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Yu IC, Fang JT. Efficacy of Lemon Mouthwash in Improving Dry Mouth Symptoms and Salivary Flow in Hemodialysis Patients. J Ren Nutr 2024:S1051-2276(24)00161-4. [PMID: 38992515 DOI: 10.1053/j.jrn.2024.07.007] [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: 10/10/2023] [Revised: 06/02/2024] [Accepted: 07/05/2024] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVES Gargling mouthwash is a safe and convenient oral care intervention; it rinses the mouth and increases salivary flow rate. The effectiveness of lemon mouthwash in relieving xerostomia and increasing the salivary flow rate among hemodialysis patients has not been studied. Our study sought to analyze the effectiveness of varying concentrations of lemon in mouthwash solutions on xerostomia and salivary flow rate. METHODS A multi-concentration test was used to assess lemon mouthwash at 20%, 15%, 10%, 5%, and 2.5% concentrations to determine the optimal concentration for relieving dry mouth and increasing salivary flow rate. Generalized estimating equations were used to analyze the differences between various concentrations of lemon mouthwash and baseline values. RESULTS In total, 44 patients were recruited. The 10% lemon concentration mouthwash was the most effective for increasing salivary flow rate, but the 5% and 2.5% were better accepted by the participants. Our findings can help establish intervention guidelines to relieve xerostomia among hemodialysis patients. CONCLUSION Our findings can help establish intervention guidelines to relieve xerostomia among hemodialysis patients.
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Affiliation(s)
- I-Chen Yu
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital in Linkou, Tao-Yuan, Taiwan.
| | - Ji-Tseng Fang
- Department of Nephrology, Chang Gung Memorial Hospital in Linkou, Tao-Yuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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Sandvik RKNM, Husebo BS, Selbaek G, Strand G, Patrascu M, Mustafa M, Bergh S. Oral symptoms in dying nursing home patients. Results from the prospective REDIC study. BMC Oral Health 2024; 24:129. [PMID: 38273300 PMCID: PMC10811859 DOI: 10.1186/s12903-024-03901-x] [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: 02/15/2023] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The mouth is a central organ for communication and fluid intake, also for dying nursing home patients. This study describes the prevalence and severity of oral symptoms from nursing home admission until the day of perceived dying and the day of death. METHODS A prospective, longitudinal cohort study including 696 patients who were admitted to 47 Norwegian nursing homes in 35 municipalities. During the first year of their stay, 189 died (27%), of whom 82 participants were assessed on the day they were perceived as dying and 134 on the day of death. Mouth care, nutrition, and bedsores were assessed with the Residents' Assessment Instrument for nursing homes (RAI-NH) and palliative care (RAI-PC). Pain intensity was assessed with the Mobilization-Observation-Behaviour-Intensity-Dementia-2 Pain Scale (MOBID-2). RESULTS The proportion of patients with ≥ 6 oral symptoms increased from 16% when perceived as dying to 20% on the day of death (P = 0.001). On the day of death, xerostomia (66%), dysphagia (59%), and mastication problems (50%) were the most frequently observed oral symptoms. Only 16% received mouth care every hour and 12% were in pain during this procedure. Compared to people without dementia, those with a diagnosis of dementia at admission (N = 112, 86%) had xerostomia and mastication problems more frequently (50% vs. 73%; 32% vs. 56% (P = 0.038), respectively) on the day of death. CONCLUSIONS The high extent of oral symptoms such as xerostomia, dysphagia, and mastication problems underline the need for systematic assessment and improved oral palliative care for dying nursing home patients with dementia. TRIAL REGISTRATION Clinicaltrials.gov NCT01920100 08/08/2013. First submission to BMC oral 15/03/2023.
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Affiliation(s)
- Reidun K N M Sandvik
- Department of Health and Caring sciences, Faculty of Health and Social Sciences, Western University of Applied Sciences, Haukelandsbakken 15, Bergen, N-5009, Norway.
| | - Bettina S Husebo
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
- Department of Global Public Health and Primary Care, Neuro-SysMed Center, University of Bergen, Bergen, Norway
| | - Geir Selbaek
- The Norwegian National Centre for Ageing and Health (Ageing and Health), P.O. box 2136, Tønsberg, 3103, Norway
- Faculty of medicine, University of Oslo, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Gunhild Strand
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Monica Patrascu
- Department of Global Public Health and Primary Care, Centre for Elderly and Nursing Home Medicine, University of Bergen, Bergen, Norway
- Department of Global Public Health and Primary Care, Neuro-SysMed Center, University of Bergen, Bergen, Norway
- Department of Automatic Control and System Engineering, Complex Systems Laboratory, University Politehnica of Bucharest, Bucharest, Romania
| | - Manal Mustafa
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| | - Sverre Bergh
- The Research Centre for Age Related Functional Decline and Diseases, Innlandet Hospital Trust, P.O. box 68, Ottestad, 2313, Norway
- The Norwegian National Centre for Ageing and Health (Ageing and Health), P.O. box 2136, Tønsberg, 3103, Norway
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AlDehlawi H, Jazzar A. The Power of Licorice ( Radix glycyrrhizae) to Improve Oral Health: A Comprehensive Review of Its Pharmacological Properties and Clinical Implications. Healthcare (Basel) 2023; 11:2887. [PMID: 37958031 PMCID: PMC10648065 DOI: 10.3390/healthcare11212887] [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: 09/19/2023] [Revised: 10/20/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
Licorice (Radix glycyrrhizae) is a plant root extract widely used in various applications, including cosmetics, food supplements, and traditional medicine. It has a long history of medicinal use in different cultures due to its diverse pharmacological properties. Licorice has traditionally been used for treating gastrointestinal problems, respiratory infections, cough, bronchitis, arthritis, and skin conditions. In recent years, the potential therapeutic benefits of licorice for oral health have gained significant interest. This paper aims to provide a comprehensive review of the effects of licorice extracts and their bioactive components on common oral diseases such as dental caries, periodontitis, halitosis, candidiasis, and recurrent aphthous ulcers. The chemical composition of licorice has shown the presence of several bioactive compounds such as glycyrrhizin, glabridin, isoliquiritigenin (ISL), and licochalcone exhibiting various pharmacological activities, including anti-inflammatory, antimicrobial, antioxidative, and immunomodulatory effects. Interestingly, in certain patients, licorice has shown a promising potential to inhibit the spread of viruses, prevent biofilm formation, reduce inflammation, boost immune responses, alleviate pain, and exert antioxidative effects. In this review, we provide a brief overview of the current understanding of licorice's therapeutic benefits in the treatment of oral ailments, emphasising its potential as an alternative treatment option for oral diseases. Further research is warranted to explore its efficacy, safety, and clinical applications using placebo-controlled clinical trials.
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Affiliation(s)
- Hebah AlDehlawi
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
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4
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Ambili R, Ramadas K, Nair LM, Raj D, Nazeer F, George PS, Rejnish Kumar R, Radhakrishna Pillai M. Efficacy of a herbal mouthwash for management of periodontitis and radiation-induced mucositis - A consolidated report of two randomized controlled clinical trials. J Ayurveda Integr Med 2023; 14:100791. [PMID: 37897968 PMCID: PMC10641263 DOI: 10.1016/j.jaim.2023.100791] [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: 09/14/2022] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Oral diseases like periodontitis and mucositis often require home care using topical agents in the form of mouthwashes. Many herbal mouthwashes are found to be beneficial; however lack proper scientific evidence to support their use. OBJECTIVES Study 1 evaluated clinical efficacy of herbal mouthwash in the management of chronic periodontitis in comparison with chlorhexidine mouthwash. Study 2 aimed at assessment of herbal mouthwash in patients of radiation-induced mucosititis. METHODS The novel herbal mouthwash used in the present study wa prepared from extracts of five plants namely Emblica Officinalis, Terminalia chebula, Terminalia bellerica, Glycyrrhiza glabra, and Azadirachta indica. 50 periodontitis patients were randomly allocated to two groups. As per allocation, they were instructed to use either herbal mouthwash or chlorhexidine mouthwash twice daily for two weeks after nonsurgical periodontal therapy. Similarly, patients with radiation-induced mucositis were randomly given herbal mouthwash and soda saline mouthwash. Intergroup and intragroup comparisons of continuous variables were conducted using paired and unpaired t-tests. Categorical variables were compared using the chi-square test. RESULTS Significant reductions in gingival bleeding, plaque accumulation, and pocket depth were noticed in periodontitis patients in both groups. Patients reported acceptable taste, freshness, and satisfaction after the use of herbal mouthwash. The herbal mouthwash group noticed a significant reduction in the severity of radiation-induced mucositis and analgesic requirements. The intensity of pain, dryness of mouth, oral hygiene, and need for the use of antibiotic and antifungal during radiotherapy was not significant among the groups. CONCLUSION The results of this preliminary clinical trial support the use of the tested herbal formulation mouthwash as an adjunct in the treatment of periodontitis as well as radiation-induced mucositis. CLINICAL TRIAL REGISTRATION NUMBER For Study 1: CTRI/2019/10/021574, Study 2: CTRI/2020/04/024851.
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Affiliation(s)
- R Ambili
- Department of Periodontics, PMS College of Dental Science and Research, Thiruvananthapuram, India.
| | - K Ramadas
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, India
| | - Lekha M Nair
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, India
| | - Divya Raj
- Division of Dental Care, Regional Cancer Centre, Thiruvananthapuram, India
| | - Farida Nazeer
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, India
| | - Preethi Sara George
- Division of Cancer Epidemiology, Regional Cancer Centre, Thiruvananthapuram, India
| | - R Rejnish Kumar
- Department of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, India
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Potocka W, Assy Z, Bikker FJ, Laine ML. Current and Potential Applications of Monoterpenes and Their Derivatives in Oral Health Care. Molecules 2023; 28:7178. [PMID: 37894657 PMCID: PMC10609285 DOI: 10.3390/molecules28207178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Plant products have been employed in medicine for centuries. As the world becomes more health-conscious, there is a growing interest in natural and minimally processed products for oral health care. This has led to an increase in research into the bioactive compounds found in plant products, particularly monoterpenes. Monoterpenes are known to have beneficial biological properties, but the specific mechanisms by which they exert their effects are not yet fully understood. Despite this, some monoterpenes are already being used in oral health care. For example, thymol, which has antibacterial properties, is an ingredient in varnish used for caries prevention. In addition to this, monoterpenes have also demonstrated antifungal, antiviral, and anti-inflammatory properties, making them versatile for various applications. As research continues, there is potential for even more discoveries regarding the benefits of monoterpenes in oral health care. This narrative literature review gives an overview of the biological properties and current and potential applications of selected monoterpenes and their derivatives in oral health care. These compounds demonstrate promising potential for future medical development, and their applications in future research are expected to expand.
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Affiliation(s)
- Wiktoria Potocka
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; (Z.A.); (F.J.B.)
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands;
| | - Zainab Assy
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; (Z.A.); (F.J.B.)
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands;
| | - Floris J. Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; (Z.A.); (F.J.B.)
| | - Marja L. Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands;
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Ibrahim SS, Abou-Bakr A, Ghalwash DM, Hussein RR. Effectiveness of thyme honey in the management of xerostomia in geriatric patients with end-stage renal disease: a randomized controlled clinical trial with a biochemical assessment. Eur J Med Res 2023; 28:406. [PMID: 37805605 PMCID: PMC10559599 DOI: 10.1186/s40001-023-01351-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/09/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Taking into consideration the value of the oral health condition in geriatric people with end-stage renal disease (ESRD) associated with xerostomia and believing that salivary stimulants or substitutes could potentially be used to manage this condition. This study aimed to evaluate the clinical effectiveness of thyme honey as oral rinse in geriatric patients with ESRD using the subjective dry mouth score as a primary objective and to assess the effect of thyme honey on the salivary nitric oxide level, salivary flow rate, and salivary ph in addition to objective dry mouth score as a secondary objective. METHODS This was a single blinded randomized controlled trial with two equal arms, the interventional arm (thyme honey oral rinse) and the control arm (saline). Twenty-eight geriatric patients with ESRD undergoing hemodialysis complained of xerostomia were recruited from the renal dialysis center. Patients in both arms followed the same administration protocol either with thyme honey oral rinse or saline. The following clinical parameters (the subjective and objective dry mouth scores, salivary flow rate, salivary ph, and salivary nitric oxide (NO) levels) were evaluated for both groups at different intervals (baseline, 1 week, and 1 month). RESULTS In the current study, it was found that both the subjective and objective dry mouth scores were significantly lower after one month of using thyme honey oral rinse (1.86 ± 0.66B) and (2.21 ± 0.43B) respectively, than the control group (3.07 ± 0.73B) and (3.07 ± 0.83B), respectively with a (p < 0.001). Also, the salivary flow rate was significantly higher after one month of using thyme honey oral rinse (1.56 ± 0.51A), than the control group (0.78 ± 0.27A) with a (p < 0.001). For the NO levels, there was a significant increase in measured value after 1 month in the intervention group (p < 0.001), while for the control group the change was not statistically significant (p = 0.166). CONCLUSIONS The results of the current study have revealed the efficacy of Thyme honey oral rinse in the management of xerostomia in geriatric patients with ESRD. Trial registration The ClinicalTrials.gov Identifier for this study is NCT05247008.
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Affiliation(s)
- Suzan S Ibrahim
- Oral Medicine and Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
- Faculty of Oral and Dental Medicine, Nahda University in Beni Seuf City, Beni Seuf, Egypt
| | - Asmaa Abou-Bakr
- Oral Medicine and Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt.
| | - Dalia M Ghalwash
- Oral Medicine and Periodontology, Faculty of Dentistry, The British University in Egypt, El Sherouk City, Egypt
| | - Radwa R Hussein
- Oral Medicine and Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. STUDY DESIGN A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. RESULTS From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. CONCLUSION There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
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Gong J, Waldréus N, Hu S, Luo Z, Xu M, Zhu L. Thirst and factors associated with thirst in hospitalized patients with heart failure in China. Heart Lung 2022; 53:83-88. [DOI: 10.1016/j.hrtlng.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 11/04/2022]
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Bal Ozkaptan B, Aydin Sayilan A, Unver V, Ozen N. The reliability and validity of the Turkish version of the Shortened Xerostomia Inventory in hemodialysis patients. Ther Apher Dial 2022; 26:797-805. [PMID: 35438251 DOI: 10.1111/1744-9987.13858] [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: 02/24/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to translate, linguistically validate and evaluate the psychometric properties of the Shortened Xerostomia Inventory (SXI) among Turkish patients undergoing hemodialysis. METHODS The study was conducted with 81 chronic hemodialysis patients in the hemodialysis units of two state hospitals between June and August 2020. Explanatory Factor Analysis (EFA) were implemented to test the construct validity. In addition, the test-retest method was performed to test the reliability and consistency of the scale over time. RESULTS A total of 81 patients participated in the study. The Cronbach's alpha coefficient of SXI was 0.788. The mean values for the test was 12.84±6.78 and re-test scores was 11.03±6.88. ICC value calculated as 0.992 and accordingly a statistically significant relationship between the test and retest scores (p<0.001). CONCLUSIONS Our study showed that the SXI is a valid and reliable measurement tool for Turkish hemodialysis patients.
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Affiliation(s)
- Bilge Bal Ozkaptan
- Sinop University Faculty of Health Sciences, Nursing Department, Sinop, Turkey
| | - Aylin Aydin Sayilan
- Kırklareli University Faculty of Health Science, Nursing Department, Kırklareli, Turkey
| | - Vesile Unver
- Acıbadem Mehmet Ali Aydınlar University, Faculty of Health Sciences, Nursing Department, Istanbul, Turkey
| | - Nurten Ozen
- Demiroglu Bilim University Florence Nightingale Hospital School of Nursing, Istanbul, Turkey
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Mubarik F, Noreen S, Farooq F, Khan M, Khan AU, Pane YS. Medicinal Uses of Licorice (Glycyrrhiza glabra L.): A Comprehensive Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Innumerable plants have been used widely as integral medicinal sources since the start of human civilization. The demand for herbal medicines is constantly increasing with time overtime. Licorice
(
Glycyrrhiza glabra
family Leguminosae) is one of the most used herbal plants in foods, in medicinal forms, and substantially researched on a worldwide scale. It was used as traditional and complementary medicine against innumerable ailments including allergies, liver toxicity, gastric ulcer, lung diseases, skin disorders, oral health problems including tooth decay, and inflammation. The constituents of licorice include various essential oils, sugars, inorganic salts, resins, amino acids, and nucleic acids. Biological activity has been observed to be portrayed by active compounds of licorice including triterpene, flavonoids, and saponins. In recent years, licorice has been widely researched to discover its benefits, constituents, and its mechanism of action. The review summarizes the therapeutic and pharmacological benefits of licorice and its uses in different health-related conditions along with its toxicity and maximum levels of licorice consumption.
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Yu IC, Liu CY, Fang JT. Effects of hemodialysis treatment on saliva flow rate and saliva composition during in-center maintenance dialysis: a cross-sectional study. Ren Fail 2021; 43:71-78. [PMID: 33327832 PMCID: PMC7751405 DOI: 10.1080/0886022x.2020.1857769] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim To analyze changes in saliva flow rate and clinical measures from unstimulated whole saliva (UWS) among patients undergoing hemodialysis for end-stage kidney disease (ESKD). Background Chronic hemodialysis causes changes in blood chemistry as well as dry mouth, due to removal of excess fluids. UWS is used to examine saliva flow rate as an indicator of mouth dryness. Whether UWS can be used to measure changes in clinical variables following hemodialysis has not been explored. Design A cross-sectional quantitative study. Methods Patients with ESKD were recruited by purposive sampling (n = 100) between 1 January and 30 June 2015 from a hospital in northern Taiwan. UWS was collected 1-hour pre-dialysis (T1), mid-dialysis (T2), and 1-hour post-dialysis (T3). Saliva flow rate and clinical variables were analyzed. Results Saliva flow rate increased significantly from T1 to T3 (Wald χ2 = 10.40, p < .01). Changes in saliva from T1 to T3 included decreases in blood urea nitrogen and creatinine (Wald χ2 = 97.12, p < .001 and Wald χ2 = 36.98, p < .001, respectively). The pH and osmolality also decreased (p < .001 and p < .01, respectively). Changes in electrolytes included decreases in potassium and calcium (Wald χ2 = 6.71, p < .05 and Wald χ2 = 17.64, p < .01, respectively) and increases in chloride (Wald χ2 = 17.64, p < .001). Conclusion Our findings demonstrated saliva flow rate and several saliva components were altered during hemodialysis. The total volume of saliva secretion increased following dialysis, which can reduce xerostomia. Therefore, medical personnel could provide interventions of relieving dry mouth symptoms and increasing saliva flow rate before hemodialysis treatment.
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Affiliation(s)
- I-Chen Yu
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan.,Department of Nephrology, Chang Gung Memorial Hospital in Linkou, Tao-Yuan, Taiwan
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Ji-Tseng Fang
- Department of Nephrology, Chang Gung Memorial Hospital in Linkou, Tao-Yuan, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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Yao XY, Wang Y, Liu ZJ, Li YQ, Fan XL. Influencing factors of resource utilisation in haemodialysis patients-Based on socioecological pyramid model. J Clin Nurs 2021; 31:770-780. [PMID: 34396613 PMCID: PMC9290955 DOI: 10.1111/jocn.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/22/2021] [Accepted: 06/04/2021] [Indexed: 11/07/2022]
Abstract
Aims and objectives To describe the current situation and analyse influencing factors of resource utilisation in maintenance haemodialysis patients. Background The self‐management level of patients undergoing maintenance haemodialysis in China is low. The applicability of the Chronic Illness Resources Survey in Chinese maintenance haemodialysis patients has been validated, and this survey can be used to assess the utilisation of self‐management support resources among haemodialysis patients. Determining the influencing factors of resource utilisation can help improve the self‐management behaviour of haemodialysis patients and control the progression of the disease. Design A descriptive study design was chosen. Methods A convenience sample of 314 patients undergoing haemodialysis was recruited from dialysis centres in three hospitals in western Xinjiang from June 2018–April 2019. SPSS19.0 software was used to describe the current situation of resource utilisation. Moreover, t test, analysis of variance and multivariate linear regression were applied to explore the influencing factors of patients’ resource utilisation. Standards for observational studies STROBE Statement checklist‐v4 were chosen on reporting the study process. Results The average score of the total resource utilisation was 2.95 ± 0.51. The average item score of seven dimensions from high to low was 3.46 for medical staff, 3.32 for personal, 3.22 for family and friends, 3.16 for work‐related, 3.12 for media policy, 2.55 for neighbourhood/community and 2.23 for organisation. Multiple linear regression showed that there have six main factors, which explained 65.4% of the variance of haemodialysis patients’ resource utilisation. Conclusions The personal, family and friends, work and media and policy subscales were rated the highest, with support from neighbourhood/community and organisation rated the lowest. In general, participants perceived moderate levels of support. Government and healthcare team should pay more attention on haemodialysis patients who had low level of education, poor economic conditions and poor mental condition. Relevance to clinical practice ESRD has caused a burden on healthcare expenditure and has become a critical public health problem worldwide. Self‐management is particularly important for dialysis patients which have attracted extensive interest. In the future research, we can use this questionnaire to evaluate the related resources of disease management of dialysis patients, encourage patients to make full use of the resources around them and focus on those patients with low education and monthly income level and bad mental state.
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Affiliation(s)
- Xiao-Yue Yao
- Department of Nursing, School of Medicine, Shihezi University, Shihezi, China
| | - Yan Wang
- Department of Nursing, School of Medicine, Shihezi University, Shihezi, China
| | - Zhun-Ji Liu
- People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yu-Qin Li
- People's Hospital of Shihezi, Shihezi, China
| | - Xiao-Li Fan
- The First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, China
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Yang T, Wang S, Zhang X, Liu L, Liu Y, Zhang C. Efficacy of auricular acupressure in maintenance haemodialysis patients: A systematic review and meta-analysis. J Clin Nurs 2021; 31:508-519. [PMID: 34268817 DOI: 10.1111/jocn.15966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To systematically evaluate the efficacy of auricular acupressure on sleep disorders, depression, pruritus, xerostomia and daily net weight gain (%) in maintenance haemodialysis patients. BACKGROUND Auricular acupressure has been used for various complications in maintenance haemodialysis patients, such as sleep disorders, depression, pruritus and xerostomia, but the efficacy has not yet been unified. DESIGN Systematic review and meta-analysis. METHODS Randomised controlled trials comparing auricular acupressure intervention with non-AA intervention in maintenance haemodialysis patients were included. We searched English databases (PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (CNKI, WanFang, CBM and VIP database) from the inception to 27 November 2020. The risk of bias was assessed by the Cochrane risk of bias tool. The RevMan 5.3 software was used to perform the meta-analysis. A descriptive analysis was conducted if the data were high of heterogeneity or could not be meta-analysed. The PRISMA statement was used to report systematic review and meta-analysis. RESULTS A total of 12 RCTs with 805 MHD patients were included. Meta-analysis showed that auricular acupressure had a significant difference for improving sleep disorders (MD = -1.97 points, 95% CI: -2.62 to -1.32, p < .0001), pruritus (MD = -1.55 points, 95% CI: -2.01 to -1.08, p < .0001), and daily net weight gain (%) (MD = -0.29, 95% CI: -0.37 to -0.21, p < .0001). The efficacy of depression and xerostomia were analysed descriptively due to insufficient data. CONCLUSIONS The meta-analysis results indicated that auricular acupressure had a positive efficacy in maintenance haemodialysis patients to improve sleep disorders, pruritus and daily net weight gain (%). But the results should be treated conservatively on account of the low quality of included studies. Future researchers need to conduct more high-quality, large sample, multi-centre randomised controlled studies to provide a solid basis to demonstrate of the efficacy of auricular acupressure in maintenance haemodialysis patients. RELEVANCE TO CLINICAL PRACTICE Auricular acupressure has the advantages of low cost, non-invasive and easy to be accepted by patients. This review suggested that auricular acupressure could be considered a non-pharmacological intervention for maintenance haemodialysis patients. Medical staff could teach maintenance haemodialysis patients auricular acupressure to help them self-manage some complications at home.
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Affiliation(s)
- Ting Yang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shurui Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xiaohong Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lirong Liu
- Blood Purification Centre, Southeast University Zhongda Hospital, Nanjin, China
| | - Yanhui Liu
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chunmei Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Pavesi VCS, Martins MD, Coracin FL, Sousa AS, Pereira BJ, Prates RA, da Silva JF, Gonçalves MLL, Bezerra CDS, Bussadori SK, Varellis MLZ, Deana AM. Effects of photobiomodulation in salivary glands of chronic kidney disease patients on hemodialysis. Lasers Med Sci 2021; 36:1209-1217. [PMID: 33745088 DOI: 10.1007/s10103-020-03158-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 10/07/2020] [Indexed: 12/15/2022]
Abstract
This randomized placebo-controlled trial evaluates the impact of photobiomodulation (PBMT) on the salivary flow and biochemistry of patients with chronic kidney disease (CKD) on hemodialysis. Forty-four patients on hemodialysis self-responded two questionnaires for oral health and salivary gland function perception. The subjects were evaluated for function of salivary glands and randomly allocated to two groups: PBMT group (three irradiations at 808 nm, 100 mW, 142 J/cm2, and 4 J per site); and placebo group. Patients were submitted to non-stimulated and stimulated sialometry and after the treatment at baseline and 14 days. Salivary volume and biochemical of the saliva were analyzed. At baseline, most subjects had self-perception of poor oral health (52.6%) and salivary dysfunction (63.1%). Clinical exam revealed that 47.3% of subjects presented dry mucosa. PBMT promoted increase of the non-stimulated (p = 0.027) and stimulated saliva (p = 0.014) and decrease of urea levels in both non-stimulated (p = 0.0001) and stimulated saliva (p = 0.0001). No alteration was detected in total proteins and calcium analysis. Patients with kidney disease can present alteration in flow, concentrations, and composition of saliva, affecting oral health, but our findings suggest that PBMT is effective to improve hyposalivation and urea levels in saliva of patients with CKD.
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Affiliation(s)
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul (UFRGS), R. Ramiro Barcelos, 2492 Santa Cecilia, Porto Alegre, RS, Brazil
| | - Fábio Luiz Coracin
- Universidade Nove de Julho (UNINOVE), R. vergueiro, 235 Liberdade, São Paulo, SP, Brazil
| | - Aline Silva Sousa
- Universidade Nove de Julho (UNINOVE), R. vergueiro, 235 Liberdade, São Paulo, SP, Brazil
| | - Benedito Jorge Pereira
- Universidade Nove de Julho (UNINOVE), R. vergueiro, 235 Liberdade, São Paulo, SP, Brazil
| | - Renato Araújo Prates
- Universidade Nove de Julho (UNINOVE), R. vergueiro, 235 Liberdade, São Paulo, SP, Brazil
| | | | | | | | - Sandra Kalil Bussadori
- Universidade Nove de Julho (UNINOVE), R. vergueiro, 235 Liberdade, São Paulo, SP, Brazil
| | | | - Alessandro Melo Deana
- Universidade Nove de Julho (UNINOVE), R. vergueiro, 235 Liberdade, São Paulo, SP, Brazil.
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15
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Bossola M, Calvani R, Marzetti E, Picca A, Antocicco E. Thirst in patients on chronic hemodialysis: What do we know so far? Int Urol Nephrol 2020; 52:697-711. [PMID: 32100204 DOI: 10.1007/s11255-020-02401-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/01/2020] [Indexed: 01/11/2023]
Abstract
Thirst has been defined as "the sensation that leads animal's and human's actions toward the goal of finding and drinking water" or as "any drive that can motivate water intake, regardless of cause". Thirst, together with xerostomia, is the main cause of poor adherence to fluid restriction and of excessive intake of fluids in patients on chronic hemodialysis, and consequently of high interdialytic weight gain. Interdialytic weight gain (IDWG) should be lower than 4.0-4.5% of dry weight. Unfortunately, many patients have an IDWG greater than this value and some have IDWG of 10-20%. High IDWG is associated with a higher risk of all-cause and cardiovascular death and increased morbidity, such as ventricular hypertrophy and major adverse cardiac and cerebrovascular events. In addition, high IDWG leads to supplementary weekly dialysis sessions with consequent deterioration of quality of life and increased costs. Thus, the knowledge of thirst in patients on chronic hemodialysis is essential to prompt its adequate management to limit IDWG in the routine clinical practice. The present review aims to describe the physiology of thirst in patients on chronic hemodialysis, as well as the prevalence, its measures, the associated variables, the consequences, and the strategies for its reduction.
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Affiliation(s)
- Maurizio Bossola
- Servizio Emodialisi, Dipartimento Di Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - Riccardo Calvani
- Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuele Marzetti
- Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Picca
- Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuela Antocicco
- Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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16
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Kwon YJ, Son DH, Chung TH, Lee YJ. A Review of the Pharmacological Efficacy and Safety of Licorice Root from Corroborative Clinical Trial Findings. J Med Food 2019; 23:12-20. [PMID: 31874059 DOI: 10.1089/jmf.2019.4459] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Since ancient times, licorice, the root of Glycyrrhiza glabra, has been known to have a wide spectrum of therapeutic effects. Glycyrrhizin is cleaved to glycyrrhizic acid, which is subsequently converted to glycyrrhetic acid by human intestinal microflora. Glycyrrhetic acid is a potent inhibitor of 11β-hydroxysteroid dehydrogenase (11β-HSD) and performs a range of corticosteroid-like activities. The pharmacologic effects of licorice contribute to its anti-inflammatory, antioxidative, anti-allergenic, and antimicrobial properties. Licorice has been used to treat liver disease, gastrointestinal disorders, oral disease, and various skin disorders and has been used in gum, candy, herbs, alcoholic beverages, and food supplements. Licorice and its extracts, especially glycyrrhizin, can be taken orally, through the skin (in the form of gels and oils), and intravenously. Licorice demonstrates mineralocorticoid-like activity not only by inhibiting 11β-HSD2, but also by binding to a mineralocorticoid receptor, leading to potentially adverse risks of mineralocorticoid-like overactivity. Chronic use of licorice can lead to hypokalemia and hypertension, and some people are more sensitive to licorice exposure. Based on clinical trials, this review summarizes the positive effects of licorice and other reported side effects.
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Affiliation(s)
- Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Gyeongi, Korea.,Department of Medicine, Graduate School, Yonsei University, Seoul, Korea
| | - Da-Hye Son
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Ha Chung
- Department of Medicine, Graduate School, Yonsei University, Seoul, Korea.,Department of Health Medicine, Severance Hospital, Severance Check-Up, Yonsei University Health System, Seoul, Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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17
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Affiliation(s)
- Maurizio Bossola
- Servizio Emodialisi Università Cattolica del Sacro Cuore Roma Italia
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma Italia
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