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Koyama E, Kimura-Ono A, Mino T, Kurosaki Y, Tokumoto K, Yamamoto M, Nakagawa S, Osaka S, Nawachi K, Inoue-Minakuchi M, Ono M, Minakuchi H, Maekawa K, Kuboki T. Does maintaining the number of present and functional teeth benefit the longevity of life in older people requiring nursing care?: A prospective cohort study. J Prosthodont Res 2024; 68:599-605. [PMID: 38479889 DOI: 10.2186/jpr.jpr_d_23_00221] [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: 10/18/2024]
Abstract
PURPOSE This prospective cohort study examined the effects of the number of present and functional teeth on mortality among older Japanese adults requiring nursing care in an environment of comprehensive oral hygiene and nutritional management. METHODS The study included 174 older adults (mean age: 84.4 ± 8.3 years; male/female: 49/125) in need of support or long-term care, who resided in either a local specialized healthcare facility or their own homes, and received daily oral hygiene and nutritional support at facilities in Okayama, Japan. The initial clinical oral examination along with assessment of general physical condition and nursing environment of the participants were performed in July 2013 and followed up for one year. RESULTS All-cause mortality occurred in 28 (mean age: 88.7 ±13.4 years; male/female: 6 /22) individuals during the follow-up period. Cox proportional hazard analysis indicated that older age, low performance in activities of daily living (Barthel Index <40), and underweight status (body mass index <18.5) were significant risk factors for mortality. The number of present and functional teeth were not found to be significant risk factors for mortality. CONCLUSIONS During the one-year follow-up period, the number of present and functional teeth did not have a significant impact on mortality among older Japanese adults requiring nursing care in a well-managed environment of oral hygiene and nutritional status.
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Affiliation(s)
- Eri Koyama
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
| | - Aya Kimura-Ono
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Takuya Mino
- Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Hirakata, Japan
| | - Yoko Kurosaki
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Kana Tokumoto
- Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
- Department of Oral and Maxillofacial Surgery, School of Medicine, Hyogo Medical University, Nishinomiya, Japan
| | | | - Shinsuke Nakagawa
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
| | - Suguru Osaka
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
| | - Kumiko Nawachi
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
| | - Mami Inoue-Minakuchi
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
| | - Mitsuaki Ono
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
- Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hajime Minakuchi
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
| | - Kenji Maekawa
- Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, Hirakata, Japan
| | - Takuo Kuboki
- Department of Oral Rehabilitation and Implantology, Okayama University Hospital, Okayama, Japan
- Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
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Chen MA, Yang YH, Liu CK, Matsuo K, Hsu CC, Lin YC, Huang HL. Salivary Antimicrobial Peptide in Patients With Dementia Before and After Clinical Oral Rehabilitation Programme: A Randomised Controlled Trial. J Oral Rehabil 2024. [PMID: 39370532 DOI: 10.1111/joor.13867] [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: 06/30/2024] [Revised: 09/06/2024] [Accepted: 09/15/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND Emerging evidence suggests a link between salivary metabolite changes and neurodegenerative dementia, with antimicrobial peptides (AMPs) implicated in its pathogenesis. OBJECTIVE We investigated the effects of a clinical oral rehabilitation programme tailored for dementia patients on salivary flow rate, AMP levels and oral health-related quality of life (OHRQoL). METHODS Eligible patients were randomly assigned to either the experimental group (EG; n = 28) or the control group (CG; n = 27). Both groups received a leaflet on oral health. In addition, the EG received an oral care intervention that included individual lessons on oral muscle exercises and oral self-care practices. Saliva samples and OHRQoL data were collected at baseline and follow-up visits. Generalised estimating equation models were used to analyse the changes over time. RESULTS At the 3-month follow-up, EG showed significantly lower histatin 5 (HTN-5) levels (β = -0.08; effect size [ES] = 0.72) than CG. At 6 months, EG exhibited improved salivary flow rate (β = 0.89; ES = 0.89) and OHRQoL (β = 6.99; ES = 1.31) compared to CG. Changes in salivary flow rate (β = 4.03), HTN-5 level (β = -0.78) and beta-defensin 2 level (BD-2) (β = -0.91) at 3 months predicted improved OHRQoL at 6 months (all p < 0.05). CONCLUSIONS Our clinical oral rehabilitation programme reduced the level of salivary HTN-5, increased salivary flow rate and enhanced OHRQoL in dementia patients. Furthermore, changes in salivary flow rate, HTN-5 level and BD-2 level were associated with improvements in patients' OHRQoL.
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Affiliation(s)
- Ming-An Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral Hygiene, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Yuan-Han Yang
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Kuan Liu
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Koichiro Matsuo
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, Taiwan
| | - Ying-Chu Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Goto A, Umeki K, Hiramatsu K, Kadota JI, Komiya K. Factors associated with readmission for community-onset pneumonia among older people: A retrospective study. Respir Investig 2024; 62:739-743. [PMID: 38905993 DOI: 10.1016/j.resinv.2024.06.002] [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: 03/11/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Although older individuals are prone to pneumonia relapse, little real-world evidence is available on the main factors contributing to pneumonia recurrence. This study assessed the impact of patients' lifestyles on hospital readmission due to pneumonia recurrence. METHODS We retrospectively included consecutive patients (aged ≥65 years) who were admitted for community-onset pneumonia. A binary or multiple-choice postal questionnaire survey on lifestyles after hospitalization was conducted to identify the factors associated with readmission due to pneumonia recurrence. RESULTS Of 117 patients who responded to the questionnaires, 89 were included in the analyses after excluding 28 patients who died within 1 year of discharge. Twenty-four of 89 (27%) patients were readmitted to the hospital for pneumonia within 1 year of discharge. Multivariate analysis revealed that cerebrovascular disease (odds ratio [OR], 3.912; 95% confidence interval [CI], 1.104-13.861; p = 0.035) and need of assistance at mealtime (OR, 2.225; 95% CI, 1.182-4.186; p = 0.013) were significantly associated with readmission due to pneumonia recurrence. Oral care and mealtime body position were not associated with readmission. CONCLUSIONS Host factors, not patients' lifestyles such as oral care and body position, mainly contribute to the development of pneumonia among older people. These results should be considered risk factors for readmission by medical workers and family members.
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Affiliation(s)
- Akihiko Goto
- Department of Respiratory Medicine, Tenshindo Hetsugi Hospital, 5956 Nihongi, Nakahetsugi, Oita, 879-7761, Japan.
| | - Kenji Umeki
- Department of Respiratory Medicine, Tenshindo Hetsugi Hospital, 5956 Nihongi, Nakahetsugi, Oita, 879-7761, Japan.
| | - Kazufumi Hiramatsu
- Department of Medical Safety Management, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
| | - Jun-Ichi Kadota
- Department of Medical Safety Management, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan; Nagasaki Harbor Medical Center, 6-39 Shinchi-machi, Nagasaki, 850-8555, Japan
| | - Kosaku Komiya
- Department of Respiratory Medicine, Tenshindo Hetsugi Hospital, 5956 Nihongi, Nakahetsugi, Oita, 879-7761, Japan; Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, Japan.
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James A, KM S, Krishnappa P. Perception of Caregivers about Oral Health Services for Institutionalized Older Adults: A Mixed Method Study. Ann Geriatr Med Res 2024; 28:362-369. [PMID: 38952331 PMCID: PMC11467519 DOI: 10.4235/agmr.24.0068] [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: 03/12/2024] [Revised: 05/30/2024] [Accepted: 06/17/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND In India, the absence of formal training in geriatric dentistry and the lack of recognition of it as a speciality contributes to the deterioration of oral health in the older adults. India lacks specific oral healthcare policies for older adults. Additionally, caregivers' perspective in old age homes regarding oral healthcare services remains underexplored, necessitating further studies in this context. METHODS A mixed method study was conducted, and the quantitative component focused on assessing the oral health status of institutionalized older adults and caregivers' perceptions using a questionnaire. The qualitative part evaluates caregivers' perceptions of providing oral healthcare services for older adults through in-depth interviews. RESULTS Mean DMFT among institutionalized older adults was 15.52±8.23. More than 50% of caregivers perceived that the oral health status of institutionalized older adults was fair. Barriers to oral health services include autonomy, difficulty in traveling, lack of financial support, lack of knowledge and time. Approaches to enhancing oral health services for institutionalized older adults include oral health education for older adults and their caregivers, monthly dental visits to the institution, utilization of portable dental chair services, collaboration with dental colleges/dental clinics, distribution of oral health education materials, and provision of oral hygiene aids. CONCLUSION Findings from our study indicate the need to collaborate with dental institutions to provide oral health services in old age homes, to improve the oral health status of older adults and caregivers' knowledge.
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Affiliation(s)
- Anju James
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Shwetha KM
- Department of Public Health Dentistry, Faculty of Dental Sciences, M. S. Ramaiah University of Applied Sciences, Bengaluru, India
| | - Pushpanjali Krishnappa
- Department of Public Health Dentistry, Faculty of Dental Sciences, M. S. Ramaiah University of Applied Sciences, Bengaluru, India
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Ko KA, Lee BA, Kim YT, Lee JS. Professional dental care and survival rates in long-term care recipients: A cohort study of 1 459 163 individuals in South Korea. Gerodontology 2024. [PMID: 39076067 DOI: 10.1111/ger.12781] [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] [Accepted: 07/09/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVES To determine the dental care pattern and survival rates of participants who received long-term care (LTC) and a matched control cohort in South Korea. BACKGROUND Global ageing trends and the development of superaged societies pose healthcare challenges. South Korea's LTC system aids those with chronic illnesses and disabilities. Despite the link between oral health and systemic diseases, providing dental care in LTC facilities often reflects social neglect. METHODS We identified 1 459 163 individuals eligible for LTC insurance in the Korean National Health Insurance Service database from July 2008 to 2015 (LTC cohort) and 1 459 544 individuals matched through propensity-score matching (matched cohort). The LTC recipients were further categorised into subgroups based on their care type (institutional, home or mixed care). Population of utilising dental services and the average number of dental visits were counted in each cohort, and the survival rate of the LTC cohort was determined according to dental utilisation. RESULTS Population of utilising dental services increased steadily in all cohorts except for institutional care, with the highest utilisation (around 30%) observed in the matched cohort. Lower independence in LTC cohorts was associated with lower dental utilisation: 18-27% for home care, 12-18% for mixed care, and 10% for institutional care. The survival rates in the LTC cohort were significantly lower than in the matched cohort (P < .0001), with 28.1% survival in LTC vs 59.3% in the matched cohort. CONCLUSION Long-term care recipients experience social neglect for oral care, while higher survival rates were observed in those utilised dental services.
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Affiliation(s)
- Kyung-A Ko
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Bo-A Lee
- Department of Periodontology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Young-Taek Kim
- Department of Periodontology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
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Lisiecka D, Kearns Á, Evans W, Farrell D. Aspiration pneumonia in nursing literature-a mapping review. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1393368. [PMID: 39113687 PMCID: PMC11304538 DOI: 10.3389/fresc.2024.1393368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/03/2024] [Indexed: 08/10/2024]
Abstract
Introduction Aspiration pneumonia (AP) is an infection of the lungs caused by inhalation of material. The reported incidences vary across literature and clinical populations and is associated with high morbidity and mortality. Management of AP is best carried out by a multidisciplinary team. Methods This aim of this review was to collate and describe the available evidence on AP to develop a greater understanding of the concept of AP as it is represented in the nursing literature. As a collaborative team, we undertook the six stages of a systematic mapping review. We searched for the term aspiration pneumonia in 200 peer reviewed nursing journals across 10 databases, over a ten-year period (2013-2023). Results In this review, 293 papers were coded. Dysphagia, oral health and tube feeding emerged as the most frequent risk factors for AP, and the most reported factors for preventing this condition. Mortality was the most commonly described consequence of AP, followed by hospitalisations and morbidity. Multiple management approaches were reported including dysphagia assessment, risk evaluation, oral care and texture modification of food and fluids. The role of nurses and interprofessional collaborations were described. Discussion Despite limited evidence related to the topic of AP in the nursing literature, the complexity of the causes, prevention, management and consequences of AP emerged. Certain factors, such as dysphagia, oral health, and tube feeding, were described under prevention, cause and management of AP. The importance of multidisciplinary approach in the management and prevention of AP was presented.
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Affiliation(s)
- Dominika Lisiecka
- Department of Nursing and Healthcare Sciences, Munster Technological University—Kerry Campus, Tralee, Ireland
- Kerry Speech & Language Therapy Clinic, Tralee, Ireland
| | - Áine Kearns
- Health Research Institute, School of Allied Health, University of Limerick, Limerick, Ireland
| | - William Evans
- Department of Nursing and Healthcare Sciences, Munster Technological University—Kerry Campus, Tralee, Ireland
| | - Dawn Farrell
- Department of Nursing and Healthcare Sciences, Munster Technological University—Kerry Campus, Tralee, Ireland
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Zhou BJ, Jiang CQ, Jin YL, Au Yeung SL, Lam TH, Cheng KK, Zhang WS, Xu L. Association of oral health with all-cause and cause-specific mortality in older Chinese adults: A 14-year follow-up of the Guangzhou Biobank Cohort study. J Glob Health 2024; 14:04111. [PMID: 38968002 PMCID: PMC11225964 DOI: 10.7189/jogh.14.04111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024] Open
Abstract
Background Poor oral hygiene is associated with overall wellness, but evidence regarding associations of oral health with all-cause mortality remain inconclusive. We aimed to examine the associations of oral health with all-cause and cause-specific mortality in middle-aged and older Chinese adults. Methods 28 006 participants were recruited from 2003-2008 and followed up until 2021. Oral health was assessed by face-to-face interview and causes of death was identified via record linkage. Cox regression yielded hazard ratios (HRs) and 95% confidence intervals (CIs) with adjustment of multiple potential confounders. Results During an average of 14.3 years of follow-up, we found that a lower frequency of toothbrushing was associated with higher risks of all-cause mortality with a dose-response pattern (P for trend <0.001). Specially, the adjusted HR (95% CI) (vs. ≥ twice/d) was 1.16 (1.10, 1.22) (P < 0.001) for brushing once/d and 1.27 (1.00, 1.61) (P = 0.048) for < once/d. Similar associations were also found for cardiovascular disease (CVD), stroke, and respiratory disease mortality, but not for ischemic heart disease (IHD) and cancer mortality. A greater number of missing teeth was also associated with higher risks of all-cause, CVD, stroke, and respiratory disease mortality with a dose-response pattern (all P for trend <0.05). The association of missing teeth with all-cause mortality was stronger in lower-educated participants. Conclusions Both less frequent toothbrushing and a greater number of missing teeth were associated with higher risks of all-cause, CVD, stroke, and respiratory disease mortality, showing dose-response patterns, but not with IHD and cancer mortality. Moreover, the dose-response association of missing teeth with all-cause mortality was stronger in lower-educated participants.
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Affiliation(s)
- Bai Jing Zhou
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Great Bay Area Public Health Research Collaboration, Guangdong-Hong Kong- Macao, China
| | - Chao Qiang Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou, Guangdong, China
- Great Bay Area Public Health Research Collaboration, Guangdong-Hong Kong- Macao, China
| | - Ya Li Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou, Guangdong, China
| | - Shiu Lun Au Yeung
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Great Bay Area Public Health Research Collaboration, Guangdong-Hong Kong- Macao, China
| | - Tai Hing Lam
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou, Guangdong, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Great Bay Area Public Health Research Collaboration, Guangdong-Hong Kong- Macao, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Wei Sen Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People’s Hospital, Guangzhou, Guangdong, China
- Great Bay Area Public Health Research Collaboration, Guangdong-Hong Kong- Macao, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Great Bay Area Public Health Research Collaboration, Guangdong-Hong Kong- Macao, China
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Ashford JR. Impaired oral health: a required companion of bacterial aspiration pneumonia. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1337920. [PMID: 38894716 PMCID: PMC11183832 DOI: 10.3389/fresc.2024.1337920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
Laryngotracheal aspiration has a widely-held reputation as a primary cause of lower respiratory infections, such as pneumonia, and is a major concern of care providers of the seriously ill orelderly frail patient. Laryngeal mechanical inefficiency resulting in aspiration into the lower respiratory tract, by itself, is not the cause of pneumonia. It is but one of several factors that must be present simultaneously for pneumonia to develop. Aspiration of oral and gastric contentsoccurs often in healthy people of all ages and without significant pulmonary consequences. Inthe seriously ill or elderly frail patient, higher concentrations of pathogens in the contents of theaspirate are the primary catalyst for pulmonary infection development if in an immunocompromised lower respiratory system. The oral cavity is a complex and ever changing eco-environment striving to maintain homogeneity among the numerous microbial communities inhabiting its surfaces. Poor maintenance of these surfaces to prevent infection can result inpathogenic changes to these microbial communities and, with subsequent proliferation, can altermicrobial communities in the tracheal and bronchial passages. Higher bacterial pathogen concentrations mixing with oral secretions, or with foods, when aspirated into an immunecompromised lower respiratory complex, may result in bacterial aspiration pneumonia development, or other respiratory or systemic diseases. A large volume of clinical evidence makes it clear that oral cleaning regimens, when used in caring for ill or frail patients in hospitals and long-term care facilities, drastically reduce the incidence of respiratory infection and death. The purpose of this narrative review is to examine oral health as a required causative companionin bacterial aspiration pneumonia development, and the effectiveness of oral infection control inthe prevention of this disease.
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Teixeira ABV, Carvalho-Silva JM, Ferreira I, Schiavon MA, Cândido Dos Reis A. Silver vanadate nanomaterial incorporated into heat-cured resin and coating in printed resin - Antimicrobial activity in two multi-species biofilms and wettability. J Dent 2024; 145:104984. [PMID: 38583645 DOI: 10.1016/j.jdent.2024.104984] [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: 02/16/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024] Open
Abstract
OBJECTIVES To incorporate the nanostructured silver vanadate decorated with silver nanoparticles (AgVO3) into denture base materials: heat-cured (HC) and 3D printed (3DP) resins, at concentrations of 2.5 %, 5 %, and 10 %; and to evaluate the antimicrobial activity in two multi-species biofilm: (1) Candida albicans, Candida glabrata, and Streptococcus mutans, (2) Candida albicans, Pseudomonas aeruginosa, and Staphylococcus aureus, and the wettability. METHODS The AgVO3 was added to the HC powder, and printed samples were coated with 3DP with AgVO3 incorporated. After biofilm formation, the antimicrobial activity was evaluated by colony forming units per milliliter (CFU/mL), metabolic activity, and epifluorescence microscopy. Wettability was assessed by the contact angles with water and artificial saliva. RESULTS In biofilm (1), HC-5 % and HC-10 % showed activity against S. mutans, HC-10 % against C. glabrata, and HC-10 % and 3DP-10 % had higher CFU/mL of C. albicans. 3DP-5 % had lower metabolic activity than the 3DP control. In biofilm (2), HC-10 % reduced S. aureus and P. aeruginosa, and HC-5 %, 3DP-2.5 %, and 3DP-5 % reduced S. aureus. 3DP incorporated with AgVO3, HC-5 %, and HC-10 % reduced biofilm (2) metabolic activity. 3DP-5 % and 3DP-10 % increased wettability with water and saliva. CONCLUSION HC-10 % was effective against C. glabrata, S. mutans, P. aeruginosa, and S. aureus, and HC-5 % reduced S. mutans and S. aureus. For 3DP, 2.5 % and 5 % reduced S. aureus. The incorporation of AgVO3 into both resins reduced the metabolic activity of biofilms but had no effect on C. albicans. The wettability of the 3DP with water and saliva increased with the addition of AgVO3. CLINICAL SIGNIFICANCE The incorporation of silver vanadate into the denture base materials provides antimicrobial efficacy and can prevent the aggravation of oral and systemic diseases. The incorporation of nanomaterials into printed resins is challenging and the coating is an alternative to obtain the inner denture base with antimicrobial effect.
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Affiliation(s)
- Ana Beatriz Vilela Teixeira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - João Marcos Carvalho-Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - Izabela Ferreira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil
| | - Marco Antônio Schiavon
- Department of Natural Sciences, Federal University of São João Del-Rei, São João Del-Rei, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, Brazil.
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Salazar J, Andersen C, Øzhayat EB. Effect of oral health interventions for dependent older people-A systematic review. Gerodontology 2024; 41:200-219. [PMID: 37847812 DOI: 10.1111/ger.12720] [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] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND There is an increasing proportion of older people in the population worldwide, with a large group being dependent on the care of others. Dependent older people are more vulnerable to oral diseases, which can heavily impact their quality of life (OHRQoL) and general health. OBJECTIVE The purpose of this systematic review was to comprehensively assess interventions to improve oral health or guarantee access and adherence to dental treatment of dependent older people. METHODS We searched MEDLINE, EMBASE, CENTRAL and clinical trial registries. Two reviewers performed the selection, data extraction, risk of bias evaluation using the Cochrane Risk of Bias tool and assessment of certainty of the evidence. When possible, we conducted a meta-analysis to calculate effect estimates and their 95%CIs. Primary outcomes were OHRQoL, oral/dental health, and use of the oral care system. RESULTS We included a total of 30 randomised clinical trials assessing educational and non-educational interventions for community-dwelling older people (n = 2) and those residing in long-term care facilities (n = 28). Most studies assessed oral hygiene and showed that interventions may result in a reduction in dental plaque in the short term (with low certainty of evidence), but there is limited evidence for long-term effectiveness. Only one study assessed OHRQoL, and none evaluated changes in the use of the oral health care system. CONCLUSION Our findings do not provide strong conclusions in favour of any specific intervention, mainly due to study quality and imprecision. There is limited information about the long-term effect of interventions, and further research is needed, especially targeting community-dwelling older people. PROSPERO ID CRD42021231721.
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Affiliation(s)
- Josefina Salazar
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christina Andersen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Esben Boeskov Øzhayat
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Mikami R, Mizutani K, Ishimaru M, Gohda T, Iwata T, Aida J. Preventive dental care reduces risk of cardiovascular disease and pneumonia in hemodialysis population: a nationwide claims database analysis. Sci Rep 2024; 14:12372. [PMID: 38811608 PMCID: PMC11137030 DOI: 10.1038/s41598-024-62735-3] [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: 01/29/2024] [Accepted: 05/21/2024] [Indexed: 05/31/2024] Open
Abstract
This study aims to investigate the impact of dental care utilization status on the occurrence of fatal complications such as cerebral/cardiovascular disease (CVD) and infectious diseases in patients with end-stage renal disease (ESRD) undergoing hemodialysis. This retrospective cohort study was performed using the Japanese claims database and included patients who first underwent hemodialysis between April 2014 and September 2020. The exposure variable of interest was the pattern of dental utilization, which was categorized into three groups, "dental treatment group", "preventive dental care group", and "no-dental visit group". The primary outcomes were the time interval until a composite end point of first major cardiovascular event (acute myocardial infarction, heart failure, or cerebral infarction) of infectious disease (pneumonia and sepsis). The secondary outcomes were the time interval until the incidence of each component of primary outcomes. Survival analyses, including log-rank tests and Cox proportional hazards regression analyses, were performed. Among the 10,873 patients who underwent the first dialysis treatment, 6152 were assigned to the no-dental visit group, 2221 to the dental treatment group, and 2500 to the preventive dental care group. The preventive dental care group had significantly lower hazard ratios (HRs) of the incidence of CVD (adjusted hazard ratio [aHR]: 0.86, 95% confidence interval [CI]: 0.77-0.96) and infectious diseases (aHR: 0.86, 95% CI: 0.76-0.97). As for pneumonia, preventive dental care and dental treatment groups had significantly lower HRs (aHR: 0.74 and 0.80, 95% CI: 0.61-0.88, 0.66-0.96) than the no-dental visit group. This study demonstrated that dental visits for preventive dental care were associated with a significant risk reduction in CVD and infectious complications in patients with ESRD undergoing hemodialysis.
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Affiliation(s)
- Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Miho Ishimaru
- Institute of Education, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Tomohito Gohda
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, 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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Xu H, Zhang R, Zhang X, Cheng Y, Lv L, Lin L. Microbiological Profile of Patients with Aspiration Pneumonia Identified by Combined Detection Methods. Infect Drug Resist 2024; 17:2077-2088. [PMID: 38813526 PMCID: PMC11135560 DOI: 10.2147/idr.s461935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/12/2024] [Indexed: 05/31/2024] Open
Abstract
Purpose Aspiration pneumonia (AP) challenges public health globally. The primary aim of this study was to ascertain the microbiological profile characteristics of patients with AP evaluated by combined detection methods, including conventional microbiological tests (CMTs), chips for complicated infection detection (CCID), and metagenomic next-generation sequencing (mNGS). Patients and Methods From June 2021 to March 2022, a total of thirty-nine patients with AP or community-acquired pneumonia with aspiration risk factors (AspRF-CAP) from 3 hospitals were included. Respiratory specimens, including bronchoalveolar lavage fluid (BALF), sputum, and tracheal aspirate, were collected for microorganism detection. Results Patients with AP were more inclined to be older, to have a shorter duration from illness onset to admission, to have a higher prevalence of different underlying diseases, particularly diabetes mellitus, chronic heart disease, and cerebrovascular disease, and to have a higher CURB-65 score (all P < 0.05). A total of 213 and 31 strains of microorganisms were detected in patients with AP and AspRF-CAP, respectively. The most common pathogens in AP were Corynebacterium striatum (17/213, 7.98%), Pseudomonas aeruginosa (15/213, 7.04%), Klebsiella pneumoniae (15/213, 7.04%), and Candida albicans (14/213, 6.57%). Besides, the most common pathogens in AspRF-CAP were Candida albicans (5/31, 16.13%), Pseudomonas aeruginosa (3/31, 9.68%) and Klebsiella pneumoniae (3/31, 9.68%). Moreover, Klebsiella pneumoniae (7/67, 10.45%) and Candida glabrata (5/67, 7.46%) were the most common pathogens among the 9 non-survived patients with AP. Conclusion The prevalent pathogens detected in cases of AP were Corynebacterium striatum, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Candida albicans. Early combined detection methods for patients with AP enhance the positive detection rate of pathogens and potentially expedites the initiation of appropriate antibiotic therapeutic strategies.
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Affiliation(s)
- Hui Xu
- Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China
| | - Ruixue Zhang
- Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China
| | - Xiaoxue Zhang
- Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China
| | - Yueguang Cheng
- Department of Emergency, Beijing Jingmei Group General Hospital, Beijing, People’s Republic of China
| | - Liping Lv
- Department of Interventional Pulmonology, Anhui Chest Hospital, Hefei, People’s Republic of China
| | - Lianjun Lin
- Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China
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Núñez MDRR, Engel FD, Cardoso M, Castro RG, Montoya JAG, de Mello ALSF. Oral hygiene prior to cardiac surgery to prevent infections: Randomized clinical trial. Int J Dent Hyg 2024; 22:384-393. [PMID: 36546871 DOI: 10.1111/idh.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
CONTEXT It is not clear if an oral hygiene protocol to control biofilm applied before cardiac surgery can reduce infection rates. OBJECTIVE We aim to verify the effectiveness of an oral hygiene protocol in reducing postoperative infections when compared to usual practices, in patients admitted to a cardiology unit, prior to cardiac surgery. DESIGN, SETTING AND PARTICIPANTS Randomized, blind, controlled clinical trial, with 107 participants who expected to undergo cardiac surgery, randomized into two groups: Experimental Group (EG) standardized oral hygiene protocol (54) and Control Group (CG), usual practices performed in patients admitted (53). INTERVENTION a standardized oral hygiene protocol, 1 day before surgery: professional prophylaxis with a portable ultrasound device, tooth brushing and flossing plus a 0.12% chlorhexidine gluconate solution (0.12% CHX) mouth rinsing. When applicable, removable prostheses cleaning. PRIMARY OUTCOME the presence of infection. RESULTS The occurrence of postoperative infection was higher in CG = 7 (13.2%) than in EG = 5 (9.3%); but no statistical difference was found between protocols (p = 0.518). The length of stayed from surgery to discharge presented a statistical difference (p = 0.047; RR = 4.9; CI = 1.01-24.33); the percentage of postoperative infection was almost five times higher in those participants who stayed 11 or more days. CONCLUSION The standardized oral hygiene protocol with mechanical and chemical cleaning, 1 day before cardiac surgery, was not more effective than the usual practices performed regarding the reduction of postoperative infections. Other interventions regarding oral hygiene procedures before cardiac surgery must be studied to contribute to the reduction of adverse post-surgical events. CLINICAL TRIAL REGISTRATION Site Ensaclinicos.gov.br number U1111-1214-2862. DESCRIPTORS Healthcare Associated Infections, Cardiovascular Diseases, Periodontal Diseases, Dental Biofilm, Cardiovascular Surgery.
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Matsubara C, Yamaguchi K, Imada R, Yoshizawa A, Bando Y, Kusaka T, Furuya J, Tohara H. Factors associated with the oral health status of patients with schizophrenia: A cross-sectional study. J Oral Rehabil 2024; 51:695-702. [PMID: 38044570 DOI: 10.1111/joor.13632] [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: 05/29/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Oral function deterioration attributed to ageing and medications is one of the main contributory factors of dysphagia. Therefore, oral health management is essential in older patients with schizophrenia. However, no previous studies have evaluated the oral function in patients with schizophrenia. OBJECTIVE We surveyed patients with schizophrenia to identify factors associated with ageing-related variations in oral function. METHODS This cross-sectional study included 34 male patients diagnosed with schizophrenia who were hospitalised at a psychiatric hospital between July and September 2021 and underwent a screening examination during dental care. The survey items included basic information, oral hygiene information, oral (oral diadochokinesis [ODK] and tongue pressure), physical function, and nutritional status. Thirty-six male community-dwelling older individuals were included as controls, and their outcomes were compared with those of patients with schizophrenia. RESULTS Compared with healthy older adults, patients with schizophrenia demonstrated significantly lower teeth numbers, ODK, and calf circumference (CC) (p < .05). Multiple regression analysis revealed that ODK was associated with age and schizophrenia (p < .05). Conversely, tongue pressure was associated with CC (p < .05), suggesting different factors' association with the parameters indicating decreased oral function. CONCLUSIONS Our study findings suggest that older patients with schizophrenia have decreased tongue pressure and generalised muscle mass, highlighting the need to manage oral function. Interventions for tongue pressure were more strongly associated with muscle mass and could be easier to manage than those with disease-dependent changes in ODK. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Chiaki Matsubara
- Department of Dental Hygiene, University of Shizuoka, Junior College, Shizuoka, Japan
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoko Imada
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Medical Corporation Takanawakai, Tokyo, Japan
| | - Akira Yoshizawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Dental Oral Surgery, Nasu Chuo Hospital, Tochigi, Japan
| | | | - Teruo Kusaka
- Takatsuki Hospital, Tokyo, Japan
- Welfare Planning Office Minister's Secretariat Ministry of Economy, Trade and Industry, Tokyo, Japan
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junichi Furuya
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Oral Function Management, Department of Oral Health Management, Showa University School of Dentistry, Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Yamaguchi K, Miyagami T, Imada R, Kushiro S, Yanagida R, Morikawa T, Nakagawa K, Yoshimi K, Naito T, Tohara H. Effect of poor oral health status at hospital admission on in-hospital outcomes of older patients with aspiration pneumonia. Eur Geriatr Med 2024; 15:489-496. [PMID: 38214864 DOI: 10.1007/s41999-023-00917-4] [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: 08/31/2023] [Accepted: 12/09/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE To investigate the effects of oral health status at admission on in-hospital outcomes and how it varies during hospitalization in older patients with aspiration pneumonia. METHODS This prospective cohort study involved patients aged ≥ 65 years who were admitted to an acute care hospital with a diagnosis of aspiration pneumonia. The patients' basic health information, length of hospital stay (LOS), and oral health assessment tool (OHAT), functional oral intake scale (FOIS), pneumonia severity index, and clinical frailty scale scores were recorded. Patients were divided into two groups based on their median OHAT scores, and intergroup changes were analyzed as a function of time. The relationship between the LOS, FOIS score upon discharge, and OHAT scores at admission was examined using multiple regression analysis. RESULTS Of the 89 participants (52 were men, with a mean age of 84.8 ± 7.9 years), 75 were discharged. The patients' oral health was measured weekly for 3 weeks after the initial assessment via the OHAT, wherein the median score was 7, with a significant between-group difference. Moreover, OHAT scores improved within both groups throughout their stay. OHAT scores at admission were independently associated with the LOS (B = 5.51, P = 0.009). CONCLUSION Poor oral health status at admission was associated with longer hospital stays. Both the high- and low-OHAT groups showed OHAT score improvements. Oral health status is critical in preventing the onset of and treating aspiration pneumonia.
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Affiliation(s)
- Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Taiju Miyagami
- Department of General Medicine, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ryoko Imada
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Seiko Kushiro
- Department of General Medicine, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ryosuke Yanagida
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Toru Morikawa
- Department of General Medicine, Nara City Hospital, 1-50-1 Tokijicho, Nara City, Nara, 630-8305, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Toshio Naito
- Department of General Medicine, Faculty of Medicine, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Gu L, Zhang J, Chen W, Weng Y, Chen L, Zhang L. Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study. BMC Geriatr 2024; 24:272. [PMID: 38504192 PMCID: PMC10953076 DOI: 10.1186/s12877-024-04870-0] [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: 04/11/2023] [Accepted: 03/04/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs). METHODS The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT). RESULTS The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0-3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP. CONCLUSIONS This study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents. TRIAL REGISTRATION ChiCTR2000035236 (registration date: 04/08/2020).
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Affiliation(s)
- Liyan Gu
- Department of Neurology, NO. 905 Hospital of PLA Navy, Naval Medical University, 1328 Huashan Road, 200052, Shanghai, China
- Key Laboratory of Ministry of Education for Geriatric Long-term Care, Shanghai, China
| | - Jingwen Zhang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Wenyao Chen
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Yanqiu Weng
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China
| | - Lan Chen
- Nursing Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
| | - Lingjuan Zhang
- Key Laboratory of Ministry of Education for Geriatric Long-term Care, Shanghai, China.
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital affiliated to Naval Medical University, 168 Changhai Road, Shanghai, 200433, China.
- Shanghai Quality Control Center of Geriatric Care, 168 Changhai Road, Shanghai, 200043, China.
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Kusaka S, Haruta A, Kawada-Matsuo M, Nguyen-Tra Le M, Yoshikawa M, Kajihara T, Yahara K, Hisatsune J, Nomura R, Tsuga K, Ohge H, Sugai M, Komatsuzawa H. Oral and rectal colonization of methicillin-resistant Staphylococcus aureus in long-term care facility residents and their association with clinical status. Microbiol Immunol 2024; 68:75-89. [PMID: 38230847 DOI: 10.1111/1348-0421.13111] [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: 10/01/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/18/2024]
Abstract
Staphylococcus aureus is a commensal bacterium in humans, but it sometimes causes opportunistic infectious diseases such as suppurative skin disease, pneumonia, and enteritis. Therefore, it is important to determine the prevalence of S. aureus and methicillin-resistant S. aureus (MRSA) in individuals, especially older adults. In this study, we investigated the prevalence of S. aureus and MRSA in the oral cavity and feces of residents in long-term care facilities (LTCFs). S. aureus was isolated from the oral cavity of 61/178 (34.3%) participants, including 28 MRSA-positive participants (15.7%), and from the feces of 35/127 (27.6%) participants, including 16 MRSA-positive participants (12.6%). S. aureus and MRSA were isolated from both sites in 19/127 individuals (15.0%) and 10/127 individuals (7.9%), respectively. Among 19 participants with S. aureus isolation from both sites, 17 participants showed the same sequence type (ST) type. Then, we analyzed the correlation of S. aureus and MRSA in the oral cavity and rectum with the participant's condition. S. aureus and MRSA positivity in the oral cavity was significantly related to tube feeding, while there was no correlation of rectal S. aureus/MRSA with any factors. Our findings regarding the oral inhabitation of MRSA and its risk factors indicate the importance of considering countermeasures against MRSA infection in LTCFs.
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Affiliation(s)
- Satoru Kusaka
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Azusa Haruta
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Miki Kawada-Matsuo
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Mi Nguyen-Tra Le
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Mineka Yoshikawa
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toshiki Kajihara
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Yahara
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Junzo Hisatsune
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ryota Nomura
- Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hiroki Ohge
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan
| | - Motoyuki Sugai
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hitoshi Komatsuzawa
- Department of Bacteriology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
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Carvalho-Silva JM, Teixeira ABV, Valente MLDC, Shimano MVW, Dos Reis AC. Antimicrobial activity of essential oils against biofilms formed in dental acrylic resin: a systematic review of in vitro studies. BIOFOULING 2024; 40:114-129. [PMID: 38538551 DOI: 10.1080/08927014.2024.2332709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
This study aimed to answer the question formulated according to the PICO strategy: 'Which essential oils show antimicrobial activity against biofilms formed on dental acrylic resin?' composed by population (dental acrylic resin), intervention (application of essential oils), comparison (denture cleansers, antifungal drugs, chlorhexidine, and oral mouthwashes), and outcome (antibiofilm activity). In vitro experimental studies evaluating the activity of EOs on biofilm formed on acrylic resin were included. PRISMA guidelines were followed, and the search was performed in the PubMed, Science Direct, Embase, and Lilacs databases and in the gray literature using Google Scholar and ProQuest in December 2023. A manual search of the reference lists of the included primary studies was performed. Of the 1467 articles identified, 37 were selected for full-text reading and 12 were included. Twelve EOs were evaluated, of which 11 showed activity against Candida spp., 3 against Staphylococcus aureus, and 1 against Pseudomonas aeruginosa. The EOs of Cymbopogon citratus, Cinnamomum zeylanicum, and Cymbopogon nardus showed higher action than chlorhexidine, C. nardus higher than Listerine, C. citratus higher than nystatin, and Melaleuca alternifolia higher than fluconazole and nystatin. However, chlorhexidine was more effective than Lippia sidoides and Salvia officinalis, sodium hypochlorite was more effective than L. sidoides, nystatin was more effective than Zingiber officinale, Amphotericin B more effective than Eucalyptus globulus and M. alternifolia. In conclusion, the EOs of C. zeylanicum, C. citratus, C. nardus, and M. alternifolia showed antimicrobial activity to reduce biofilm on dental acrylic resin.
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Affiliation(s)
- João Marcos Carvalho-Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Ana Beatriz Vilela Teixeira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Mariana Lima da Costa Valente
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Marcos Vinicius Wada Shimano
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
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Kokush EM, Patel R, Boardingham CE, Rothman BF, Ward J, McKay OA, Yonclas P, Glass NE. Assessing Knowledge, Usage, and Perceptions of the Frazier Free Water Protocol: A Pilot Study. J Surg Res 2024; 293:381-388. [PMID: 37806225 DOI: 10.1016/j.jss.2023.08.034] [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: 03/01/2023] [Revised: 08/04/2023] [Accepted: 08/31/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Dysphagia is very common among hospitalized patients and is associated with increased length of hospital stay, morbidity, and mortality. Diet restrictions for dysphagia cause dehydration and discontent. The Frazier Free Water Protocol (FFWP) was developed to improve hydration and quality of life in dysphagia patients by establishing the safety of allowing sips of water between meals. Despite these potential benefits, we hypothesized that the FFWP is not widely utilized. We sought to determine barriers to utilization by assessing the familiarity, usage, and perceptions of the FFWP among health-care providers at our institution. METHODS We distributed an anonymous questionnaire to a convenience sample of nurses in the hospital during daily huddles. The questionnaire was adapted from a validated framework to assess provider acceptability of health-care interventions. RESULTS Of the 66 surveys distributed, we had 58 completed (88%). Only 10 nurses (17%) had heard of the "FFWP" by name. For those that were familiar with the indications, benefits, and risks of giving free water to patients with dysphagia (n = 18), less than half (39%) reported doing so. No nurses that had less than 10 y of patient care experience gave water to dysphagia patients, even if they knew the indications, benefits, and risks. Similarly, less than a fifth (19%) of all nurses surveyed were comfortable giving water to dysphagia patients, but comfort increased for some if the protocol was recommended by a speech-language pathologist (33%) or physician (13%). Nursing experience of >10 y or in intensive care settings did not yield significant differences in knowledge, usage, or comfort level than those with less years or nonintensive care experience, respectively. CONCLUSIONS Nurses are essential to the implementation of the FFWP, yet many are unfamiliar and uncomfortable with utilizing it. Education about the protocol is necessary to improve patient outcomes and quality of life. We plan to provide targeted education about the FFWP as well as assess other members of the health-care team, in an attempt to increase utilization of the protocol and improve dysphagia management.
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Affiliation(s)
- Emily M Kokush
- Division of Trauma and Surgical Critical Care, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Radhika Patel
- Division of Trauma and Surgical Critical Care, Rutgers New Jersey Medical School, Newark, New Jersey
| | | | - Brooke F Rothman
- Speech-Language Pathology, University Hospital, Newark, New Jersey
| | - Jan Ward
- Speech-Language Pathology, University Hospital, Newark, New Jersey
| | - Ondrea A McKay
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Peter Yonclas
- Division of Trauma and Surgical Critical Care, Rutgers New Jersey Medical School, Newark, New Jersey; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Nina E Glass
- Division of Trauma and Surgical Critical Care, Rutgers New Jersey Medical School, Newark, New Jersey.
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Wang P, Wang J, Wang L, Lv J, Shao Y, He D. High throughput sequencing technology reveals alteration of lower respiratory tract microbiome in severe aspiration pneumonia and its association with inflammation. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2023; 116:105533. [PMID: 37995886 DOI: 10.1016/j.meegid.2023.105533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/18/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Aspiration pneumonia is a common and severe clinical condition. The microbiome present in the lower respiratory tract plays a crucial role in regulating human inflammatory response. However, the relationship between the altered lower respiratory tract microbiome and inflammation in aspiration pneumonia remains inadequately explored. PURPOSE To investigate the alteration of the lower respiratory tract microbiome in severe aspiration pneumonia patients and explore the potential correlation between microbiome components and inflammatory response. METHOD Patients in the severe aspiration pneumonia group and control group were enrolled from the intensive care unit of Jinshan Hospital, Fudan University between December 31, 2020 and August 19, 2021. Sputum specimens were collected from all participants and subsequently subjected to 16S rDNA high throughput sequencing technology. The concentration of inflammatory cytokines in serum was measured using enzyme-linked immunosorbent assay (ELISA) kits, and collected data including patients' demographic information, clinical data, and laboratory examination results were recorded for further analysis. RESULTS Alteration in the lower respiratory tract microbiome was observed in severe aspiration pneumonia. Compared to the control group, a significant decrease in the relative abundance of Firmicutes was found at the phylum level (P < 0.01). At the family level, the relative abundance of Corynebacteriaceae, Enterobacteriaceae and Enterococcaceae increased significantly (P < 0.001, P < 0.05, P < 0.01). There were no significant differences in community diversity of the lower respiratory tract between the two groups. Patients in the severe aspiration pneumonia group exhibited significantly higher levels of inflammation compared to those in the control group. Correlation analysis showed that the relative abundance of Corynebacteriaceae was positively correlated with the expression level of IL-1β and IL-18 (P = 0.002, P = 0.02); the relative abundance of Enterobacteriaceae was negatively correlated with IL-4 (P = 0.011); no other significant correlations have been identified between microbiome and inflammatory indicators thus far (P > 0.05). CONCLUSIONS Alteration of the lower respiratory tract microbiome is critically involved in inflammation and disease progression in severe cases of aspiration pneumonia. The potential inflammation regulation properties of the microbiome hold promising value for developing novel therapeutic approaches aimed at mitigating the severity of the disease.
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Affiliation(s)
- Pengfei Wang
- Center of Emergency and Critical Care Medicine, Jinshan Hospital, Fudan University, Shanghai 201508, China; Research Center for Chemical Injury, Emergency and Critical Medicine of Fudan University, Shanghai 201508, China; Key Laboratory of Chemical Injury, Emergency and Critical Medicine of Shanghai Municipal Health Commission, Shanghai 201508, China
| | - Junming Wang
- Center of Emergency and Critical Care Medicine, Jinshan Hospital, Fudan University, Shanghai 201508, China; Research Center for Chemical Injury, Emergency and Critical Medicine of Fudan University, Shanghai 201508, China; Key Laboratory of Chemical Injury, Emergency and Critical Medicine of Shanghai Municipal Health Commission, Shanghai 201508, China
| | - Lina Wang
- Department of General Practice, Jinshan Hospital, Fudan University, Shanghai 201508, China
| | - Jiang Lv
- Department of General Practice, Jinshan Hospital, Fudan University, Shanghai 201508, China
| | - Yiru Shao
- Center of Emergency and Critical Care Medicine, Jinshan Hospital, Fudan University, Shanghai 201508, China; Research Center for Chemical Injury, Emergency and Critical Medicine of Fudan University, Shanghai 201508, China; Key Laboratory of Chemical Injury, Emergency and Critical Medicine of Shanghai Municipal Health Commission, Shanghai 201508, China
| | - Daikun He
- Department of General Practice, Jinshan Hospital, Fudan University, Shanghai 201508, China; Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Center of Emergency and Critical Care Medicine, Jinshan Hospital, Fudan University, Shanghai 201508, China; Research Center for Chemical Injury, Emergency and Critical Medicine of Fudan University, Shanghai 201508, China; Key Laboratory of Chemical Injury, Emergency and Critical Medicine of Shanghai Municipal Health Commission, Shanghai 201508, China.
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22
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Vila-Nova TEL, Leão RDS, Santiago Junior JF, Pellizzer EP, Vasconcelos BCDE, Moraes SLD. Photodynamic therapy in the treatment of denture stomatitis: A systematic review and meta-analysis. J Prosthet Dent 2023; 130:825-832. [PMID: 35125209 DOI: 10.1016/j.prosdent.2021.11.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022]
Abstract
STATEMENT OF PROBLEM Photodynamic therapy is widely used in dentistry, but limited evidence exists regarding its effectiveness in treating denture stomatitis. High resistance to antifungals has been reported, and photodynamic therapy could be an alternative treatment. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate whether photodynamic therapy is effective in reducing denture stomatitis. MATERIAL AND METHODS A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and recorded in the prospective register of systematic reviews (PROSPERO) (CRD42020205589) to answer the population, intervention, control, outcome (PICO) question: "Is photodynamic therapy effective in the treatment of denture stomatitis when compared with the use of antifungal agents?" Electronic searches were performed in databases PubMed/MEDLINE, Cochrane library, and Web of Science for articles published until February 2021 by using the following terms: (denture stomatitis OR oral candidiasis) AND (low-level light therapy OR laser therapy OR lasers OR photodynamic therapies OR photochemotherapy) AND (antifungal drugs OR antifungal agents OR antimicrobial OR treatment). Clinical trials and randomized clinical trials, studies in the English language, and studies comparing antifungal agents with photodynamic therapy were included. RESULTS In total, 5 articles were selected for the qualitative analysis and 3 for the meta-analysis. No significant difference was detected between antifungal therapy and photodynamic therapy in the reduction of colony-forming units on the palate. In a subgroup analysis, a significant difference was found in the reduction of colony-forming units on the palate at 15 days and at the denture surface at 30 days. CONCLUSIONS Photodynamic therapy is effective in the treatment of denture stomatitis, but after 30 days and 15 days, the antifungals demonstrated better performance.
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Affiliation(s)
- Taciana Emília Leite Vila-Nova
- PhD student, Department of Oral Rehabilitation, Faculty of Dentistry, University of Pernambuco (UPE), Recife, Pernambuco, Brazil
| | - Rafaella de Souza Leão
- Adjunct Professor of Department of Prosthodontics, School of Dentistry, Pernambuco University (UPE), Recife, Pernambuco, Brazil
| | | | - Eduardo Piza Pellizzer
- Full Professor of Departament of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | | | - Sandra Lúcia Dantas Moraes
- Associate Professor, Department of Oral Rehabilitation, Faculty of Dentistry, University of Pernambuco (UPE), Recife, Pernambuco, Brazil
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23
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da Rocha Santos LMB, de Paula Ramos L, Santos CER, Miranda DG, Gimenez MG, Meccatti VM, Abu Hasna A, Dos Santos Oliveira M, Neto MB, Dias de Oliveira L. Saliva culture as a predictive indicator for current blood infections and antimicrobial resistance in the ICU setting. Sci Rep 2023; 13:20317. [PMID: 37985806 PMCID: PMC10662427 DOI: 10.1038/s41598-023-47143-3] [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: 09/09/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023] Open
Abstract
Antimicrobial resistance is a worldwide health problem and patients in intensive care are more vulnerable, requiring strict control measures and early identification. Currently, clinical culture materials are used to identify the bacterial agent, but saliva culture is not validated, which has great clinical relevance because it participates in several pathophysiological processes. The aim of this study was to validate saliva culture in an intensive care unit environment, determining its diagnostic value for infection. For this purpose, the results of the 39-month surveillance cultures, from the database of a private hospital were evaluated. A total of 323 cultures were paired between saliva, tracheal secretions, blood and urine from patients who were hospitalized for more than 5 days. The search for correlations between the results was performed using the Spearman correlation test. Severity and evolution data were also correlated. It was possible to correlate the presence of Klebsiella spp. between blood culture and saliva culture in 25% of the results (r = 0.01) and the correlation between saliva and tracheal secretion was 33% (r = 0.33447) with p < 0.0001. In conclusion, saliva can be an excellent discriminator of systemic infections, and can be considered a useful culture in clinical practice.
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Affiliation(s)
- Leonardo Moura Brasil da Rocha Santos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
- Instituto Policlin de Ensino e Pesquisas-IPEP, Av. Nove de Julho, 430-Vila Ady'Anna, São José dos Campos, SP, 12243-001, Brazil
| | - Lucas de Paula Ramos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
- Laboratory "Systemic Health Care", EA4129, University of Lyon, Lyon, France
- UFR de Médicine, Université Lyon 1, Lyon, France
| | - Carlos Eduardo Rocha Santos
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
- Instituto Policlin de Ensino e Pesquisas-IPEP, Av. Nove de Julho, 430-Vila Ady'Anna, São José dos Campos, SP, 12243-001, Brazil
| | - Diego Garcia Miranda
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
- UFR de Médicine, Université Lyon 1, Lyon, France
- Laboratoire des Multimatériaux et Interfaces CNRS (UMR 5615), Université Lyon 1, Villeurbanne, France
| | - Mariana Gadelho Gimenez
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Vanessa Marques Meccatti
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil.
| | - Marcela Dos Santos Oliveira
- Anhembi Morumbi University, Benedito Matarazzo, 6070-Jardim Aquarius, São José dos Campos, SP, 12230-002, Brazil
| | - Morun Bernardino Neto
- Departamento de Ciências Básicas e Ambientais-LOB, Escola de Engenharia de Lorena-EEL/USP, Estrada Municipal do Campinho, s/no, Lorena, SP, 12602-810, Brazil
| | - Luciane Dias de Oliveira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
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Funayama M, Koreki A, Takata T, Hisamatsu T, Mizushima J, Ogino S, Kurose S, Oi H, Mimura Y, Shimizu Y, Kudo S, Nishi A, Mukai H, Wakisaka R, Nakano M. Pneumonia Risk Increased by Dementia-Related Daily Living Difficulties: Poor Oral Hygiene and Dysphagia as Contributing Factors. Am J Geriatr Psychiatry 2023; 31:877-885. [PMID: 37286391 DOI: 10.1016/j.jagp.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Although pneumonia is the leading cause of death among patients with dementia, the specific underlying causes remain unclear. In particular, the potential connection between pneumonia risk and dementia-related daily living difficulties, such as oral hygiene practice and mobility impairment, and the use of physical restraint as a management practice, has not been extensively studied. METHODS In our retrospective study, we included 454 admissions corresponding to 336 individual patients with dementia who were admitted to a neuropsychiatric unit due to behavioral and psychological symptoms. The admissions were divided into two groups: those who developed pneumonia while hospitalized (n=62) and those who did not (n=392). We investigated differences between the two groups in terms of dementia etiology, dementia severity, physical conditions, medical complications, medication, dementia-related difficulties in daily living, and physical restraint. To control potential confounding variables, we used mixed effects logistic regression analysis to identify risk factors for pneumonia in this cohort. RESULTS Our study found that the development of pneumonia in patients with dementia was associated with poor oral hygiene, dysphagia, and loss of consciousness. Physical restraint and mobility impairment showed a weaker, nonsignificant association with the development of pneumonia. CONCLUSIONS Our findings suggest that pneumonia in this population may be caused by two primary factors: increased pathogenic microorganisms in the oral cavity due to poor hygiene, and an inability to clear aspirated contents due to dysphagia and loss of consciousness. Further investigation is needed to clarify the relationship between physical restraint, mobility impairment, and pneumonia in this population.
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Affiliation(s)
- Michitaka Funayama
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan.
| | - Akihiro Koreki
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Psychiatry (AK, SK), National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Taketo Takata
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan
| | - Tetsuya Hisamatsu
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Psychiatry, Gunma Hospital (TH), Gunma, Japan
| | - Jin Mizushima
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan
| | - Satoyuki Ogino
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Trauma and Critical Care Medicine (SO, YS), Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Shin Kurose
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan; Department of Psychiatry (AK, SK), National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan
| | - Hiroki Oi
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yu Mimura
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yusuke Shimizu
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Trauma and Critical Care Medicine (SO, YS), Kyorin University School of Medicine, Mitaka, Tokyo, Japan
| | - Shun Kudo
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Akira Nishi
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan; Department of Psychiatry, Sakuragaoka Kinen Hospital (AN), Tokyo, Japan
| | - Hiroo Mukai
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Riko Wakisaka
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan; Department of Emergency and Critical Care Medicine (RW), Nippon Medical School, Tokyo, Japan
| | - Masaaki Nakano
- Department of Neuropsychiatry (MF, AK, TT, TH, JM, SO, SK, HO, YM, YS, SK, AN, HM, RW, MN), Ashikaga Red Cross Hospital, Ashikaga, Tochigi, Japan; Department of Neuropsychiatry (MF, SK, HO, YM, SK, AN, HM, RW, MN), Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Jain A, Raval M, Srikanth S, Modi K, Raju AR, Garg M, Doshi R, Desai R. In-hospital Outcomes of Aspiration Pneumonia Hospitalizations With Acute Heart Failure: A Nationwide Analysis. INTERNATIONAL JOURNAL OF HEART FAILURE 2023; 5:191-200. [PMID: 37937201 PMCID: PMC10625882 DOI: 10.36628/ijhf.2023.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 11/09/2023]
Abstract
Background and Objectives There is a paucity of data regarding the impact of acute heart failure (AHF) on the outcomes of aspiration pneumonia (AP). Methods Using National Inpatient Sample datasets (2016 to 2019), we identified admissions for AP with AHF vs. without AHF using relevant International Classification of Diseases, Tenth Revision codes. We compared the demographics, comorbidities, and outcomes between the two groups. Results Out of the 121,097,410 weighted adult hospitalizations, 488,260 had AP, of which 13.25% (n=64,675) had AHF. The AHF cohort consisted predominantly of the elderly (mean age 80.4 vs. 71.1 years), females (47.8% vs. 42.2%), and whites (81.6% vs. 78.5%) than non-AHF cohort (all p<0.001). Complicated diabetes and hypertension, dyslipidemia, obesity, chronic pulmonary disease, and prior myocardial infarction were more frequent in AHF than in the non-AHF cohort. AP-AHF cohort had similar adjusted odds of all-cause mortality (adjusted odds ratio [AOR], 0.9; 95% confidence interval [CI], 0.78-1.03; p=0.122), acute respiratory failure (AOR, 1.0; 95% CI, 0.96-1.13; p=0.379), but higher adjusted odds of cardiogenic shock (AOR, 2.2; 95% CI, 1.30-3.64; p=0.003), and use of mechanical ventilation (MV) (AOR, 1.3; 95% CI, 1.17-1.56; p<0.001) compared to AP only cohort. AP-AHF cohort more frequently required longer durations of MV and hospital stays with a higher mean cost of the stay. Conclusions Our study from a nationally representative database demonstrates an increased morbidity burden, worsened complications, and higher hospital resource utilization, although a similar risk of all-cause mortality in AP patients with AHF vs. no AHF.
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Affiliation(s)
- Akhil Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Maharshi Raval
- Internal Medicine, Landmark Medical Center, Woonsocket, RI, USA
| | | | - Karnav Modi
- Division of Research, Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Athul Raj Raju
- Internal Medicine, Karuna Medical College, Kerala, India
| | | | - Rajkumar Doshi
- Cardiology, St Joseph’s University Medical Center, Paterson, NJ, USA
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Koga S, Takazono T, Kido T, Muramatsu K, Tokutsu K, Tokito T, Okuno D, Ito Y, Yura H, Takeda K, Iwanaga N, Ishimoto H, Sakamoto N, Yatera K, Izumikawa K, Yanagihara K, Fujino Y, Fushimi K, Matsuda S, Mukae H. Evaluation of the Effectiveness and Use of Anti-Methicillin-Resistant Staphylococcus aureus Agents for Aspiration Pneumonia in Older Patients Using a Nationwide Japanese Administrative Database. Microorganisms 2023; 11:1905. [PMID: 37630465 PMCID: PMC10456764 DOI: 10.3390/microorganisms11081905] [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: 06/29/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Studies indicated potential harm from empirical broad-spectrum therapy. A recent study of hospitalizations for community-acquired pneumonia suggested that empirical anti-methicillin-resistant Staphylococcus aureus (MRSA) therapy was associated with an increased risk of death and other complications. However, limited evidence supports empirical anti-MRSA therapy for older patients with aspiration pneumonia. In a nationwide Japanese database, patients aged ≥65 years on admission with aspiration pneumonia were analyzed. Patients were divided based on presence of respiratory failure and further sub-categorized based on their condition within 3 days of hospital admission, either receiving a combination of anti-MRSA agents and other antibiotics, or not using MRSA agents. An inverse probability weighting method with estimated propensity scores was used. Out of 81,306 eligible patients, 55,098 had respiratory failure, and 26,208 did not. In the group with and without respiratory failure, 0.93% and 0.42% of the patients, respectively, received anti-MRSA agents. In patients with respiratory failure, in-hospital mortality (31.38% vs. 19.03%, p < 0.001), 30-day mortality, and 90-day mortality were significantly higher, and oxygen administration length was significantly longer in the anti-MRSA agent combination group. Anti-MRSA agent combination use did not improve the outcomes in older patients with aspiration pneumonia and respiratory failure, and should be carefully and comprehensively considered.
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Affiliation(s)
- Satoru Koga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Keiji Muramatsu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Kei Tokutsu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Takatomo Tokito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Daisuke Okuno
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hirokazu Yura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Science, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Shinya Matsuda
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyusyu 807-8555, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
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Cilloniz C, Pericas JM, Curioso WH. Interventions to improve outcomes in community-acquired pneumonia. Expert Rev Anti Infect Ther 2023; 21:1071-1086. [PMID: 37691049 DOI: 10.1080/14787210.2023.2257392] [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: 06/22/2023] [Revised: 08/25/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Community-acquired pneumonia (CAP) is a common infection associated with high morbimortality and a highly deleterious impact on patients' quality of life and functionality. We comprehensively review the factors related to the host, the causative microorganism, the therapeutic approach and the organization of health systems (e.g. setting for care and systems for allocation) that might have an impact on CAP-associated outcomes. Our main aims are to discuss the most controversial points and to provide some recommendations that may guide further research and the management of patients with CAP, in order to improve their outcomes, beyond mortality. AREA COVERED In this review, we aim to provide a critical account of potential measures to improve outcomes of CAP and the supporting evidence from observational studies and clinical trials. EXPERT OPINION CAP is associated with high mortality and a highly deleterious impact on patients' quality of life. To improve CAP-associated outcomes, it is important to understand the factors related to the patient, etiology, therapeutics, and the organization of health systems.
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Affiliation(s)
- Catia Cilloniz
- IDIBAPS, Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Barcelona, Spain
- Facultad de Ciencias de la Salud, Universidad Continental, Huancayo, Peru
| | - Juan Manuel Pericas
- Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute for Research (VHIR), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain
| | - Walter H Curioso
- Facultad de Ciencias de la Salud, Universidad Continental, Huancayo, Peru
- Health Services Administration, Continental University of Florida, Margate, FL, USA
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Janssens L, Petrauskiene E, Tsakos G, Janssens B. Clinical and Subjective Oral Health Status of Care Home Residents in Europe: A Systematic Review. J Am Med Dir Assoc 2023; 24:1013-1019.e40. [PMID: 37105236 DOI: 10.1016/j.jamda.2023.03.021] [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: 12/21/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Several studies demonstrated the poor oral health of care home residents in Europe but there is no systematic overview of the relevant literature. The objective of this study was to systematically review the evidence on the clinical and subjective oral health outcomes of care home residents in Europe. DESIGN The study design is a systematic review. METHODS AND PARTICIPANTS All included publications presented data on clinical and/or subjective oral health outcomes in care home residents in Europe with no restrictions for language or study design. MEDLINE, Embase, and CINAHL were searched, including publications from January 2010 onward. Data extraction and quality assessment (Qualsyst tool) was performed by 2 researchers independently. Findings were synthesized narratively, lack in data homogeneity restricted the relevance of a meta-analysis. RESULTS Eighty-three papers from 18 countries were included in the systematic review, with a sample size ranging from 39 to 92,827 participants. Their mean age was older than 80 years. The residents had few natural teeth, with fewer than a third a functional natural dentition. Removable dentures were present in half to 80% of residents. A high prevalence of dental caries was reported. Oral hygiene was insufficient, for both natural teeth and removable dentures. Few residents had a healthy periodontium. Clinical treatment needs were found in most residents. Perceived treatment needs were high with at least one-third of care home residents reporting a need for care due to poor oral health. A fifth to half of the residents reported negative impacts of their oral condition on their everyday lives. CONCLUSION AND IMPLICATIONS This systematic review clearly highlights the poor oral health and high burden of oral conditions among care home residents across Europe, irrespective of country or health care system. There is need for substantial policy actions to improve oral health in care homes.
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Affiliation(s)
- Lynn Janssens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium.
| | - Egle Petrauskiene
- UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Georgios Tsakos
- UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Barbara Janssens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium
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Le KHN, Low EE, Yadlapati R. Evaluation of Esophageal Dysphagia in Elderly Patients. Curr Gastroenterol Rep 2023; 25:146-159. [PMID: 37312002 PMCID: PMC10726678 DOI: 10.1007/s11894-023-00876-7] [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] [Accepted: 05/10/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE OF REVIEW While guidelines exist for the evaluation and management of esophageal dysphagia in the general population, dysphagia disproportionately affects the elderly. In this article, we reviewed the literature on evaluating esophageal dysphagia in elderly patients and proposed a diagnostic algorithm based on this evidence. RECENT FINDINGS In older patients, dysphagia is often well compensated for by altered eating habits and physiologic changes, underreported by patients, and missed by healthcare providers. Once identified, dysphagia should be differentiated into oropharyngeal and esophageal dysphagia to guide diagnostic workup. For esophageal dysphagia, this review proposes starting with endoscopy with biopsies, given its relative safety even in older patients and potential for interventional therapy. If endoscopy shows a structural or mechanical cause, then further cross-sectional imaging should be considered to assess for extrinsic compression, and same session endoscopic dilation should be considered for strictures. If biopsies and endoscopy are normal, then esophageal dysmotility is more likely, and high-resolution manometry and additional workup should be performed following the updated Chicago Classification. Even after diagnosis of the root cause, complications including malnutrition and aspiration pneumonia should also be assessed and monitored, as they both result from and can further contribute to dysphagia. The successful evaluation of esophageal dysphagia in elderly patients requires a thorough, standardized approach to collecting a history, selection of appropriate diagnostic workup, and assessment of risk of potential complications, including malnutrition and aspiration.
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Affiliation(s)
| | - Eric E Low
- Department of Gastroenterology and Hepatology, University of California, San Diego, CA, USA
| | - Rena Yadlapati
- Department of Gastroenterology and Hepatology, University of California, San Diego, CA, USA.
- , La Jolla, CA, USA.
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Kelly N, Gormley K, Linden DA, Winning L, McClory M, Lundy FT, Cullen KM, Linden GJ, El Karim IA. The association of denture wearing with reduced lung function and increased airflow limitation in 58-72 year old men. PLoS One 2023; 18:e0285117. [PMID: 37200325 PMCID: PMC10194954 DOI: 10.1371/journal.pone.0285117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/16/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE To investigate the association between denture wearing and airflow limitation in men in Northern Ireland enrolled in the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study. METHODS A case-control design was used to study partially dentate men. Cases were men aged 58-72 years who were confirmed as denture wearers. Controls were never denture wearers who were matched by age (± 1 month) and smoking habit to the cases. The men had a periodontal assessment and completed a questionnaire detailing their medical history, dental history and behaviours, social circumstances, demographic background and tobacco use. Physical examination and spirometry measurements of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were also undertaken. Spirometry data for edentulous men who wore complete dentures were compared with that recorded for the partially dentate men studied. RESULTS There were 353 cases who were partially dentate and were confirmed denture wearers. They were matched for age and smoking habit to never denture wearer controls. The cases had an FEV1 that was on average 140 ml lower than the controls, p = 0.0013 and a 4% reduction in percent predicted FEV1, p = 0.0022. Application of the GOLD criteria indicated that 61 (17.3%) of the cases had moderate to severe airflow limitation compared with 33 (9.3%) of controls, p = 0.0051. Fully adjusted multivariable analysis showed that partially dentate men who were denture wearers were significantly more likely (p = 0.01) to have moderate to severe airflow reduction with an adjusted odds ratio (OR) of 2.37 (95% confidence intervals 1.23-4.55). In the 153 edentulous men studied moderate to severe airflow limitation was recorded in 44 (28.4%), which was significantly higher than in the partially dentate denture wearers (p = 0.017), and the men who had never worn a denture (p<0.0001). CONCLUSION Denture wearing was associated with an increased risk of moderate to severe airflow limitation in the cohort of middle-aged Western European men studied.
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Affiliation(s)
- Niamh Kelly
- Centre for Dentistry, School of Medicine Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Kyra Gormley
- Centre for Dentistry, School of Medicine Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Dermot A. Linden
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Lewis Winning
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Mary McClory
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Fionnuala T. Lundy
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Kathy M. Cullen
- Centre for Medical Education, School of Medicine Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Gerard J. Linden
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Ikhlas A. El Karim
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, United Kingdom
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Okubo R, Hoshi SL, Kondo M. Cost-effectiveness of professional and mechanical oral care for preventing pneumonia in nursing home residents. J Am Geriatr Soc 2023; 71:756-764. [PMID: 36334034 DOI: 10.1111/jgs.18122] [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: 07/18/2022] [Revised: 09/28/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Pneumonia is common in nursing home residents and is a leading cause of hospitalization and death. Nursing home residents with cerebrovascular diseases and impaired consciousness are at high risk of aspiration pneumonia. Professional and mechanical oral care by dentists and hygienists in addition to daily oral care by caregivers was shown to be effective in preventing pneumonia in nursing home residents. However, professional and mechanical oral care has not been widely provided in Japan, while daily oral care by caregivers has been widely provided as a basic service in nursing homes. This study aimed to evaluate the cost-effectiveness of providing professional and mechanical oral care for preventing pneumonia in nursing home residents. METHODS Using a decision tree and Markov modeling, we conducted a cost-effectiveness analysis from the payer's perspective (social insurers and patients) in Japan. RESULTS The incremental cost-effectiveness ratio for professional and mechanical oral care compared with daily oral care only was calculated as 4,079,313 Japanese yen (¥; 33,994 United States dollars [US$], US$1 = ¥120) per quality-adjusted life year. CONCLUSIONS Using the official value of social willingness to pay for a one-quality-adjusted life year gain in Japan of ¥5 million (US$41,667) as the threshold to judge cost-effectiveness, providing professional and mechanical oral care is cost-effective. Our results suggest professional and mechanical oral care for preventing pneumonia in nursing home residents could be justifiable as efficient use of finite healthcare resources. The results have implications for oral care in nursing homes both in Japan and worldwide.
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Affiliation(s)
- Reiko Okubo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
- Department of Clinical Laboratory Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Shu-Ling Hoshi
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Gholami L, Shahabi S, Jazaeri M, Hadilou M, Fekrazad R. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol 2023; 13:1020995. [PMID: 36687594 PMCID: PMC9850114 DOI: 10.3389/fmicb.2022.1020995] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
Given the emergence of resistant bacterial strains and novel microorganisms that globally threaten human life, moving toward new treatment modalities for microbial infections has become a priority more than ever. Antimicrobial photodynamic therapy (aPDT) has been introduced as a promising and non-invasive local and adjuvant treatment in several oral infectious diseases. Its efficacy for elimination of bacterial, fungal, and viral infections and key pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Candida albicans, and Enterococcus faecalis have been investigated by many invitro and clinical studies. Researchers have also investigated methods of increasing the efficacy of such treatment modalities by amazing developments in the production of natural, nano based, and targeted photosensitizers. As clinical studies have an important role in paving the way towards evidence-based applications in oral infection treatment by this method, the current review aimed to provide an overall view of potential clinical applications in this field and summarize the data of available randomized controlled clinical studies conducted on the applications of aPDT in dentistry and investigate its future horizons in the dental practice. Four databases including PubMed (Medline), Web of Science, Scopus and Embase were searched up to September 2022 to retrieve related clinical studies. There are several clinical studies reporting aPDT as an effective adjunctive treatment modality capable of reducing pathogenic bacterial loads in periodontal and peri-implant, and persistent endodontic infections. Clinical evidence also reveals a therapeutic potential for aPDT in prevention and reduction of cariogenic organisms and treatment of infections with fungal or viral origins, however, the number of randomized clinical studies in these groups are much less. Altogether, various photosensitizers have been used and it is still not possible to recommend specific irradiation parameters due to heterogenicity among studies. Reaching effective clinical protocols and parameters of this treatment is difficult and requires further high quality randomized controlled trials focusing on specific PS and irradiation parameters that have shown to have clinical efficacy and are able to reduce pathogenic bacterial loads with sufficient follow-up periods.
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Affiliation(s)
- Leila Gholami
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Shiva Shahabi
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marzieh Jazaeri
- Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Hadilou
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran,*Correspondence: Reza Fekrazad,
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Knowledge, attitudes and practices of nurses regarding oral hygiene of dependent inpatients. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:22-29. [PMID: 35680116 DOI: 10.1016/j.enfcle.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/16/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Assess nurses' knowledge, attitudes and practices towards oral hygiene of dependent inpatients. METHODS Quantitative, descriptive, and cross-sectional study. Data were collected through a self-administered questionnaire applied to 100 nurses from internal medicine wards of two hospitals in Northern Portugal, which assessed three dimensions: knowledge, attitudes, and practices regarding oral hygiene. Knowledge, attitudes, and practices in oral care were summarized in statistical descriptions including percentages, frequencies, means, and standard deviations using SPSS version 23 for data analysis. RESULTS The mean total knowledge score was 13.98 out of 22 and the participants' mean score of the attitudes towards oral care was 48.35 out of 60 points. All participants acknowledge the importance of oral care for inpatients, with 96% associating poor oral hygiene with systemic disease. As for practices, 90% of participants assess the need for oral care of inpatients in the first 24 h, and 61% document the result of this assessment. CONCLUSION The results show that although participants are aware of the importance of oral care, knowledge and practices are not consistent. Concerning oral health practices, it is urgent to narrow the gap between evidence and practice and promote oral care standardization.
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Liu F, Song S, Ye X, Huang S, He J, Wang G, Hu X. Oral health-related multiple outcomes of holistic health in elderly individuals: An umbrella review of systematic reviews and meta-analyses. Front Public Health 2022; 10:1021104. [PMID: 36388333 PMCID: PMC9650948 DOI: 10.3389/fpubh.2022.1021104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/29/2022] [Indexed: 01/28/2023] Open
Abstract
Background and aims Along with an aging population, exploring the impact of oral health on holistic health and determining exact outcomes in elderly individuals are important in both scientific research and clinical practice. Significant increase in the number of systematic reviews shows that oral health can directly or indirectly affect the overall health of elderly people physically, mentally and socially. To systematically collate, appraise, and synthesize the current evidence, we carried out an umbrella review of the impacts of oral health on holistic health in elderly individuals. Methods A systematic reviews and meta-analyses search was performed in the major databases PubMed, MEDLINE, Web of Science and the Cochrane Library from inception to February 1, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The JBI (Joanna Briggs Institute) Critical Appraisal Checklist for Systematic Reviews and Research Syntheses was referred to assess methodological quality, and the GRADE (Grading of Recommendations, assessment, Development, and Evaluation working group classification) was used to assess the quality of evidence for each outcome included in the umbrella review. Results Out of 1,067 records, a total of 35 systematic reviews were included. Respiratory diseases, malnutrition, age-related oral changes, frailty, cognitive impairment, depression and poor quality of life were identified as seven key outcomes that affect the physical, mental and social health of elderly individuals. Meanwhile, three intervention measures of oral health were summarized as (i) more rigorous and universal scales, (ii) dental cleaning and denture installation, and (iii) improving self-awareness regarding oral care. Conclusions Evidence showed that oral health can significantly affect holistic health, and the diverse oral diseases directly lead to multiple health outcomes in elderly individuals. Clear high-quality evidence revealed that oral health is strongly associated with seven health outcomes covering physical, mental, and social levels, which directly corresponds to holistic health, and impacts the quality of life of elderly individuals. Such the results remind the importance of oral care in public health, and further studies need to be conducted to verity more specific association between oral health and other chronic diseases. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier: CRD42022315315.
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Affiliation(s)
- Fan Liu
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China,Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Siping Song
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Ye
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Shuqi Huang
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jing He
- West China School of Nursing, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Guan Wang
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Xiuying Hu
- Innovation Center of Nursing Research, Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Xiuying Hu
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Ogawa T, Nishio J. Evaluation of wiping edible sesame oils in the oral cavities of hospitalised older patients who resist oral hygiene management. Indian J Dent Res 2022; 33:356-362. [PMID: 37005996 DOI: 10.4103/ijdr.ijdr_410_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Context One of the causes of aspiration pneumonia is poor oral hygiene. We need care methods that caregivers can quickly, safely and inexpensively implement for convalescents with inadequate self-care. Edible sesame oil containing sesamin or sesaminol has already been shown to inhibit bacterial and fungal growth and have a vasodilating effect. Aims The aim of this study is to evaluate the usefulness of using edible sesame oils for oral hygiene management. Settings and Design This study evaluates an oral hygiene management method using two types of sesame oils in elderly hospitalised patients resistant to oral hygiene management. Methods and Material The inpatients received oral care for 90 days. In the intervention groups, nurses brushed and wiped the oral cavity with roasted sesame oil (RSO) or sesame salad oil, while in the control group, care with tap water alone and brushing were done. Bacteria and Candida counts from tongue swabs, water content from the tongue's surface and cheek mucosa, oral health assessment tool (OHAT) and cytology of the cheek mucosa were assessed every 30 days before and after the intervention. Results RSO showed a tendency to reduce the number of bacteria and Candida. There was an improvement in the OHAT scores with both oils. The water content or cytology was not changing. Conclusions Sesame oils may improve oral hygiene and maintain health in older patients.
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Affiliation(s)
- Toshiko Ogawa
- Department of Nursing Pathobiology, Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Junko Nishio
- Department of Nursing Pathobiology, Graduate School of Nursing, Chiba University, Chiba, Japan
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The Impact of 3S2E Nursing Management on the Psychological Status of Respiratory Function and Quality of Life of Patients with Severe Pneumonia in the ICU. Emerg Med Int 2022; 2022:4949498. [PMID: 36193544 PMCID: PMC9525793 DOI: 10.1155/2022/4949498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
Objective. This study examines the effects of the 3S2E nursing management mode on patients with severe pneumonia in the intensive care unit’s respiratory function, psychological status, and quality of life (ICU). Methods. According to a random number table, 82 ICU patients with severe pneumonia who were admitted between March 2021 and March 2022 were enrolled and assigned to the control and observation class (n = 41, respectively) in a 1 : 1 ratio. The observation class added 3S2E manner in addition to ordinary breastfeeding, whereas the control class received treatment in the usual nursing mode. The two groups’ preintervention and postintervention times for mechanical ventilation, white blood cell count (WBC) recovery, duration of hospital stay, problems, respiratory function, psychological state, and living quality were compared. Results. Fever time abatement, mechanical ventilation time, WBC recovery time, and length of hospital stay in the observation category were found to be shorter in comparison with the control class (
). In contrast to the other group, the observation group had fewer issues (
). Both teams’ oxygenation indices and SaO2 were higher after the intervention (
), with the observation team’s index being higher than the control group’s index. The total SAS and SDS scores of the two groups were less in the postintervention period than in the preintervention period, with the observational class having lower postintervention SAS and SDS ratings than the comparison group (
). The postintervention ratings in the observation class were higher than those in the control, and the World Health Organization Quality of Life (WHOQOL) scale scores in the 2 categories were greater after the intervention than they were before (
). Conclusion. 3S2E nursing management model improves respiratory function, alleviates negative emotions, and improves living quality in ICU patients with severe pneumonia.
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Zhang M, Lo ECM. Compare the physicochemical and biological properties of engineered polymer-functionalized silver nanoparticles against Porphyromonas gingivalis. Front Microbiol 2022; 13:985708. [PMID: 36160232 PMCID: PMC9493255 DOI: 10.3389/fmicb.2022.985708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSome polymer-functionalized AgNPs (P-AgNPs) have been developed to optimize the biological properties of AgNPs. However, there are no studies in the literature comparing the differences in physicochemical and biological properties of AgNPs caused by various polymer-functionalizations and providing evidence for the selection of polymers to optimize AgNPs.MethodsTwo AgNPs with similar nano-size and opposite surface charges were synthesized and functionalized by seven polymers. Their physicochemical properties were evaluated by UV-Visible absorption, dynamic light scattering, transmission electron microscopy and inductively coupled plasma optical emission spectroscopy. Their biological properties against Porphyromonas gingivalis and human gingival fibroblast were investigated by MIC determination, time-dependent antibacterial assay, antibiofilm activity and cell viability assay. Silver diamine fluoride, AgNO3 and metronidazole were used as positive controls.ResultsComparative analysis found that there were no significant differences between P-AgNPs and AgNPs in nano-size and in surface charge. Raman spectroscopy analysis provided evidence about the attachment of polymers on AgNPs. For antibacterial property, among the negatively charged AgNPs, only polyvinylpyrrolidone (PVP)-functionalized AgNPs-1 showed a significant lower MIC value than AgNPs-1 (0.79 vs. 4.72 μg/ml). Among the positively charged AgNPs, the MIC values of all P-AgNPs (0.34–4.37 μg/ml) were lower than that of AgNPs-2 (13.89 μg/ml), especially PVP- and Pluronic127-AgNPs-2 (1.75 and 0.34 μg/ml). For antibiofilm property, PVP-AgNPs-1 (7.86 μg/ml, P = 0.002) and all P-AgNPs-2 (3.42–31.14 μg/ml, P < 0.001) showed great antibiofilm effect against P. gingivalis biofilm at 5* to 10*MIC level. For cytotoxicity, all negatively charged AgNPs and PVP-AgNPs-2 showed no cytotoxicity at MIC level, but significant cytotoxicity was detected at 2.5* to 10*MIC levels.ConclusionAmong the polymers studied, polymer functionalization does not significantly alter the physical properties of AgNPs, but modifies their surface chemical property. These modifications, especially the functionalization of PVP, contribute to optimize the antibacterial and antibiofilm properties of AgNPs, while not causing cytotoxicity at the MIC level.
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Heague M, Dyson J, Cowdell F. Barriers and facilitators to delivering everyday personal hygiene care in residential settings: A systematic review. J Clin Nurs 2022. [PMID: 35765172 DOI: 10.1111/jocn.16413] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Globally, the population is ageing, and more people live in residential care. Best practice in personal hygiene care may reduce distressing and debilitating skin and oral problems and improve resident outcomes. Although there is guidance on personal hygiene care, implementation may be a challenge. AIM To identify barriers and facilitators to delivering personal hygiene care for older persons in residential care settings. METHODS Systematic review reported according to PRISMA 2020 guidance. Databases MEDLINE, CIHAHL and PsychINFO were systematically searched using terms and synonyms 'barriers', 'facilitators', 'hygiene', 'older adults' and 'residential care'. Only empirical studies, reporting everyday skin and oral care, in English, peer reviewed and published from 2000 to 2021 were included. Due to methodological heterogeneity, a narrative synthesis was conducted. RESULTS Sixteen papers yielded nine categories of barrier or facilitator. Five related to skin and oral care: (i) knowledge, (ii) skills relating to hygiene care, (iii) skills relating to supporting 'uncooperative' behaviours, (iv) lack of resources and (v) time, workload and staffing levels. The remainder related only to oral care: (vi) resident, family or carer motivation, (vii) dislike of hygiene care, (viii) carer attitudes and beliefs and (ix) social influences and communication. Six papers reported interventions to optimise care. CONCLUSION This review highlights the persistent dearth of research into everyday personal hygiene practices, in particular skin hygiene in residential care. Existing literature identifies a range of barriers; however, there is a mismatch between these and reported interventions to improve practice. RELEVANCE TO CLINICAL PRACTICE Advances in implementation science to support optimal care have yet to be applied to interventions to support hygiene practices in care homes and it is imperative this is addressed. Future interventions should involve: (i) systematically and theoretically assessing barriers, (ii) application of tailored behaviour change techniques (iii) using these co-design pragmatic, locally acceptable strategies.
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Andrade-Leite DB, Martins-Santos SC, Marques-Gomes SM, Oliveira IDJ. Conocimientos, actitudes y prácticas enfermeros en materia de higiene bucal de los pacientes hospitalizados dependientes. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Distribution of Yeast Species and Risk Factors of Oral Colonization after Oral-Care Education among the Residents of Nursing Homes. J Fungi (Basel) 2022; 8:jof8030310. [PMID: 35330312 PMCID: PMC8953697 DOI: 10.3390/jof8030310] [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: 02/08/2022] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023] Open
Abstract
Most yeasts causing infections in humans are part of commensal microflora and etiological agents of different infections when hosts become susceptible, usually due to becoming immunocompromised. The colonization of potentially pathogenic microbes in the oral cavity is increased by poor oral hygiene. This follow-up survey was conducted approximately two months after providing information on proper oral care at 10 nursing homes in Taiwan. Among the 117 of 165 residents colonized by yeasts, 67 were colonized by more than one yeast species. A total of 231 isolates comprising eight fungal genera and 25 species were identified. Candida albicans (44.6%) was the dominant species, followed by Candida glabrata (17.7%), Candida parapsilosis (8.7%), Candida tropicalis (7.8%), and Candida pararugosa (7.3%). Residents having a yeast colony-forming unit >10 (OR, 8.897; 95% CI 2.972−26.634; p < 0.001) or using a wheelchair (OR, 4.682; 95% CI 1.599−13.705; p = 0.005) were more likely to be colonized by multiple species. By comparing before and after oral-care education, dry mouth (OR, 3.199; 95% CI 1.448−7.068; p = 0.011) and having heart disease (OR, 2.681; 95% CI 1.068−6.732; p = 0.036) emerged as two independent risk factors for increased density of colonizing yeast.
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Incidence of Postoperative Pneumonia and Oral Microbiome for Patients with Cancer Operation. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12062920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Postoperative pneumonia is a serious problem for patients and medical staff. In Japan, many hospitals introduced perioperative oral care management for the efficient use of medical resources. However, a high percentage of postoperative pneumonia still developed. Therefore, there is a need to identify the specific respiratory pathogens to predict the incidence of pneumonia The purpose of this study was to find out the candidate of bacterial species for the postoperative pneumonia. This study applied case-control study design for the patients who had a cancer operation with or without postoperative pneumonia. A total of 10 patients undergoing a cancer operation under general anesthesia participated in this study. The day before a cancer operation, preoperative oral care management was applied. Using the next generation sequence, oral microbiome of these patients was analyzed at the time of their first visit, the day before and after a cancer operation. Porphyromonas gingivalis and Fusobacterium nucleatum group can be a high risk at first visit. Atopobium parvulum and Enterococcus faecalis before a cancer operation can be a high risk. Poor oral hygiene increased the risk of incidence of postoperative pneumonia. Increased periodontal pathogens can be a high risk of the incidence of postoperative pneumonia. In addition, increased intestinal bacteria after oral care management can also be a high risk for the incidence of postoperative pneumonia.
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Persson J, Svensson A, Lindén IG, Kylén S, Hägglin C. Aspects of Expansive Learning in the Context of Healthy Ageing-A Formative Intervention between Dental Care and Municipal Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1089. [PMID: 35162112 PMCID: PMC8834131 DOI: 10.3390/ijerph19031089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023]
Abstract
There are great risks of diseases in the ageing population, and oral diseases are no exception. Poor oral health has profound negative impacts on the quality of life. It is therefore crucial to include the oral health perspective in the care for older adults. To meet the challenges associated with oral health in the ageing population, a formative intervention was launched. The intervention, called the TAIK project (="Dental hygienist in a municipality organization", in Swedish: Tandhygienist i kommunal verksamhet), meant that six dental hygienists served non-clinically as oral health consultants in five Swedish municipal organizations. The intervention formed an infrastructure and platform for work that benefits the ageing population and created a new basis for decisions regarding oral health in homecare. The aim of this paper is to explore how aspects of collaboration in an interprofessional and interorganizational intervention may lead to expansive learning. Expansive learning forms the theoretical framework of this study. The dental hygienists and the local head nurses were interviewed individually in-depth. Reflection documents from the dental hygienists were also part of the analyzed data. The conclusion is that the formative intervention was reliant of change which created a foundation for reciprocal understanding that led to expansive learning between dental care and municipal healthcare, with resilience and empowerment as crucial factors.
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Affiliation(s)
- Jessica Persson
- Department of Health Sciences, University West, 461 86 Trollhättan, Sweden
- Centre for Gerodontology, Public Dental Service, Region Västra Götaland, 402 33 Gothenburg, Sweden; (I.G.L.); (C.H.)
| | - Ann Svensson
- School of Business, Economics and IT, University West, 461 86 Trollhättan, Sweden;
| | - Ingela Grönbeck Lindén
- Centre for Gerodontology, Public Dental Service, Region Västra Götaland, 402 33 Gothenburg, Sweden; (I.G.L.); (C.H.)
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Sven Kylén
- R&D Department, Primary Health Care, Regionhälsan, Region Västra Götaland, 462 35 Vänersborg, Sweden;
| | - Catharina Hägglin
- Centre for Gerodontology, Public Dental Service, Region Västra Götaland, 402 33 Gothenburg, Sweden; (I.G.L.); (C.H.)
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
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COVID-19 Pandemic and Periodontal Practice: The Immunological, Clinical, and Economic Points of View. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3918980. [PMID: 35047633 PMCID: PMC8763038 DOI: 10.1155/2022/3918980] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022]
Abstract
The recent global health problem, COVID-19, has had far-reaching impacts on lifestyles. Although many effective WHO-approved vaccines have been produced that have reduced the spread and severity of the disease, it appears to persist in humans for a long time and possibly forever as everyday it turns out to have new mutations. COVID-19 involves the lungs and other organs primarily through cytokine storms, which have been implicated in many other inflammatory disorders, including periodontal diseases. COVID-19 is in a close association with dental and periodontal practice from two respects: first, repeated mandatory lockdowns have reduced patient referrals to dentists and limited the dental and periodontal procedures to emergency treatments, whereas it is important to recognize the oral manifestations of COVID-19 as well as the influence of oral and periodontal disease on the severity of COVID-19. Second, dentistry is one of the high-risk professions in terms of close contact with unmasked individuals, necessitating redefining the principles of infection control. The pressures of the economic recession on patients as well as dentists add to the difficulty of resuming elective dental services. Therefore, this study is divided into two parts corresponding to what mentioned above: the first part examines the clinical and immunological associations between COVID-19 and periodontal and oral diseases, and the second part delineates the measures needed to control the disease transmission in dental clinics as well as the economic impact of the pandemic era on dental services.
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Dong J, Li W, Wang Q, Chen J, Zu Y, Zhou X, Guo Q. Relationships Between Oral Microecosystem and Respiratory Diseases. Front Mol Biosci 2022; 8:718222. [PMID: 35071321 PMCID: PMC8767498 DOI: 10.3389/fmolb.2021.718222] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/09/2021] [Indexed: 02/05/2023] Open
Abstract
Oral microecosystem is a very complicated ecosystem that is located in the mouth and comprises oral microbiome, diverse anatomic structures of oral cavity, saliva and interactions between oral microbiota and between oral microbiota and the host. More and more evidence from studies of epidemiology, microbiology and molecular biology is establishing a significant link between oral microecosystem and respiratory diseases. Microbiota settling down in oral microecosystem is known as the main source of lung microbiome and has been associated with the occurrence and development of respiratory diseases like pneumonia, chronic obstructive pulmonary disease, lung cancer, cystic fibrosis lung disease and asthma. In fact, it is not only indigenous oral microbes promote or directly cause respiratory infection and inflammation when inhaled into the lower respiratory tract, but also internal environment of oral microecosystem serves as a reservoir for opportunistic respiratory pathogens. Moreover, poor oral health and oral diseases caused by oral microecological dysbiosis (especially periodontal disease) are related with risk of multiple respiratory diseases. Here, we review the research status on the respiratory diseases related with oral microecosystem. Potential mechanisms on how respiratory pathogens colonize oral microecosystem and the role of indigenous oral microbes in pathogenesis of respiratory diseases are also summarized and analyzed. Given the importance of oral plaque control and oral health interventions in controlling or preventing respiratory infection and diseases, we also summarize the oral health management measures and attentions, not only for populations susceptible to respiratory infection like the elderly and hospitalized patients, but also for dentist or oral hygienists who undertake oral health care. In conclusion, the relationship between respiratory diseases and oral microecosystem has been established and supported by growing body of literature. However, etiological evidence on the role of oral microecosystem in the development of respiratory diseases is still insufficient. Further detailed studies focusing on specific mechanisms on how oral microecosystem participate in the pathogenesis of respiratory diseases could be helpful to prevent and treat respiratory diseases.
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Affiliation(s)
- Jiajia Dong
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qi Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiahao Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Zu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qiang Guo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Oral Assessment and Preventive Actions within the Swedish Quality Register Senior Alert: Impact on Frail Older Adults' Oral Health in a Longitudinal Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413075. [PMID: 34948684 PMCID: PMC8701784 DOI: 10.3390/ijerph182413075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 12/24/2022]
Abstract
Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide–Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011–2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was “Assistance with cleaning teeth”. Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.
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Relationship between weight loss and regular dental management of older adults residing in long-term care facilities: a 1-year multicenter longitudinal study. Eur Geriatr Med 2021; 13:221-231. [PMID: 34709606 DOI: 10.1007/s41999-021-00576-3] [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: 07/04/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aimed to determine the association between home visits by a dentist and regular oral hygiene management by a dental hygienist (regular dental management: RDM) and weight loss among older adults in long-term care facilities. METHODS A total of 468 older residents from 26 Japanese long-term care facilities participated in two surveys in 2018 and 2019. Participants were divided into two groups based on their diet during the baseline survey (regular diet, n = 256; dysphagia diet, n = 212). Participants with a regular diet were further divided into those who exhibited a weight loss ≥ 5% over 1 year (weight loss group: n = 77) and those with a weight loss < 5% (consistent weight group: n = 179). The explanatory variables were age, sex, baseline weight, Barthel index, and clinical dementia rating, as well as the patients' medical history of pneumonia, stroke, diabetes, and depression (which is reportedly associated with weight). Additionally, a Poisson regression with robust standard error, was carried out to analyze the explanatory variables, namely the prevalence of RDM noted during the study and functional teeth (which seemed to affect weight loss). RESULTS A multivariate analysis revealed that older residents' lack of RDM, clinical dementia assessment, and their history of pneumonia (prevalence rate ratio: 0.35, 95% confidence interval 0.24-0.95) were all significantly associated with weight loss when on a regular diet. CONCLUSION Thus, weight loss and RDM were related to each other. Weight loss may be suppressed by incorporating RDMs during the early nursing care for older residents on regular diets.
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Andersson M, Persenius M. Good in Providing Oral Care, but we Could be Better-Nursing Staff Identification of Improvement Areas in Oral Care. SAGE Open Nurs 2021; 7:23779608211045258. [PMID: 34632061 PMCID: PMC8495511 DOI: 10.1177/23779608211045258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/23/2019] [Indexed: 01/04/2023] Open
Abstract
Introduction Oral care to older people in short-term care units is a complex and challenging everyday practice for nursing staff. Oral care research and knowledge about prerequisites and obstacles is extensive. However, there is a lack of knowledge about how nursing staff in short-term care units describe their satisfaction about provided oral care in order to maintain older people's oral health. Objective The purpose of this study was to describe how nursing staff perceive their satisfaction of oral care provided for older people in short-term care units and to identify oral care improvements. Methods This study reports on the results of two open-ended questions that were part of a larger study. Informants (n = 54) were nursing staff working in the involved short-term care units in municipalities from both densely and sparsely populated regions in central and northern Sweden. The answers to the open-ended questions were analyzed using content analysis. Results The analysis yielded one main category; “Working together to improve satisfaction with older people's oral care” and four subcategories: “Older people's oral health,” “Consideration and respect for the older person's autonomy,” “Having access to adequate products,” and “Working together in the same direction.” Conclusion Identification of older people's oral health problems together with adequate nursing intervention will increase older people's health outcomes and quality of life. However, regardless of work role, the nursing staff might have difficulty changing their behavior or transforming intentions into actions. Oral care is a complicated and proactive practice that requires nursing staff's attention as well as both educational and organizational initiatives. Working in a supportive and collaborative relationship provides prerequisites for optimal oral care in short-term care units.
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Affiliation(s)
- Maria Andersson
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Mona Persenius
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
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Winning L, Lundy FT, Blackwood B, McAuley DF, El Karim I. Oral health care for the critically ill: a narrative review. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2021; 25:353. [PMID: 34598718 PMCID: PMC8485109 DOI: 10.1186/s13054-021-03765-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/11/2021] [Indexed: 12/13/2022]
Abstract
Background The link between oral bacteria and respiratory infections is well documented. Dental plaque has the potential to be colonized by respiratory pathogens and this, together with microaspiration of oral bacteria, can lead to pneumonia particularly in the elderly and critically ill. The provision of adequate oral care is therefore essential for the maintenance of good oral health and the prevention of respiratory complications. Main body Numerous oral
care practices are utilised for intubated patients, with a clear lack of consensus on the best approach for oral care. This narrative review aims to explore the oral-lung connection and discuss in detail current oral care practices to identify shortcomings and offer suggestions for future research. The importance of adequate oral care has been recognised in guideline interventions for the prevention of pneumonia, but practices differ and controversy exists particularly regarding the use of chlorhexidine. The oral health assessment is also an important but often overlooked element of oral care that needs to be considered. Oral care plans should ideally be implemented on the basis of an individual oral health assessment. An oral health assessment prior to provision of oral care should identify patient needs and facilitate targeted oral care interventions. Conclusion Oral health is an important consideration in the management of the critically ill. Studies have suggested benefit in the reduction of respiratory complication such as Ventilator Associated Pneumonia associated with effective oral health care practices. However, at present there is no consensus as to the best way of providing optimal oral health care in the critically ill. Further research is needed to standardise oral health assessment and care practices to enable development of evidenced based personalised oral care for the critically ill.
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Affiliation(s)
- Lewis Winning
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Fionnuala T Lundy
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
| | - Bronagh Blackwood
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
| | - Daniel F McAuley
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
| | - Ikhlas El Karim
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK.
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Jun MK, Ku JK, Kim IH, Park SY, Hong J, Kim JY, Lee JK. Hospital Dentistry for Intensive Care Unit Patients: A Comprehensive Review. J Clin Med 2021; 10:jcm10163681. [PMID: 34441976 PMCID: PMC8397125 DOI: 10.3390/jcm10163681] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/31/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to review the oral hygiene status, oral care guidelines, and outcomes of oral care in intensive care unit (ICU) patients from a dental perspective for effective oral care. A literature search using the keywords "Hospital dentistry" OR "Oral care" OR "Intensive care unit" OR "Hospital inpatient" OR "Hospitalization" OR "Emergency service" AND "Oral health" OR "Oral hygiene" OR "Dental plaque" was conducted in PubMed, Medline, and Google Scholar to identify publications reporting on the oral care of the patients admitted to ICUs. A total of 17,400 articles were initially identified. Of these, 58 were selected and classified into three categories for critical review. Seven of these studies evaluated the oral status of ICU patients, and most of the studies indicated that ICU patients had poor oral hygiene or required active dental treatment. Thirty-three of these studies evaluated oral care methods for ICU patients, and in general, oral care methods using chlorhexidine as adjuncts along with tooth brushing were recommended. However, there were insufficient studies to evaluate oral hygiene through effective assessment tools from a dental perspective. In 36 studies on the outcomes of oral care in ICU patients, interventions by dental professionals showed effective results in preventing hospital-acquired infection. This review highlights the importance of establishing guidelines for the evaluation of oral status in ICU patients and summarizes data that may be useful for future studies. Further studies on maintaining good oral hygiene among ICU patients are needed.
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Affiliation(s)
- Mi-Kyoung Jun
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, Suwon 16499, Korea;
| | - Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul 06273, Korea; (J.-K.K.); (J.-Y.K.)
| | - Il-hyung Kim
- Department of Oral and Maxillofacial Surgery, Armed Forces Capital Dental Hospital, Armed Forces Medical Command, Seongnam 13574, Korea; (I.-h.K.); (S.-Y.P.)
| | - Sang-Yoon Park
- Department of Oral and Maxillofacial Surgery, Armed Forces Capital Dental Hospital, Armed Forces Medical Command, Seongnam 13574, Korea; (I.-h.K.); (S.-Y.P.)
| | - Jinson Hong
- Department of Prosthodontics, Armed Forces Capital Dental Hospital, Armed Forces Medical Command, Seongnam 13574, Korea;
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul 06273, Korea; (J.-K.K.); (J.-Y.K.)
| | - Jeong-Keun Lee
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, Suwon 16499, Korea;
- Correspondence: ; Tel.: +82-31-219-5333; Fax: +82-31-219-5329
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Pathak JL, Yan Y, Zhang Q, Wang L, Ge L. The role of oral microbiome in respiratory health and diseases. Respir Med 2021; 185:106475. [PMID: 34049183 DOI: 10.1016/j.rmed.2021.106475] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 12/16/2022]
Abstract
The oral cavity (mouth) has various microbial habitats, including, teeth, gingival sulcus, gingiva, tongue, inner cheek, hard palate, and soft palate. The human oral cavity houses the second most diverse microbiome in the body harboring over 700 bacterial species. The fine-tuned equilibrium of the oral microbiome ecosystem maintains oral health. Oral dysbiosis caused by food habits and poor oral hygiene leads to various oral diseases such as periodontitis, caries, gingivitis, and oral cancer. Recent advances in technology have revealed the correlation between the oral microbiome and systemic diseases such as pulmonary diseases, cardiovascular diseases, rheumatoid arthritis, Alzheimer's disease, and other metabolic diseases. Since the oral cavity directly connects with the upper respiratory tract, the oral microbiome has easier access to the respiratory system compared to other organ systems. Direct aspiration of oral microflora in the respiratory system and oral dysbiosis-induced host immune reaction and inflammation are mainly responsible for various pulmonary complications. Numbers of literature have reported the correlation between oral diseases and pulmonary diseases, suggesting the possible role of the oral microbiome in respiratory diseases such as chronic obstructive pulmonary diseases, pneumonia, lung cancer, etc. This paper reviews the current evidence in establishing a link between the oral microbiome and pulmonary diseases. We also discuss future research directions focusing on the oral microbiome to unravel novel therapeutic approaches that could prevent or treat the various pulmonary complications.
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Affiliation(s)
- Janak L Pathak
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Yongyong Yan
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Qingbin Zhang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Liping Wang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China.
| | - Linhu Ge
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China.
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