature, including four Chinese and four English online databases, from their inception to the protocol publication date. Records obtained will be managed and screened via Endnote X7. All literature will be selected following pre-established inclusion criteria by two independent review authors to obtain quality trials. The quality of the included records will be evaluated according to the "risk of bias table", recommended by the Cochrane Handbook for Systematic Reviews of Interventions. All the data will be extracted by one author and checked by another. If there is any disagreement, a final agreement will be reached with a third reviewer via consultation. If there are missing data, the original authors will be emailed to ask for it. If enough data were collected, the data synthesis will be performed using Review Manager (RevMan5.3). Both a random effect model and a fixed effect model will be undertaken. A Bayesian meta-analysis will also be performed to estimate the magnitude of the heterogeneity variance and comparing it with the distribution using the WinBUGS software. Otherwise, the results will be reported narratively. The sources of heterogeneity will be determined using meta-regression and subgroup analysis if there is significant heterogeneity. A funnel plot will be used to assess publication bias if there are enough records included. The Cochrane Handbook for Systematic Reviews of Interventions will be followed throughout the system evaluation process. CONCLUSION This review will provide evidence of oral care for intensive care unit patients without mechanical ventilation to prevent nosocomial pneumonia. TRIAL REGISTRATION PROSPERO Research registration identifying number: CRD42020146932.
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Affiliation(s)
- Xiaoxia Tang
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Yunxia Shen
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Xuejiao Pan
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Jianglong Liao
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Yanfei Xu
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Wen Luo
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Xiaolin Zhang
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Chun'e Li
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Qing Wan
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Xin Cai
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Xiaomei Zhang
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China
| | - Tao Wang
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China.
| | - Guilan Zhang
- Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China.
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14
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Shinohara M, Maetani M, Kitada C, Nishigami Y, Yazawa A, Kamitani S. Analysis of the Effects of Food Additives on Porphyromonas gingivalis. Pathogens 2022; 11:pathogens11010065. [PMID: 35056013 PMCID: PMC8779409 DOI: 10.3390/pathogens11010065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/31/2021] [Accepted: 12/31/2021] [Indexed: 12/04/2022] Open
Abstract
This study aims to investigate six food additives (octanoic acid, decanoic acid, acesulfame K, aspartame, saccharin, and sucralose) used in foods for the elderly or people with dysphagia because of the effect of these food additives on Porphyromonas gingivalis (P. gingivalis), which is a keystone pathogen of periodontal diseases. The growth of P. gingivalis was inhibited by 5 mM octanoic acid, 1.25 mM decanoic acid, 1.25% acesulfame K, 0.0625% aspartame, 0.03125% saccharin, and 0.625% sucralose. In addition, these food additives showed bactericidal activity for planktonic P. gingivalis (5 mM octanoic acid, 5 mM decanoic acid, 0.25% aspartame, 0.25% saccharin, and 5% sucralose). Moreover, biofilm formation was inhibited by 10 mM octanoic acid, 10 mM decanoic acid, 10% acesulfame K, 0.35% aspartame, 0.5% saccharin, and 7.5% sucralose. Moreover, the same concentration of these food additives without aspartame killed P. gingivalis in the biofilm. Aspartame and sucralose did not show cytotoxicity to human cell lines at concentrations that affected P. gingivalis. These findings may be useful in clarifying the effects of food additives on periodontopathogenic bacteria.
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15
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Okabe T, Kamiya Y, Kikuchi T, Goto H, Umemura M, Suzuki Y, Sugita Y, Naiki Y, Hasegawa Y, Hayashi JI, Kawamura S, Sawada N, Takayanagi Y, Fujimura T, Higuchi N, Mitani A. Porphyromonas gingivalis Components/Secretions Synergistically Enhance Pneumonia Caused by Streptococcus pneumoniae in Mice. Int J Mol Sci 2021; 22:12704. [PMID: 34884507 PMCID: PMC8657795 DOI: 10.3390/ijms222312704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Streptococcus pneumoniae is an important causative organism of respiratory tract infections. Although periodontal bacteria have been shown to influence respiratory infections such as aspiration pneumonia, the synergistic effect of S. pneumoniae and Porphyromonas gingivalis, a periodontopathic bacterium, on pneumococcal infections is unclear. To investigate whether P. gingivalis accelerates pneumococcal infections, we tested the effects of inoculating P. gingivalis culture supernatant (PgSup) into S. pneumoniae-infected mice. Mice were intratracheally injected with S. pneumoniae and PgSup to induce pneumonia, and lung histopathological sections and the absolute number and frequency of neutrophils and macrophages in the lung were analyzed. Proinflammatory cytokine/chemokine expression was examined by qPCR and ELISA. Inflammatory cell infiltration was observed in S. pneumoniae-infected mice and S. pnemoniae and PgSup mixed-infected mice, and mixed-infected mice showed more pronounced inflammation in lung. The ratios of monocytes/macrophages and neutrophils were not significantly different between the lungs of S. pneumoniae-infected mice and those of mixed-infected mice. PgSup synergistically increased TNF-α expression/production and IL-17 production compared with S. pneumoniae infection alone. We demonstrated that PgSup enhanced inflammation in pneumonia caused by S. pneumoniae, suggesting that virulence factors produced by P. gingivalis are involved in the exacerbation of respiratory tract infections such as aspiration pneumonia.
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Affiliation(s)
- Teppei Okabe
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Yosuke Kamiya
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Takeshi Kikuchi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Hisashi Goto
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Masayuki Umemura
- Molecular Microbiology Group, Department of Tropical Infectious Diseases, Tropical Biosphere Research Center, University of the Ryukyus, 1 Senbaru, Nishihara-cho, Nakagami-gun, Nishihara 903-0213, Japan;
| | - Yuki Suzuki
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Yoshihiko Sugita
- Department of Oral Pathology and Forensic Odontology, School of Dentistry, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan;
| | - Yoshikazu Naiki
- Department of Microbiology, School of Dentistry, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan; (Y.N.); (Y.H.)
| | - Yoshiaki Hasegawa
- Department of Microbiology, School of Dentistry, Aichi Gakuin University, 1-100 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan; (Y.N.); (Y.H.)
| | - Jun-ichiro Hayashi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Shotaro Kawamura
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Noritaka Sawada
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Yuhei Takayanagi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Takeki Fujimura
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
| | - Naoya Higuchi
- Department of Endodontics, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan;
| | - Akio Mitani
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan; (T.O.); (T.K.); (H.G.); (Y.S.); (J.H.); (S.K.); (N.S.); (Y.T.); (T.F.); (A.M.)
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16
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Martínez JE, Vargas A, Pérez-Sánchez T, Encío IJ, Cabello-Olmo M, Barajas M. Human Microbiota Network: Unveiling Potential Crosstalk between the Different Microbiota Ecosystems and Their Role in Health and Disease. Nutrients 2021; 13:2905. [PMID: 34578783 PMCID: PMC8466470 DOI: 10.3390/nu13092905] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 12/13/2022] Open
Abstract
The human body is host to a large number of microorganisms which conform the human microbiota, that is known to play an important role in health and disease. Although most of the microorganisms that coexist with us are located in the gut, microbial cells present in other locations (like skin, respiratory tract, genitourinary tract, and the vaginal zone in women) also play a significant role regulating host health. The fact that there are different kinds of microbiota in different body areas does not mean they are independent. It is plausible that connection exist, and different studies have shown that the microbiota present in different zones of the human body has the capability of communicating through secondary metabolites. In this sense, dysbiosis in one body compartment may negatively affect distal areas and contribute to the development of diseases. Accordingly, it could be hypothesized that the whole set of microbial cells that inhabit the human body form a system, and the dialogue between the different host microbiotas may be a contributing factor for the susceptibility to developing diseased states. For this reason, the present review aims to integrate the available literature on the relationship between the different human microbiotas and understand how changes in the microbiota in one body region can influence other microbiota communities in a bidirectional process. The findings suggest that the different microbiotas may act in a coordinated way to decisively influence human well-being. This new integrative paradigm opens new insights in the microbiota field of research and its relationship with human health that should be taken into account in future studies.
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Affiliation(s)
| | | | | | | | - Miriam Cabello-Olmo
- Biochemistry Area, Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain; (J.E.M.); (A.V.); (T.P.-S.); (I.J.E.)
| | - Miguel Barajas
- Biochemistry Area, Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain; (J.E.M.); (A.V.); (T.P.-S.); (I.J.E.)
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Lee MH, Park YH. The effectiveness of the information-motivation-behavioral skills model-based intervention on preventive behaviors against respiratory infection among community-dwelling older adults. PATIENT EDUCATION AND COUNSELING 2021; 104:2028-2036. [PMID: 33531157 DOI: 10.1016/j.pec.2021.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/14/2021] [Accepted: 01/16/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of an information-motivation-behavioral skills (IMB) model-based multi-component intervention on engagement and the quality of preventive behaviors against respiratory infections among community-dwelling older adults. METHODS This study was a controlled pretest-posttest study in which 91 community-dwelling older adults aged above 65 years were included. The intervention group (n = 42) received the six-week intervention theoretically based on the IMB model that comprised weekly group education and 5-10 min of tele-counseling per week. RESULTS The results showed that, after the intervention, the improvement in the level of knowledge, self-efficacy, self-reported engagement, and the quality of respiratory infection preventive behaviors was significantly greater in the intervention group compared to the control group. There was no significant difference between the two groups for the perceived threat of respiratory infection. CONCLUSION The IMB model-based intervention improved the engagement and quality of preventive behaviors by increasing the level of knowledge and self-efficacy in community-dwelling older adults. PRACTICE IMPLICATIONS The IMB model-based multi-component intervention can be an effective approach to improve preventive behaviors and will contribute to the preparation of communities for outbreaks of respiratory infections.
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Affiliation(s)
- Min Hye Lee
- Department of Nursing, Dong-A University, 32 Daesin gongwon-ro, Seo-gu, Busan, 49201, South Korea.
| | - Yeon-Hwan Park
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
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18
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Weimers MJ, Pillay M. Pathogenic oral bacteria in hospitalised patients with dysphagia: The silent epidemic. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2021; 68:e1-e7. [PMID: 34342488 PMCID: PMC8335773 DOI: 10.4102/sajcd.v68i1.798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/18/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022] Open
Abstract
Background Aspiration pneumonia is a serious and fatal complication of dysphagia, secondary to the ingestion of bacteria-laden secretions. However, no studies have documented the oral hygiene features present in patients who present with dysphagia. Objectives The purpose of this study was to describe the oral hygiene problems of adults admitted to a sub-acute rehabilitation hospital and who presented with dysphagia. Methods A descriptive, cross-sectional survey was conducted, during which 40 participants – 57.5% (n = 23) male and 42.5% (n = 17) female – underwent a clinical swallow evaluation using the Mann Assessment of Swallowing Ability (MASA) augmented with cervical auscultation (CA) and pulse oximetry (PO), an oral hygiene assessment using an adapted version of the Oral Health Assessment Tool (OHAT), followed by microbiology laboratory analysis of buccal swab samples to detect bacteria not considered part of the normal oral flora. Results Results indicated that poor oral hygiene status was a common feature amongst all participants who presented with dysphagia. The most prevalent oral hygiene issues were related to abnormalities concerning saliva (60%), oral cleanliness (82.5%), the tongue (80%) and the use of dentures (71.4%). A high prevalence, 62.5% (n = 25), of opportunistic bacteria was found. The most commonly occurring bacteria groups were: (1) Candida albicans (47.5%) and (2) respiratory pathogens (37.5%) such as Klebsiella pneumoniae and Staphylococcus aureus. Conclusion Persons with dysphagia have poor oral hygiene which creates favourable environments for bacteria to flourish and increases the prevalence of pathogenic oral bacteria associated with the development of aspiration pneumonia. The management of oral health issues for persons with dysphagia should receive greater attention during hospitalisation.
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Affiliation(s)
- Merryl J Weimers
- Department of Speech Pathology and Audiology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban.
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19
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Oral hygiene and health-related quality of life in institutionalized older people. Eur Geriatr Med 2021; 13:213-220. [PMID: 34313976 PMCID: PMC8860786 DOI: 10.1007/s41999-021-00547-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/16/2021] [Indexed: 11/18/2022]
Abstract
Aim We evaluated oral hygiene level and its association with oral health and general health-related quality of life (HRQoL) among older residents in long-term care facilities. Findings Only one-fifth of residents had good oral hygiene. Poor oral hygiene was associated with poor oral health and diminished HRQoL. Message Oral hygiene, oral health, and HRQoL may be improved with oral care education of caregivers, professional cooperation, and regular oral healthcare of older residents in long-term care facilities. Purpose We evaluated the level of oral hygiene and its association with oral health status and need for oral treatment among older residents in long-term care facilities. In addition, the association between oral hygiene level and health-related quality of life (HRQoL) was explored. Methods This cross-sectional study assessed 231 dentate residents in long-term care facilities (71% female, mean age 81 years, 70% had dementia). Nurses assessed residents and completed questionnaires on participants’ background information, diagnoses, oral healthcare habits, and HRQoL with the 15D instrument. Two qualified dentists performed clinical oral examinations (number of teeth, plaque index, periodontal condition, open caries lesions, and dry mouth). We used a modified plaque index (PI) to measure the level of oral hygiene (good, moderate, and poor) and calculated the clinical Asymptotic Dental Score (ADS) to determine the oral inflammation burden. Results Of the residents, 21% had good, 35% moderate, and 44% poor oral hygiene according to PI. Poor oral hygiene was associated with poorer cognitive status (P = 0.010) and higher oral inflammation burden (P < 0.001). Moreover, poor oral hygiene was associated with poorer HRQoL in a correlation analysis adjusted for age and gender. Conclusions Oral hygiene of older individuals in long-term care is insufficient. Poor oral hygiene is a marker for poor HRQoL. Residents also have a high burden of oral inflammatory diseases and a need for dental care. Older residents’ oral hygiene and HRQoL may be improved with oral care education of caregivers and regular dental check-ups.
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20
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Ajwani S, Ferguson C, Kong AC, Villarosa AR, George A. Patient perceptions of oral health care following stroke: a qualitative study. BMC Oral Health 2021; 21:127. [PMID: 33731086 PMCID: PMC7968245 DOI: 10.1186/s12903-021-01501-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stroke is a serious cerebrovascular disease and is one of the world's leading causes of disability. Maintaining good oral health is a challenge among those hospitalised after stroke. A multidisciplinary approach to oral care involving non-dental professionals can be beneficial in improving oral health outcomes for patients. The aim of this study was to understand the perceptions of stroke survivors regarding oral healthcare across acute and rehabilitation settings. METHODS A descriptive qualitative approach was used. Face-to-face semi-structured interviews were conducted. A framework analysis was employed to analyse the data. Patients who had recently experienced a stroke were purposively recruited across both acute and rehabilitation settings, at two metropolitan hospitals in Sydney, Australia. In total, 11 patients were interviewed. RESULTS Although participants recognised the importance of oral health, few understood the link between oral and general health. Regular oral hygiene practices varied since having stroke, with a few receiving oral care assistance from nurses. Time, cost and lack of information were some barriers to accessing dental services, while supportive measures such as coordination of oral care, financial subsidy and nurse assistance were strategies proposed to support oral care practices amongst stroke survivors. CONCLUSIONS There is scope to improve current models of oral care in stroke. While stroke survivors understand the importance of oral care, an integrated oral health model with a multidisciplinary approach could improve health outcomes.
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Affiliation(s)
- Shilpi Ajwani
- Oral Health Promotion and Oral Health Research, Sydney Local Health District Oral Health Services/Sydney Dental Hospital/University of Sydney, Sydney, 2010, Australia
| | - Caleb Ferguson
- Heart Foundation Postdoctoral Fellow, Western Sydney Nursing and Midwifery Research Centre, Western Sydney University/Western Sydney Local Health District/Centre for Oral Health Outcomes and Research Translation (COHORT)/Ingham Institute for Applied Medical Research/Translational Health Research Institute (THRI) Blacktown Clinical and Research School Blacktown Hospital, Marcel Crescent, Blacktown, NSW, 2148, Australia
| | - Ariana C Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), South Western Sydney Local Health District/Ingham Institute for Applied Medical Research, Western Sydney University, Liverpool, NSW, 2170, Australia
| | - Amy R Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), South Western Sydney Local Health District/Ingham Institute for Applied Medical Research, Western Sydney University, Liverpool, NSW, 2170, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), South Western Sydney Local Health District/Ingham Institute for Applied Medical Research/Translational Health Research Institute/University of Sydney, Western Sydney University, Liverpool, NSW, 2170, Australia.
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21
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Banerji R, Kanojiya P, Patil A, Saroj SD. Polyamines in the virulence of bacterial pathogens of respiratory tract. Mol Oral Microbiol 2020; 36:1-11. [PMID: 32979241 DOI: 10.1111/omi.12315] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/24/2020] [Accepted: 09/16/2020] [Indexed: 12/11/2022]
Abstract
Polyamines are positively charged hydrocarbons that are essential for the growth and cellular maintenance in prokaryotes and eukaryotes. Polyamines have been demonstrated to play a role in bacterial pathogenicity and biofilm formation. However, the role of extracellular polyamines as a signaling molecule in the regulation of virulence is not investigated in detail. The bacterial pathogens residing in the respiratory tract remain asymptomatic for an extended period; however, the factors that lead to symptomatic behavior are poorly understood. Further investigation to understand the relation between the host-secreted factors and virulence of pathogenic bacteria in the respiratory tract may provide insights into the pathogenesis of respiratory tract infections. Polyamines produced within the bacterial cell are generally sequestered. Therefore, the pool of extracellular polyamines formed by secretion of the commensals and the host may be one of the signaling molecules that might contribute toward the alterations in the expression of virulence factors in bacterial pathogens. Besides, convergent mechanisms of polyamine biosynthesis do exist across the border of species and genus level. Also, several novel polyamine transporters in the host and bacteria remain yet to be identified. The review focuses on the role of polyamines in the expression of virulence phenotypes and biofilm formation of the respiratory tract pathogens.
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Affiliation(s)
- Rajashri Banerji
- Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, India
| | - Poonam Kanojiya
- Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, India
| | - Amrita Patil
- Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, India
| | - Sunil D Saroj
- Symbiosis School of Biological Sciences, Symbiosis International (Deemed University), Pune, India
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22
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Bao L, Zhang C, Dong J, Zhao L, Li Y, Sun J. Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection. Front Microbiol 2020; 11:1840. [PMID: 32849438 PMCID: PMC7411080 DOI: 10.3389/fmicb.2020.01840] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
The new coronavirus SARS-CoV-2, the cause of COVID-19, has become a public health emergency of global concern. Like the SARS and influenza pandemics, there have been a large number of cases coinfected with other viruses, fungi, and bacteria, some of which originate from the oral cavity. Capnocytophaga, Veillonella, and other oral opportunistic pathogens were found in the BALF of the COVID-19 patients by mNGS. Risk factors such as poor oral hygiene, cough, increased inhalation under normal or abnormal conditions, and mechanical ventilation provide a pathway for oral microorganisms to enter the lower respiratory tract and thus cause respiratory disease. Lung hypoxia, typical symptoms of COVID-19, would favor the growth of anaerobes and facultative anaerobes originating from the oral microbiota. SARS-CoV-2 may aggravate lung disease by interacting with the lung or oral microbiota via mechanisms involving changes in cytokines, T cell responses, and the effects of host conditions such as aging and the oral microbiome changes due to systemic diseases. Because the oral microbiome is closely associated with SARS-CoV-2 co-infections in the lungs, effective oral health care measures are necessary to reduce these infections, especially in severe COVID-19 patients. We hope this review will draw attention from both the scientific and clinical communities on the role of the oral microbiome in the current global pandemic.
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Affiliation(s)
- Lirong Bao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Cheng Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiajia Dong
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Periodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jianxun Sun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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23
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Mammen MJ, Scannapieco FA, Sethi S. Oral-lung microbiome interactions in lung diseases. Periodontol 2000 2020; 83:234-241. [PMID: 32385873 DOI: 10.1111/prd.12301] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The proximity and continuity of the oral cavity and the lower respiratory tract allows the oropharyngeal microbiome to be a major determinant of the lung microbiome. In addition, host-pathogen interactions related to the oropharyngeal microbiome or its metabolites could propagate systemic inflammation or modulate host defense mechanisms that could affect other organs, including the lung. There is increasing appreciation of the pathophysiologic significance of the lung microbiome, not only in the classical infection-related diseases, pneumonia, bronchiectasis, and cystic fibrosis, but also in chronic noninfectious lung diseases, such as chronic obstructive pulmonary disease, asthma, and pulmonary fibrosis. In this review, we will explore the relationship of the oral microbiome with lung diseases, such as pneumonia, chronic obstructive pulmonary disease, asthma, and cystic fibrosis.
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Affiliation(s)
- Manoj J Mammen
- Division of Pulmonary, Critical Care, and Sleep Medicine, Jacobs School of Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Frank A Scannapieco
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Sanjay Sethi
- Division of Pulmonary, Critical Care, and Sleep Medicine, Jacobs School of Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA.,Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA
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24
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Outer membrane vesicles derived from Porphyromonas gingivalis induced cell death with disruption of tight junctions in human lung epithelial cells. Arch Oral Biol 2020; 118:104841. [PMID: 32717445 DOI: 10.1016/j.archoralbio.2020.104841] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Porphyromonas gingivalis (P. gingivalis) is a major bacterium responsible for the progression of periodontitis. P. gingivalis produces small vesicles called outer membrane vesicles (OMVs) containing virulence factors. Increasing evidence suggests a close relationship between periodontitis and respiratory system diseases, such as aspiration pneumonia. However, little is known about whether P. gingivalis OMVs give rise to the impediment of lung epithelial cells. We investigated the effect of the OMVs on cell viability and tight junctions of lung epithelial cells. DESIGN Human lung epithelial A549 cells were treated with P. gingivalis OMVs. Cell viability was evaluated, and cell morphology was examined using scanning electron and phase contrast microscopies. To detect apoptosis induced by P. gingivalis OMVs, activation of caspase-3 and poly ADP-ribose polymerase (PARP) cleavage was examined by using Western blotting. Immunocytochemistry was performed to stain tight junction proteins. RESULTS P. gingivalis OMVs decreased cell viability in A549 cells in a dose- and time-dependent manner. Microscopic analysis revealed that the OMVs induced morphological changes leading to irregular cell membrane structures. The OMVs caused cell shrinkage, membrane blebbing, and cytoplasmic expulsion in a dose-dependent manner. Western blot analysis showed the OMVs induced caspase-3 activation and PARP cleavage. Treatment with the OMVs disrupted the intact distributions of tight junction proteins. CONCLUSIONS These results indicate that P. gingivalis OMVs induced cell death by destroying the barrier system in lung epithelial cells. Our present study raises the possibility that P. gingivalis OMVs is an important factor in the engagement of periodontitis with respiratory system diseases.
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25
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Garand KLF, McCullough G, Crary M, Arvedson JC, Dodrill P. Assessment Across the Life Span: The Clinical Swallow Evaluation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:919-933. [PMID: 32650662 DOI: 10.1044/2020_ajslp-19-00063] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This clinical focus article considers the roles of the clinical swallow examination (CSE) as a clinically meaningful assessment method used in both adult and pediatric populations. Method This clinical focus article explores the utility of the CSE across the life span. Specifically, components, reliability, standardized assessments, and limitations of the CSE within the adult and pediatric populations are highlighted. Conclusions The CSE remains a crucial assessment tool for the speech-language pathologist. The experienced clinician can make important judgments regarding patient safety and function. If the CSE is conducted mindfully and methodically, findings can help chart the course of care for individuals needing additional assessment and possibly intervention.
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Affiliation(s)
| | - Gary McCullough
- Department of Communication Sciences and Disorders, Appalachian State University, Boone, NC
| | - Michael Crary
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | - Joan C Arvedson
- Department of Pediatrics, Children's Hospital of Wisconsin, Medical College of Wisconsin-Milwaukee
| | - Pamela Dodrill
- Department of Otolaryngology, Boston Children's Hospital Boston, MA
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26
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Shida H, Okabayashi S, Yoshioka M, Takase N, Nishiura M, Okazawa Y, Kiyohara K, Konda M, Nishioka N, Kawamura T, Iwami T. Effectiveness of a digital device providing real-time visualized tooth brushing instructions: A randomized controlled trial. PLoS One 2020; 15:e0235194. [PMID: 32584893 PMCID: PMC7316295 DOI: 10.1371/journal.pone.0235194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 06/08/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction The aim of this trial was to investigate whether a digital device that provides real-time visualized brushing instructions would contribute to the removal of dental plaque over usual brushing instructions. Methods We conducted a single-center, parallel-group, stratified permuted block randomized control trial with 1:1 allocation ratio. Eligibility criteria included people aged ≥ 18 years, and exclude people who met the following criteria: severely crowded teeth; using interdental cleaning implement; having external injury in the oral cavity, or stomatitis; having less than 20 teeth; using orthodontic apparatus; visited to a dental clinic; having the possibility of consulting a dental clinic; having a dental license; not owning a smartphone or tablet device; smoker; taken antibiotics; pregnant; an allergy to the staining fluid; and employee of Sunstar Inc. All participants received tooth brushing instructions using video materials and were randomly assigned to one of two groups for four weeks: (1) an intervention group who used the digital device, providing real-time visualized instructions by connection with a mobile application; and (2) a control group that used a digital device which only collected their brushing logs. The primary outcome was the change in 6-point method plaque control record (PCR) score of all teeth between baseline and week 4. The t-test was used to compare the two groups in accordance with intention-to-treat principles. Results Among 118 enrolled individuals, 112 participants were eligible for our analyses. The mean of PCR score at week 4 was 45.05% in the intervention group and 49.65% in the control group, and the change of PCR score from baseline was −20.46% in the intervention group and −15.77% in the control group (p = 0.088, 95% confidence interval −0.70–10.07). Conclusions A digital device providing real-time visualized brushing instructions may be effective for the removal of dental plaque.
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Affiliation(s)
- Haruka Shida
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | | | - Masami Yoshioka
- Department of Oral Health Sciences, Faculty of Health and Welfare, Tokushima Bunri University, Tokushima, Japan
| | | | | | | | - Kosuke Kiyohara
- Department of Food Science, Otsuma Women’s University, Tokyo, Japan
| | - Manako Konda
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Norihiro Nishioka
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | | | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
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27
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van Noort HHJ, Witteman BJM, den Hertog-Voortman R, Everaars B, Vermeulen H, Huisman-de Waal G. A context analysis on how oral care is delivered in hospitalised patients: A mixed-methods study. J Clin Nurs 2019; 29:1991-2003. [PMID: 31793109 DOI: 10.1111/jocn.15130] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/25/2019] [Accepted: 11/10/2019] [Indexed: 12/23/2022]
Abstract
AIMS AND OBJECTIVES To analyse oral care delivery in one hospital through exploring experiences from both nurses' and patients' perspectives and examining patients' oral health. BACKGROUND Oral health problems are associated with undernutrition and other general health outcomes. Although oral care belongs to the essentials of nursing, it is often neglected. Improving oral health may require behaviour change of both nurses and patients. Defining tailored strategies need a clear view on the context. DESIGN A context analysis in one hospital using a convergent parallel mixed-methods design was reported following the EQUATOR guidelines using two checklists: COnsolidated criteria for REporting Qualitative research (qualitative research) and STROBE (observational research). METHODS Semi-structured interviews were conducted with 19 nurses and 11 patients. The topic list was based on the Integrated Change Model. Prospective oral examination was performed among 91 surgical patients using the Oral Health Assessment Tool (OHAT). RESULTS Nurses acknowledged that they did not prioritise oral care in daily practice. Furthermore, they lacked knowledge and skills to identify and provide care for oral problems. Nurses mentioned helpful resources to perform oral care, like standardised language and instruments. However, they had no access to or were unaware of them. Patients admitted that they did not prioritise oral care due to their sickness during hospitalisation, were unaware of the importance of oral care, but felt responsible for their oral care. The most prominent oral problems identified with the OHAT were unclean mouths (n = 75, 82%), unhealthy gum and tissues (n = 55, 60%) and dry mouth (n = 42, 46%). CONCLUSIONS This context analysis identified inadequate oral care due to lack of positive attitude and knowledge in both nurses and patients, skills for nurses, and resources. RELEVANCE TO CLINICAL PRACTICE The behavioural factors indicate strategies for development of a multicomponent intervention to improve oral care in this hospital, nutritional status and general health outcomes.
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Affiliation(s)
- Harm H J van Noort
- Department of Nutrition, Physical Activity and Sports, Gelderse Vallei Hospital, Ede, The Netherlands.,Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Nursing, Christian University of Applied Sciences, Ede, The Netherlands
| | - Ben J M Witteman
- Department of Gastroenterology and Hepatology, Gelderse Vallei Hospital, Ede, The Netherlands.,Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | | | - Babette Everaars
- Research Group Innovations in Preventive Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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28
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Schroeder S, Adamsen C, Ward C. Dental Care Utilization and Service Needs Among American Indian/Alaska Native/Native Hawaiian Elders: 2008 to 2017. J Aging Health 2019; 31:1917-1940. [PMID: 30238843 DOI: 10.1177/0898264318800598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Objective: This study describes trends in self-reported dental care utilization and services needed among American Indian/Alaska Native/Native Hawaiian (AI/AN/NH) elders 2008 to 2017, including demographic and socioeconomic variability. Method: Researchers utilized data from the Survey of Elders administered by the National Resource Center on Native American Aging, representing all regions of the United States and 262 tribes. Data were analyzed comparing means over time and between/within groups. Results: Between April 2008 and March 2017, there was a statistically significant (p < .001) increase in the proportion of older adults who visited a dentist and an increase in need for treatment. A smaller proportion of older adults reported need for treatment among those who were privately insured, high income, had no tobacco use, were employed, and had visited a dental professional in the last year. Discussion: These findings highlight current dental needs among tribal elders while also identifying elders at greater risk of poor oral health.
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Affiliation(s)
| | | | - Cole Ward
- University of North Dakota, Grand Forks, USA
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29
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Falcao A, Bullón P. A review of the influence of periodontal treatment in systemic diseases. Periodontol 2000 2019; 79:117-128. [PMID: 30892764 DOI: 10.1111/prd.12249] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The effects and consequences of periodontal diseases might not be confined to the oral cavity. A great body of evidence has arisen supporting the claim demonstrating an association with several systemic conditions and diseases. With different levels of evidence, an association between periodontal disease and cardiovascular disease, diabetes, psoriasis, rheumatoid arthritis, pregnancy outcomes and respiratory diseases has been established. However, the true nature of this association, if it is causal, still remains elusive. For a better understanding of the complex relationships linking different conditions, interventional studies now begin to focus on the possible outcomes of periodontal treatment in relation to the events, symptoms and biomarkers of several systemic disorders, assessing if periodontal treatment has any impact on them, hopefully reducing their severity or prevalence. Therefore, we proceeded to review the recent literature on the subject, attempting to present a brief explanation of the systemic condition or disease, what proposed mechanisms might give biological plausibility to its association with periodontal disease, and finally and more importantly, what data are currently available pertaining to the effects periodontal treatment may have. Raising awareness and discussing the possible benefits of periodontal treatment on overall systemic health is important, in order to change the perception that periodontal diseases are only limited to the oral cavity, and ultimately providing better and comprehensive care to patients.
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Affiliation(s)
- Artur Falcao
- Department of Periodontology, Dental School, University of Sevilla, Sevilla, Spain
| | - Pedro Bullón
- Department of Periodontology, Dental School, University of Sevilla, Sevilla, Spain
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30
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Hata R, Noguchi S, Kawanami T, Yamasaki K, Akata K, Ikegami H, Fukuda K, Hirashima S, Miyawaki A, Fujino Y, Oya R, Yatera K, Mukae H. Poor oral hygiene is associated with the detection of obligate anaerobes in pneumonia. J Periodontol 2019; 91:65-73. [DOI: 10.1002/jper.19-0043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/20/2019] [Accepted: 06/05/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Ryosuke Hata
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Shingo Noguchi
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Toshinori Kawanami
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Kei Yamasaki
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Kentaro Akata
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Hiroaki Ikegami
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Kazumasa Fukuda
- Department of MicrobiologyUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Soichi Hirashima
- Department of Dentistry and Oral SurgeryUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Akihiko Miyawaki
- Department of Dentistry and Oral SurgeryUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Yoshihisa Fujino
- Department of Environmental EpidemiologyInstitute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Ryoichi Oya
- Department of Dentistry and Oral SurgeryUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Kazuhiro Yatera
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Hiroshi Mukae
- Department of Respiratory MedicineUnit of Translational MedicineNagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
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31
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Lopes MP, Cruz ÁA, Xavier MT, Stöcker A, Carvalho-Filho P, Miranda PM, Meyer RJ, Soledade KR, Gomes-Filho IS, Trindade SC. Prevotella intermedia and periodontitis are associated with severe asthma. J Periodontol 2019; 91:46-54. [PMID: 31342509 DOI: 10.1002/jper.19-0065] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/24/2019] [Accepted: 05/27/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Periodontitis, an inflammatory disease of multibacterial etiology that affects the protective and supporting tissues surrounding teeth, can influence the course of respiratory diseases, such as asthma, due to epithelial alterations arising from inflammatory and immunological processes, bronchial remodeling, or by the aspiration of pathogenic colonizers found in periodontal pockets. This study evaluated the levels of periodontal pathogens Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans in the subgingival biofilm of individuals with and without severe asthma. METHODS A case-control study enrolling 457 individuals (220 with asthma and 237 without asthma) was conducted at the Program for Control of Asthma in Bahia (ProAR) Clinic located in Salvador, Bahia, Brazil. A structured questionnaire was used to obtain data on sociodemographic, health status, and lifestyle habits. A clinical periodontal assessment was performed, including bleeding on probing, probing depth, and clinical attachment level. Subgingival biofilm was collected at the deepest site of each sextant, and bacterial DNA was extracted. Quantitative real-time PCR analysis was performed to detect and relatively quantify periodontopathogens in the biofilm. RESULTS Statistically significant positive associations were found between periodontitis and severe asthma, (odds ratio [OR]adjusted] : 4.00; 95% confidence interval [CI]: 2.26 to 7.10). High levels of P. intermedia were found in association with the presence of severe asthma (ORadjusted : 2.64; 95% CI: 1.62 to 4.39; P < 0.01). CONCLUSIONS The present results suggest that periodontitis and P. intermedia are associated with severe asthma. However, the functional consequences of this dysbiosis upon asthma susceptibility and its phenotypes remain unclear.
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Affiliation(s)
- Mabel P Lopes
- Post-Graduation Program, Federal University of Bahia, Salvador, Brazil
| | - Álvaro A Cruz
- Faculty of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Márcia T Xavier
- Department of Biointeraction, Federal University of Bahia, Salvador, Brazil
| | - Andreas Stöcker
- Universitary Hospital Professor Edgard Santos, Federal University of Bahia, Salvador, Brazil
| | | | | | - Roberto J Meyer
- Department of Biointeraction, Federal University of Bahia, Salvador, Brazil
| | - Kaliane R Soledade
- Department of Biointeraction, Federal University of Bahia, Salvador, Brazil
| | - Isaac S Gomes-Filho
- Department of Health, Feira de Santana State University, Feira de Santana, Brazil
| | - Soraya C Trindade
- Post-Graduation Program, Federal University of Bahia, Salvador, Brazil.,Department of Health, Feira de Santana State University, Feira de Santana, Brazil
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Abstract
PURPOSE OF REVIEW Hospital-acquired pneumonia (HAP) is the leading cause of death from hospital-acquired infection. Little work has been done on strategies for prevention of HAP. This review aims to describe potential HAP prevention strategies and the evidence supporting them. Oral care and aspiration precautions may attenuate some risk for HAP. Oral and digestive decontamination with antibiotics may be effective but could increase risk for resistant organisms. Other preventive measures, including isolation practices, remain theoretical or experimental. RECENT FINDINGS Hospital-acquired pneumonia occurs because of pharyngeal colonization with pathogenic organisms and subsequent aspiration of these pathogens. SUMMARY Most potential HAP prevention strategies remain unproven.
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33
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Quek HC, Lee YS. Dentistry considerations for the dysphagic patient: Recognition of condition and management. PROCEEDINGS OF SINGAPORE HEALTHCARE 2019. [DOI: 10.1177/2010105819868252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dysphagia is a symptom of various underlying medical conditions. It can be attributed to age related changes, neurological, cognitive, respiratory and gastrointestinal diseases. These conditions may cause functional and anatomical changes along the swallowing tract. Impaired swallowing function and oromotor insufficiencies may result in inadvertent aspiration of fluids and/or particles during dental procedures. This article attempts to highlight the importance of identifying patients with dysphagia and discusses ways to reduce life threatening conditions that may arise during dental procedures.
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Affiliation(s)
- Heng Chuan Quek
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | - Yan Shan Lee
- Speech Therapy Department, Singapore General Hospital, Singapore
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Miles A, Hunting A. Development, intra- and inter-rater reliability of the New Zealand Secretion Scale (NZSS). INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 21:377-384. [PMID: 29879369 DOI: 10.1080/17549507.2018.1458901] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 11/27/2017] [Accepted: 03/24/2018] [Indexed: 06/08/2023]
Abstract
Purpose: The New Zealand Secretion Scale (NZSS) has been developed for comprehensive assessment of accumulated secretions during endoscopy. The scale rates secretion severity under the subcategories location, amount and response. This study describes the scale's development and reliability when used by experts and untrained raters. Method: One expert scored 254 endoscopy videos using the NZSS and performed repeat measures on 100 randomly selected videos one month later. These 100 videos were scored by a second expert in a randomised order. In a second arm of the study, 28 raters scored 10 endoscopy videos, without training on the NZSS. Seventeen had experience in endoscopy (mean 1.8 years, SD = 1.0). Reliability was calculated across the entire cohort and as a function of experience interpreting endoscopy. Result: Strong internal consistency (Cronbach's α = 0.88), and high inter-item (>0.60) and corrected item-total correlations (>0.70) were established. Inter-rater (ICC = 0.99) and intra-rater reliability (ICC = 0.95) of the experts was excellent. Inter-rater reliability of the untrained raters ranged from ICC = 0.65-0.79, with no significant influence of experience on reliability. Conclusion: The NZSS is a reliable assessment of secretion severity during endoscopy and can be used without training. This comprehensive scale will support research evaluating the predictive value of accumulated secretions.
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Affiliation(s)
- Anna Miles
- Department of Psychology, The University of Auckland , Auckland , New Zealand
| | - Alexandra Hunting
- Department of Psychology, The University of Auckland , Auckland , New Zealand
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Ju LY, Weng SC, Chung YJ, Yang SH, Huang YH, Huang LG, Chin CS, Hoogland AI, Chang PH. Effects of the bass brushing method on dental plaque and pneumonia in older adults hospitalized with pneumonia after discharge: A randomized controlled trial. Appl Nurs Res 2019; 46:1-7. [PMID: 30853068 DOI: 10.1016/j.apnr.2018.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/19/2018] [Accepted: 12/26/2018] [Indexed: 11/17/2022]
Abstract
AIM The purpose of this pilot study was to evaluate the effects of the Bass brushing method on dental plaque and pneumonia in older adults hospitalized with pneumonia after discharge. BACKGROUND Poor oral hygiene may lead to pneumonia. Complications of pneumonia in older adults can be life-threatening during hospitalization and after discharge. METHODS Older adults hospitalized with pneumonia (n = 30) were randomly assigned to intervention (with the Bass brushing method; n = 15) or control (with usual care; n = 15) groups. Dental plaque index and pneumonia as detected on chest x-rays were evaluated prior to the intervention (baseline) and every month for six months after discharge. RESULTS Participants in the intervention group experienced a sustained reduction in dental plaque from the fourth to the sixth months (p = .024; p = .025; p = .000, respectively) that was not found in the control group. There were no group differences in detected pneumonia throughout the follow-up period. Pneumonia as detected on the chest x-rays at baseline (p = .001) and dental plaque index (p = .021) were significant predictors of the risk of pneumonia across groups. CONCLUSIONS The Bass brushing method is a simple and effective oral hygiene practice that reduces dental plaque in older adults hospitalized with pneumonia after discharge.
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Affiliation(s)
- Li-Ying Ju
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan; School of Nursing, Chung Shan Medical University, Taichung, Taiwan
| | - Shuo-Chun Weng
- Center for Geriatrics and Gerontology, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Jen Chung
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shu-Hui Yang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Hui Huang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Liang-Gie Huang
- Division of Endodontics and Periodontics, Department of Stomatology, Taichung Veterans General Hospital, Taichung, Taiwan; Executive Master of Health Administration, Tunghai University, Taichung, Taiwan
| | - Chun-Shih Chin
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA
| | - Pi-Hua Chang
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan; School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Ikeda K, Ejima D, Arakawa T, Koyama AH. Protein aggregation suppressor arginine as an effective mouth cleaning agent. Int J Biol Macromol 2019; 122:224-227. [PMID: 30393137 DOI: 10.1016/j.ijbiomac.2018.10.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 10/23/2018] [Accepted: 10/23/2018] [Indexed: 11/28/2022]
Abstract
We have tested here whether or not arginine, a well-known aggregation suppressor, is effective in removing bacterial cells, which may present a potential risk of accidental pneumonia infection in aged individuals, from the oral mucosal membranes. This is based on the ability of arginine to suppress protein-protein interaction and surface adsorption and increase the solubility of organic compounds. Twelve student volunteers were subjected to mouthwashes with saline, citrate buffer (pH 3.5), arginine (pH 3.5) and a commercial Listerine. Insignificant effects were observed with saline and citrate buffer, whereas arginine and Listerine mouthwashes led to significant reduction of bacterial cells from the dorsal side of the volunteer's tongue. Arginine also appeared to disrupt biofilms present in the mouth.
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Affiliation(s)
- Keiko Ikeda
- Adult Nursing, School of Health and Nursing Science, Wakayama Medical University, Wakayama 641-0011, Wakayama, Japan
| | - Daisuke Ejima
- Technology Development, Sysmex Corporation, 4-4-4 Takatsukadai, Nishi-ku, Kobe 651-2271, Hyogo, Japan
| | - Tsutomu Arakawa
- Alliance Protein Laboratories, San Diego, CA 92121, United States of America.
| | - A Hajime Koyama
- Graduate School of Medicine, Wakayama Medical University, Wakayama 641-0011, Wakayama, Japan
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Marcolino MAZ, Miranda VSGD, Rech RS. Dysphagia in the elderly in long-stay institutions - a systematic literature review. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/201921116418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Tamura M, Cueno ME, Abe K, Kamio N, Ochiai K, Imai K. Ions released from a S-PRG filler induces oxidative stress in Candida albicans inhibiting its growth and pathogenicity. Cell Stress Chaperones 2018; 23:1337-1343. [PMID: 29876727 PMCID: PMC6237688 DOI: 10.1007/s12192-018-0922-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/10/2018] [Accepted: 05/30/2018] [Indexed: 11/26/2022] Open
Abstract
Candida albicans causes opportunistic fungal infections usually hidden among more dominant bacteria and does not exhibit high pathogenicity in vivo. Among the elderly, due to reduced host resistance to pathogens attributable to immunoscenesence, oral candidiasis is more likely to develop often leading to systemic candidiasis. Surface pre-reacted glass ionomer filler (S-PRG filler) is an ion-releasing functional bioactive glass that can release and recharge six ions which in turn strengthens tooth structure, inhibits demineralization arising from dental caries, and suppresses dental plaque accumulation. However, its effects on C. albicans have never been elucidated. Here, we evaluated the effects of ion released from S-PRG filler on C. albicans. Results show that extraction liquids containing released ions (ELIS) decreased the amount of hydrogen peroxide and catalase activity in C. albicans. Moreover, ELIS presence was found to affect C. albicans: (1) suppression of fungal growth and biofilm formation, (2) prevent adherence to denture base resin, (3) inhibit dimorphism conversion, and (4) hinder the capability to produce secreted aspartyl proteinase. Taken together, our findings suggest that ELIS induces oxidative stress in C. albicans and suppresses its growth and pathogenicity. In this regard, we propose that ELIS has the potential to be clinically used to help prevent the onset and inhibition of oral candidiasis among the elderly population.
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Affiliation(s)
- Muneaki Tamura
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, 101-8310, Japan.
| | - Marni E Cueno
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, 101-8310, Japan
| | - Kazumasa Abe
- Nihon University School of Dentistry at Matsudo, Chiba, 271-8587, Japan
| | - Noriaki Kamio
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, 101-8310, Japan
| | - Kuniyasu Ochiai
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, 101-8310, Japan
| | - Kenichi Imai
- Department of Microbiology, Nihon University School of Dentistry, Tokyo, 101-8310, Japan
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Marchini L, Recker E, Hartshorn J, Cowen H, Lynch D, Drake D, Blanchette DR, Dawson DV, Kanellis M, Caplan D. Iowa nursing facility oral hygiene (INFOH) intervention: A clinical and microbiological pilot randomized trial. SPECIAL CARE IN DENTISTRY 2018; 38:345-355. [PMID: 30194737 DOI: 10.1111/scd.12327] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/12/2018] [Accepted: 07/24/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE/AIM The aim of this pilot study was to evaluate feasibility and gather initial data for a definitive study to test the clinical and microbiological effectiveness of a nursing facility (NF) customized oral hygiene protocol, intended to be delivered by dental hygienists and NF personnel. MATERIALS AND METHODS A convenience sample of 8 Eastern Iowa NFs was recruited, and each NF was assigned to one of three intervention groups: (1) control (current oral hygiene practice), (2) educational program only, and (3) educational program plus 1% chlorhexidine varnish monthly application. Demographic information, systemic health data, patient centered data, oral health data, and microbiology samples were collected at baseline and after 6 months. RESULTS Recruitment response rates were 21% for NFs and 23% for residents. A total of 81 residents were examined at baseline and of those, 49 were examined at 6 months (39.5% attrition). There were no statistically or clinically significant differences among the intervention groups at 6 months for any of the recorded clinical or microbiological outcomes. CONCLUSIONS Recruitment and retention posed a significant challenge to this trial, even with a relatively short observation period. Results from this pilot study did not encourage further investigation of this customized oral hygiene protocol.
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Affiliation(s)
- Leonardo Marchini
- Assistant Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Erica Recker
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Jennifer Hartshorn
- Clinical Assistant Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Howard Cowen
- Clinical Professor, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - David Lynch
- Post-Doctoral Fellow, Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - David Drake
- Professor, Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Derek R Blanchette
- Biostatistician, Division of Biostatistics and Computational Biology, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Deborah V Dawson
- Morris Bernstein Professor of Dentistry, Professor of Biostatistics, Iowa Institute for Oral Health Research and the Departments of Pediatric Dentistry & Biostatistics, and the Interdisciplinary Programs in Genetics and in Informatics, University of Iowa, Iowa City, IA, USA
| | - Michael Kanellis
- Associate Dean for Patient Care, Professor, Department of Pediatric Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - Daniel Caplan
- Professor and Head, Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
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Farpour S, Farpour HR, Smithard D, Kardeh B, Ghazaei F, Zafarghasempour M. Dysphagia Management in Iran: Knowledge, Attitude and Practice of Healthcare Providers. Dysphagia 2018; 34:105-111. [PMID: 29931606 DOI: 10.1007/s00455-018-9919-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 06/11/2018] [Indexed: 12/17/2022]
Abstract
Despite the remarkable burden of dysphagia, appropriate multidisciplinary management is lacking in Iran and patients are often deprived of effective treatments. Obtaining a full understanding of knowledge, attitude and practice (KAP) of healthcare providers is necessary to determine the gaps in improvement of the quality of care for dysphagic patients. A questionnaire was designed covering demographic information and the parameters of KAP. Face and content validity were determined. Test-retest reliability confirmed that the questionnaire scores are stable over time (r = 0.77, p value < 0.01). Participants were healthcare providers employed in university-affiliated hospitals in three major cities of Iran; Tehran, Shiraz and Mashhad. In total, 312 healthcare professionals completed our survey. The majority (96.8%) were familiar with the term "dysphagia or swallowing disorders". Most of the participants believed their profession (88.5%), as well as other disciplines (92.3%) can play an important role in the management of dysphagia; and this problem should be recognized in a multidisciplinary manner (96.2%). Also, 60.9% had encountered a patient with dysphagia. 52.2% had used at least one assessment method, while 49.9% had applied at least one treatment method. However, very few participants were familiar with a standard test for screening and assessment of dysphagia (11.9%). 74.7% were willing to participate in a workshop on dysphagia. As the main pitfalls of care lie in diagnosis and treatment expertise, the policy of hospitals should prioritize educating and updating the skills of healthcare professionals, encourage multidisciplinary teamwork, establishing clear guidelines and facilitate access to advanced tools.
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Affiliation(s)
- Sima Farpour
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Reza Farpour
- Department of Physical Medicine and Rehabilitation, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, 7187719446, Iran.
| | - David Smithard
- Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK
| | - Bahareh Kardeh
- Bone and Joint Diseases Research Center, Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Ghazaei
- Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Zafarghasempour
- Department of Physical Medicine and Rehabilitation, Mashhad University of Medical Sciences, Mashhad, Iran
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Britton D, Karam C, Schindler JS. Swallowing and Secretion Management in Neuromuscular Disease. Clin Chest Med 2018; 39:449-457. [DOI: 10.1016/j.ccm.2018.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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42
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Nakano M, Wakabayashi H, Sugahara H, Odamaki T, Yamauchi K, Abe F, Xiao JZ, Murakami K, Ishikawa K, Hironaka S. Effects of lactoferrin and lactoperoxidase-containing food on the oral microbiota of older individuals. Microbiol Immunol 2018; 61:416-426. [PMID: 28881387 DOI: 10.1111/1348-0421.12537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/21/2017] [Accepted: 09/01/2017] [Indexed: 11/30/2022]
Abstract
The oral microbiota influences health and disease states. Some gram-negative anaerobic bacteria play important roles in tissue destruction associated with periodontal disease. Lactoferrin (LF) and lactoperoxidase (LPO) are antimicrobial proteins found in saliva; however, their influence on the whole oral microbiota currently remains unknown. In this randomized, double-blinded, placebo-controlled study, the effects of long-term ingestion of LF and LPO-containing tablets on the microbiota of supragingival plaque and tongue coating were assessed. Forty-six older individuals ingested placebo or test tablets after every meal for 8 weeks. The relative abundance of bacterial species was assessed by 16S rRNA gene high-throughput sequencing. Most of the bacterial species in supragingival plaque and tongue coating that exhibited significant decreases in the test group were gram-negative bacteria, including periodontal pathogens. Decreases in the total relative abundance of gram-negative organisms in supragingival plaque and tongue coating correlated with improvements in assessed variables related to oral health, such as oral malodor and plaque accumulation. Furthermore, there was significantly less microbiota diversity in supragingival plaque at 8 weeks in the test group than in the placebo group and low microbiota diversity correlated with improvements in assessed variables related to oral health. These results suggest that LF and LPO-containing tablets promote a shift from a highly diverse and gram-negative-dominated to a gram-positive-dominated community in the microbiota of supragingival plaque and tongue coating. This microbial shift may contribute to improvements in oral health, including oral malodor and state of the gingiva.
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Affiliation(s)
- Manabu Nakano
- Food Ingredients and Technology Institute, Morinaga Milk Industry, 5-1-83 Higashihara, Zama, Kanagawa 252-8583
| | - Hiroyuki Wakabayashi
- Food Ingredients and Technology Institute, Morinaga Milk Industry, 5-1-83 Higashihara, Zama, Kanagawa 252-8583
| | - Hirosuke Sugahara
- Next Generation Science Institute, Morinaga Milk Industry, 5-1-83 Higashihara, Zama, Kanagawa 252-8583
| | - Toshitaka Odamaki
- Next Generation Science Institute, Morinaga Milk Industry, 5-1-83 Higashihara, Zama, Kanagawa 252-8583
| | - Koji Yamauchi
- Food Ingredients and Technology Institute, Morinaga Milk Industry, 5-1-83 Higashihara, Zama, Kanagawa 252-8583
| | - Fumiaki Abe
- Food Ingredients and Technology Institute, Morinaga Milk Industry, 5-1-83 Higashihara, Zama, Kanagawa 252-8583
| | - Jin-Zhong Xiao
- Next Generation Science Institute, Morinaga Milk Industry, 5-1-83 Higashihara, Zama, Kanagawa 252-8583
| | - Kohji Murakami
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan
| | - Kentaro Ishikawa
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan
| | - Shouji Hironaka
- Department of Special Needs Dentistry, Division of Hygiene and Oral Health, Showa University School of Dentistry, Tokyo, Japan
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Jablonski RA, Winstead V, Azuero A, Ptacek T, Jones-Townsend C, Byrd E, Geisinger ML, Morrow C. Feasibility of Providing Safe Mouth Care and Collecting Oral and Fecal Microbiome Samples from Nursing Home Residents with Dysphagia: Proof of Concept Study. J Gerontol Nurs 2018; 43:9-15. [PMID: 28841221 DOI: 10.3928/00989134-20170811-04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Individuals with dysphagia who reside in nursing homes often receive inadequate mouth care and experience poor oral health. From a policy perspective, the combination of absent evidence-based mouth care protocols coupled with insufficient dental coverage create a pool of individuals at great risk for preventable infectious illnesses that contribute to high health care costs. The purpose of the current study was to determine (a) the safety of a mouth care protocol tailored for individuals with dysphagia residing in nursing homes without access to suction equipment, and (b) the feasibility of collecting oral and fecal samples for microbiota analyses. The mouth care protocol resulted in improved oral hygiene without aspiration, and oral and fecal samples were safely collected from participants. Policies supporting ongoing testing of evidence-based mouth care protocols for individuals with dysphagia are important to improve quality, demonstrate efficacy, and save health care costs. [Journal of Gerontological Nursing, 43(9), 9-15.].
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Lim ML, Yong BYP, Mar MQM, Ang SY, Chan MM, Lam M, Chong NCJ, Lopez V. Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses. J Clin Nurs 2018. [PMID: 29518266 DOI: 10.1111/jocn.14347] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIMS AND OBJECTIVES To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. BACKGROUND The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. METHODS A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. RESULTS Ninety-nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed-bound (90%) and required full assistance with their feeding (99%). Most were not on follow-up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. CONCLUSION To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. RELEVANCE TO CLINICAL PRACTICE This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition.
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Affiliation(s)
- Mei Ling Lim
- Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | - Violeta Lopez
- National University of Singapore, Singapore, Singapore
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Hakansson AP, Orihuela CJ, Bogaert D. Bacterial-Host Interactions: Physiology and Pathophysiology of Respiratory Infection. Physiol Rev 2018; 98:781-811. [PMID: 29488821 PMCID: PMC5966719 DOI: 10.1152/physrev.00040.2016] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 09/08/2017] [Accepted: 09/11/2017] [Indexed: 02/06/2023] Open
Abstract
It has long been thought that respiratory infections are the direct result of acquisition of pathogenic viruses or bacteria, followed by their overgrowth, dissemination, and in some instances tissue invasion. In the last decades, it has become apparent that in contrast to this classical view, the majority of microorganisms associated with respiratory infections and inflammation are actually common members of the respiratory ecosystem and only in rare circumstances do they cause disease. This suggests that a complex interplay between host, environment, and properties of colonizing microorganisms together determines disease development and its severity. To understand the pathophysiological processes that underlie respiratory infectious diseases, it is therefore necessary to understand the host-bacterial interactions occurring at mucosal surfaces, along with the microbes inhabiting them, during symbiosis. Current knowledge regarding host-bacterial interactions during asymptomatic colonization will be discussed, including a plausible role for the human microbiome in maintaining a healthy state. With this as a starting point, we will discuss possible disruptive factors contributing to dysbiosis, which is likely to be a key trigger for pathobionts in the development and pathophysiology of respiratory diseases. Finally, from this renewed perspective, we will reflect on current and potential new approaches for treatment in the future.
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Affiliation(s)
- A P Hakansson
- Division of Experimental Infection Medicine, Department of Translational Medicine, Lund University , Lund , Sweden ; Department of Microbiology, University of Alabama at Birmingham , Birmingham, Alabama ; and Center for Inflammation Research, Queens Medical Research Institute, University of Edinburgh , Edinburgh , United Kingdom
| | - C J Orihuela
- Division of Experimental Infection Medicine, Department of Translational Medicine, Lund University , Lund , Sweden ; Department of Microbiology, University of Alabama at Birmingham , Birmingham, Alabama ; and Center for Inflammation Research, Queens Medical Research Institute, University of Edinburgh , Edinburgh , United Kingdom
| | - D Bogaert
- Division of Experimental Infection Medicine, Department of Translational Medicine, Lund University , Lund , Sweden ; Department of Microbiology, University of Alabama at Birmingham , Birmingham, Alabama ; and Center for Inflammation Research, Queens Medical Research Institute, University of Edinburgh , Edinburgh , United Kingdom
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Pedersen PU, Uhrenfeldt L, Larsen P. Oral hygiene in patients with chronic obstructive pulmonary disease: a scoping review protocol. ACTA ACUST UNITED AC 2018; 15:1236-1241. [PMID: 28498163 DOI: 10.11124/jbisrir-2016-003047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
SCOPING REVIEW OBJECTIVE It is hypothesized that systematic oral hygiene may reduce airway infections in patients with chronic obstructive pulmonary disease (COPD). Before considering doing a systematic review, a scoping review is necessary to explore and map literature on the subject and identify which interventions have been carried out, if there is relevant literature available for a systematic review, or if further research should be initiated.The objective of this scoping review is to comprehensively identify and describe qualitative or quantitative literature reporting of non-invasive interventions that have been carried out to improve oral hygiene and relieve and/or reduce respiratory tract infections, exacerbation and/or hospital readmission in patients with diagnosed with COPD. A further objective is to undertake a comprehensive search to identify qualitative literature reporting on the experiences of oral hygiene in people diagnosed with COPD and/or their relatives and/or healthcare providers (HCPs).Specifically, the scoping review questions are as follows.
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Affiliation(s)
- Preben U Pedersen
- 1Danish Center of Systematic Review: a Joanna Briggs Institute Centre of Excellence, Centre of Clinical Guidelines, Aalborg University, Aalborg, Denmark 2Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Ek K, Browall M, Eriksson M, Eriksson I. Healthcare providers' experiences of assessing and performing oral care in older adults. Int J Older People Nurs 2018; 13:e12189. [PMID: 29512291 DOI: 10.1111/opn.12189] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 02/01/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to describe healthcare providers' experiences, knowledge and attitudes in relation to the assessment of oral health in older adults. BACKGROUND Oral health is an important element in the care of older adults. An increasing proportion of older people need the help and support of community-based healthcare services, which are responsible for providing oral health assessment for this group. Although oral care is an important part of nursing care, studies show that it is often an overlooked area in the care of older people. DESIGN An inductive qualitative description design was used. METHODS The participating healthcare providers were selected from a municipality in western Sweden. Purposeful sampling was employed and data were collected through focus-group interviews and were analysed with content analysis. RESULTS The analysis resulted in four categories: healthcare providers' knowledge and attitudes to oral health; routines affect flexibility; challenges in assessing and performing oral care and ethical dilemmas. The results showed that oral health was neglected because of several factors. Lack of knowledge, inadequate procedures and time constraints were most prominent. The healthcare providers' own attitudes affected the performing of oral health assessments. Ethical dilemmas related to the attitudes of those people in receipt of care and their relatives, and their integrity and autonomy, could be seen as complicating factors. CONCLUSIONS The healthcare providers expressed that they did not have the necessary knowledge of oral health that was required in their area of responsibility. In addition, they described their own attitudes as being important when attending to the patients' oral health. IMPLICATIONS FOR PRACTICE The healthcare providers themselves identified lack of knowledge and their own attitudes as being especially important factors in the oral care of older adults, and further research in this area is needed.
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Affiliation(s)
- Kristina Ek
- School of Health and Education, University of Skövde, Skövde, Sweden
| | - Maria Browall
- School of Health and Education, University of Skövde, Skövde, Sweden
| | | | - Irene Eriksson
- School of Health and Education, University of Skövde, Skövde, Sweden
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Noguchi S, Yatera K, Kato T, Chojin Y, Furuta N, Akata K, Kawanami T, Yoshii C, Mukae H. Using oral health assessment to predict aspiration pneumonia in older adults. Gerodontology 2018; 35:110-116. [DOI: 10.1111/ger.12324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Shingo Noguchi
- Department of Respiratory Medicine; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Tatsuji Kato
- Department of Respiratory Medicine; Tobata Kyoritsu Hospital; Kitakyushu Fukuoka Japan
| | - Yasuo Chojin
- Department of Respiratory Medicine; Tobata Kyoritsu Hospital; Kitakyushu Fukuoka Japan
| | - Norihiko Furuta
- Department of Dental Surgery; Tobata Kyoritsu Hospital; Kitakyushu Fukuoka Japan
| | - Kentaro Akata
- Department of Respiratory Medicine; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Chiharu Yoshii
- Department of Respiratory Medicine; Wakamatsu Hospital of the University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine; Unit of Translational Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
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Pedersen PU, Larsen P, Håkonsen SJ. The effectiveness of systematic perioperative oral hygiene in reduction of postoperative respiratory tract infections after elective thoracic surgery in adults: a systematic review. ACTA ACUST UNITED AC 2018; 14:140-73. [PMID: 26878926 DOI: 10.11124/jbisrir-2016-2180] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Nosocomial infections are a significant contributor to patient morbidity and mortality. Nosocomial infections significantly increase hospital length of stay and total hospital costs. Thoracic surgery, mechanical ventilation and/or admission to an intensive care unit are known to increase patients' risk for nosocomial respiratory tract infection. OBJECTIVES To identify, appraise and synthesize the best available evidence on the effectiveness of systematic perioperative oral hygiene in the reduction of postoperative respiratory airway infections in adult patients undergoing elective thoracic surgery. INCLUSION CRITERIA Patients over the age of 18 years who had been admitted for elective thoracic surgery, regardless of gender, ethnicity, diagnosis severity, co-morbidity or previous treatment.Perioperative systematic oral hygiene (such as mechanical removal of dental biofilm or plaques and/or systematic use of mouth rinse) performed by patients themselves or by healthcare staff (such as nurses).Randomized controlled trials and quasi-experimental studies.Nosocomial infections, specifically respiratory tracts infections, and surgical site infections SEARCH STRATEGY Multiple databases (PubMed, CINAHL, Embase, Scopus, Swemed+, Health Technology Assessment Database and Turning Research Into Practice [TRIP] database) were searched from 1980 to December 2014. Studies published in English, German, Danish, Swedish and Norwegian were considered for inclusion in this review. METHODOLOGICAL QUALITY Two independent reviewers used the standard critical appraisal tool from the Joanna Briggs Institute to assess the methodological quality of studies. DATA EXTRACTION The process of data extraction was undertaken independently by two reviewers using tools from the Joanna Briggs Institute. DATA SYNTHESIS Quantitative results were synthesized in meta-analysis. RESULTS This review includes six studies: three randomized controlled trials and three quasi-experimental studies.The absolute magnitude of the summary effect sizes were: for nosocomial infections relative risk (RR) 0.65 (95% confidence interval [CI] 0.55-0.78) for respiratory tract infections RR 0.48 (95%CI: 0.36-0.65) and for deep surgical site infections RR 0.48 (95%CI 0.27-0.84). CONCLUSIONS Systematic perioperative oral hygiene reduces postoperative nosocomial, lower respiratory tract infections and surgical site infections but not urinary tract infections. The effect is statistically, clinically and practically significant.Perioperative decontamination of the nasopharynx and/or oropharynx is a strategy worth pursuing. The intervention is cheap and can easily be carried out by the patients themselves. (Grade A)Studies testing decontamination of the nasopharynx and/or oropharynx have until now only included patients undergoing thoracic surgical procedures. As the interventions are cheap, easy to carry out and have a great impact on the patients' outcome, it is recommendable to carry out more studies involving other type of patients undergoing major surgery with a high prevalence of nosocomial infections, respiratory tract infections and surgical site infections.
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Affiliation(s)
- Preben U Pedersen
- 1. Danish Center of Systematic Reviews in Nursing: a Collaborating Center of the Joanna Briggs Institute
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Park YH, Lee SH, Yi YM, Lee CY, Lee MH. Compliance with Respiratory Infection Preventive Behaviors and Its related Factors in Older Adults using a Senior Center. ACTA ACUST UNITED AC 2018. [DOI: 10.12799/jkachn.2018.29.3.322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Yeon-Hwan Park
- Professor, College of Nursing, Seoul National University, Seoul, Korea
| | - Seong Hyeon Lee
- Master's Degree Student, College of Nursing, Seoul National University, Seoul, Korea
| | - Yu Mi Yi
- Doctoral Student, College of Nursing, Seoul National University, Seoul, Korea
| | - Chi Young Lee
- Doctoral Student, School of Nursing, Duke University, Durham, NC, USA
| | - Min Hye Lee
- Doctoral Student, College of Nursing, Seoul National University, Seoul, Korea
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