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Brigg N, Patterson S, Pradhan A. Enabling people with severe mental illness to overcome barriers to access dental treatment: a qualitative study applying COM-B framework analysis. J Ment Health 2022; 31:765-773. [PMID: 32780601 DOI: 10.1080/09638237.2020.1803230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The oral health of people with severe mental illness is severely compromised. Rates of premature total tooth loss and tooth decay are substantially higher than in the general population. Causation is complex, restricted access to treatment a major contributing factor. AIMS To examine factors enabling people with complex problems related to severe mental illness to attend scheduled dental appointments. METHOD Qualitative semi-structured interviews were conducted with 15 service users who attended no-cost treatment at a university clinic, following oral health screening at an inner-city community mental health service. Analysis used a framework approach informed by a theoretical model of behaviour (COM-B). RESULTS Complex individual motivations, related variously to function, pain and/or self or social appraisal, were also influenced by expectations of treatment. Capabilities included managing "messy" life circumstances; participants overcame various psychological and physical challenges to attend treatment, enabled by opportunities of social and instrumental support. CONCLUSIONS Genuine partnerships between agencies to provide access opportunities, in addition to individual support responsive to personal motivators and adapted to capabilities can enable access to services and improve the lives of people with severe mental illness.
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Affiliation(s)
- Nicole Brigg
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
| | - Sue Patterson
- Metro North Mental Health, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia.,School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Archana Pradhan
- School of Dentistry, The University of Queensland, Brisbane, Australia.,Metro North Oral Health Service, Brisbane, Australia
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Costa C, Santiago H, Pereira S, Castro AR, Soares SC. Oral Health Status and Multiple Sclerosis: Classic and Non-Classic Manifestations—Case Report. Diseases 2022; 10:diseases10030062. [PMID: 36135218 PMCID: PMC9498041 DOI: 10.3390/diseases10030062] [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: 07/29/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Multiple sclerosis is an autoimmune disease of the central nervous system with neurological and motor symptoms that affect the orofacial region. The aim of this work is to present a patient that lacks the three classic orofacial manifestations but has other less common clinical alterations. Case presentation: A 49-year-old female patient diagnosed with long-term relapsing–remitting multiple sclerosis visited the dentist complaining of mild but persistent orofacial pain including the temporomandibular joint and pain not specific to any tooth. She presented mucosal irritation, xerostomia, halitosis, and localized gingivitis. There was excessive wear of the upper and lower incisal edges and the occlusal faces of the upper canines and loss of six teeth due to caries. After a clinical oral examination, the diagnosis was temporomandibular joint disorder, gingivitis, dental hypersensitivity, bruxism, hyposalivation, xerostomia, and halitosis. Conclusions: Patients with multiple sclerosis present classic orofacial manifestations. Although these were not observed in this patient, she had others, such as gingivitis, tooth hypersensitivity, and bruxism. In addition, despite few studies associating a higher prevalence of caries with these patients, the number of carious and missing teeth in this patient highlight the evidence that multiple sclerosis has had a significant impact on the patient’s dental status over the years.
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Affiliation(s)
- Céu Costa
- Escola Superior da Saúde, Universidade Fernando Pessoa, 4200-253 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal
- Grupo de Patologia Experimental e Terapêutica, Centro de Investigação, Instituto Português de Oncologia do Porto, 4200-072 Porto, Portugal
- Correspondence:
| | - Hugo Santiago
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
| | - Sofia Pereira
- Escola Superior da Saúde, Universidade Fernando Pessoa, 4200-253 Porto, Portugal
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal
- Grupo de Patologia Experimental e Terapêutica, Centro de Investigação, Instituto Português de Oncologia do Porto, 4200-072 Porto, Portugal
| | - Ana Rita Castro
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
| | - Sandra Clara Soares
- Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-I3ID (FP-BHS), 4249-004 Porto, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
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Cognitive function and oral health in relapsing-remitting multiple sclerosis. Clin Oral Investig 2021; 26:2899-2907. [PMID: 34773142 DOI: 10.1007/s00784-021-04272-1] [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: 08/11/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Multiple sclerosis (MS) is often associated with reduced cognitive function, and there is also emerging evidence of a heightened vulnerability to oral health problems. However, although links between cognitive function and oral health have been identified in other special populations, it remains to be established whether this relationship is also evident for people with MS. The aim of this study was to provide the first empirical test of whether there is a relationship between cognitive function and oral health in people diagnosed with relapsing-remitting multiple sclerosis (RRMS). METHODS One hundred and eleven individuals were evaluated: 56 people diagnosed with RRMS and 55 demographically matched healthy controls. All participants completed an objective oral health assessment as well as a standardized battery that assessed six distinct neurocognitive domains. RESULTS Relative to controls, people with RRMS presented with higher rates of decayed teeth and mild gingivitis, and also performed more poorly in three of the six neurocognitive domains assessed (language, complex attention, and executive function). However, for the RRMS group, no associations emerged between oral health with performance on any of the six neurocognitive domains. CONCLUSIONS These data cross-validate previous research which shows people with RRMS are more likely to present with both reduced cognitive function and poorer oral health, but also extends this literature in a meaningful way by additionally showing for the first time that these clinical features are unrelated in RRMS. CLINICAL RELEVANCE The findings emphasize the need for early assessment of both oral health and cognitive function in people with RRMS so that appropriate interventions and support can be put in place for each of these clinical symptoms.
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He Q, Shen J, Guan X, Han Y, Jiang X, Shen X, Huang X, Chen Y, Lei C, Xiao X, Lin W. A Zr‐Based MOF with N‐heterocycle and its pH‐controlled drug release behavior. Z Anorg Allg Chem 2021. [DOI: 10.1002/zaac.202100248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Qing He
- Key Laboratory of Air-driven Equipment Technology of Zhejiang Quzhou University Quzhou 324000 P. R. China E-mail: address:
| | - Jie Shen
- Department of Gynecology the First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310006 P. R. China
| | - Xinghua Guan
- Quzhou Xianfeng Advanced Materials Co., Ltd Quzhou 324021 P. R. China
| | - Yuanbo Han
- Key Laboratory of Air-driven Equipment Technology of Zhejiang Quzhou University Quzhou 324000 P. R. China E-mail: address:
| | - Xiaoying Jiang
- Key Laboratory of Air-driven Equipment Technology of Zhejiang Quzhou University Quzhou 324000 P. R. China E-mail: address:
| | - Xiaoan Shen
- Key Laboratory of Air-driven Equipment Technology of Zhejiang Quzhou University Quzhou 324000 P. R. China E-mail: address:
| | - Xiajuan Huang
- School of Materials Science and Engineering Zhejiang Sci-Tech University Hangzhou 310018 P. R. China
| | - Yufeng Chen
- School of Materials Science and Engineering Zhejiang Sci-Tech University Hangzhou 310018 P. R. China
| | - Chen Lei
- School of Materials Science and Engineering Zhejiang Sci-Tech University Hangzhou 310018 P. R. China
| | - Xiaoyan Xiao
- State Key Laboratory of Silicon Materials School of Materials Science & Engineering Zhejiang University Hangzhou 310027 P. R. China
| | - Wenxin Lin
- School of Materials Science and Engineering Zhejiang Sci-Tech University Hangzhou 310018 P. R. China
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Interventions for Nursing Home Residents with Dysphagia-A Scoping Review. Geriatrics (Basel) 2021; 6:geriatrics6020055. [PMID: 34064095 PMCID: PMC8162353 DOI: 10.3390/geriatrics6020055] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 11/16/2022] Open
Abstract
Oropharyngeal dysphagia is common in nursing home residents. The objective of this scoping review was to summarize and disseminate the findings from the literature on interventions for dysphagia in nursing home residents. Searches were conducted in four databases. The criteria for including the studies were nursing home residents, dysphagia, interventions, original research, published in English, Danish, Norwegian, or Swedish with no restriction placed regarding publication date. Excluded were literature reviews, editorial comments, conference abstracts, protocols, papers not available in full text, and studies with a mixed population, for example, geriatric patients and nursing home residents and where the results were not separated between the groups. A total of 14 papers were included and analyzed. The included papers represented interventions focusing on feeding intervention, oral hygiene, caregiver algorithm, stimulation (taste and smell), teaching the residents what to eat, mobilization of the spine, exercises/training, and positioning. This scoping review identifies sparse knowledge about interventions affecting nursing home residents' dysphagia. But the results indicate that multi-component interventions, including staff training, training of residents, and/or next of kin, might be successful. This scoping review clarifies that there is a need for well-designed studies that uncover which specific interventions have an effect in relation to nursing home residents with dysphagia and can serve as a guide for designing multi-component person-centered intervention studies. Future studies should implement high evidence study designs, define the measures of dysphagia, and quantify the severity of dysphagia, its underlying diseases, and comorbidities.
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de Carvalho HN, Dos Santos YL, Bernardino ÍDM, de Lima KC, Granville-Garcia AF, Melo de Brito Costa EM. Accuracy of a questionnaire on xerostomia as a screening tool for hyposalivation. Int Dent J 2020; 70:427-434. [PMID: 32830311 DOI: 10.1111/idj.12586] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Determine the accuracy of a questionnaire on xerostomia as a screening tool for hyposalivation. METHODS A total of 402 adults awaiting dental care at a public healthcare service answered an eight-item questionnaire addressing xerostomia and were submitted to stimulated sialometry, with ≤ 0.7 mL/min considered indicative of hyposalivation. Reproducibility and internal consistency of the questionnaire were evaluated. The correlation between the score and salivary flow was investigated. The total score was also compared between groups with and without hyposalivation and diagnostic precision measures were calculated. RESULTS Hyposalivation was identified in 162 participants (40.3%) and a total of 229 (57.0%) answered affirmatively to at least one question. The responses to each question revealed variable reproducibility (κ = 0.450-0.785) and satisfactory internal consistency (Cronbach's α = 0.70). Individuals with a larger number of positive answers had lower salivary flow (Spearman's ρ = -0.193; P < 0.001). The mean number of positive answers was greater in the group with a clinical diagnosis of hyposalivation compared to those without low salivary flow. The sensitivity of the screening tool was 64.8%, with an area under the ROC curve of 0.60 (95% confidence interval: 0.547-0.645; P < 0.001). CONCLUSION The questionnaire proved to be useful for the epidemiological screening of individuals with possible hyposalivation.
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Affiliation(s)
- Handerson Nunes de Carvalho
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia, Universidade Estadual da Paraíba (UEPB), Campina Grande, PB, Brazil
| | - Yuri Lins Dos Santos
- Graduação em Odontologia, Departamento de Odontologia, Universidade Estadual da Paraíba (UEPB), Campina Grande, PB, Brazil
| | - Ítalo de Macedo Bernardino
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia, Universidade Estadual da Paraíba (UEPB), Campina Grande, PB, Brazil
| | - Kênio Costa de Lima
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Ana Flávia Granville-Garcia
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia, Universidade Estadual da Paraíba (UEPB), Campina Grande, PB, Brazil
| | - Edja Maria Melo de Brito Costa
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia, Universidade Estadual da Paraíba (UEPB), Campina Grande, PB, Brazil
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Teoh L, Stewart K, Moses G. Where are oral and dental adverse drug effects in product information? INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2020; 28:591-598. [PMID: 32614498 DOI: 10.1111/ijpp.12650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Oral adverse drug reactions are common and are associated with some of our most frequently used medicines. It is important to identify and manage oral adverse drug effects promptly as they not only negatively impact dental health, but also adversely affect medication adherence, clinical outcomes and patient quality of life. This study assessed the location of oral drug-induced adverse effects in the registered drug company product information (PI) of the top 100 most commonly used drugs in Australia as dispensed on the Pharmaceutical Benefits Scheme in 2018. METHOD Publicly available data on dispensed medicines were accessed from the Australian Commonwealth Department of Health, to determine the top 100 medicines. The drug company PI for each of these drugs was manually searched to find their oral adverse effects. The number, type and location of the oral adverse drug reactions (ADRs) were recorded. KEY FINDINGS Oral ADRs were commonly found varying in nature and severity. However, they were difficult to find as there is no dedicated section for oral/dental adverse effects in the PI and the section they are in is inconsistently applied. CONCLUSIONS We recommend that regulatory authorities such as the Therapeutic Goods Administration in Australia create an additional section for oral/dental adverse effects so they are easier to find, which may assist health professionals detect recognise and report adverse drug effects manifesting in the oral cavity.
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Affiliation(s)
- Leanne Teoh
- Melbourne Dental School, University of Melbourne, Carlton, Vic., Australia
| | - Kay Stewart
- Centre for Medicine Use and Safety, Monash University, Parkville, Vic., Australia
| | - Geraldine Moses
- School of Pharmacy, University of Queensland, Brisbane, Qld, Australia
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Covello F, Ruoppolo G, Carissimo C, Zumbo G, Ferrara C, Polimeni A, Vozza I. Multiple Sclerosis: Impact on Oral Hygiene, Dysphagia, and Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3979. [PMID: 32512730 PMCID: PMC7312593 DOI: 10.3390/ijerph17113979] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 01/19/2023]
Abstract
Multiple sclerosis (MS) is an autoimmune disease in which the immune system reacts by damaging the central nervous system, specifically myelin and oligodendrocytes. It is the most debilitating neurological disease among young adults, causing personal, familiar, social, and professional limitations. Multiple sclerosis can cause disturbances in the orofacial district, due to a demyelination process on the nerves of the head and neck district. The aim of this study was to evaluate the oral health status, dysphagia, and quality of life of patients affected by MS. For this study, 101 patients aged between 12 and 70 (47 males, 54 females) affected by MS were selected, and three questionnaires were handed out and anonymously filled in by them: An oral hygiene test, DYMUS (DYsphagia in MUltiple Sclerosis), and IOHIP-14 (Italian version Oral Health Impact Profile). Through the analysis of the questionnaires it was possible to observe pathological conditions, such as gingival inflammation, xerostomia, dysphagia, neuralgia, and dysarthria. Through the analysis it was possible to outline how the roles of a medical team, composed of a dentist, otolaryngologist, and dental hygienist, are fundamental in coping with other medical figures, during the whole development of the diseases, as well as to prevent possible complications.
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Affiliation(s)
- Francesco Covello
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| | - Giovanni Ruoppolo
- Sensorial Organs Department, Sapienza University of Rome, 00185 Rome, Italy;
| | - Camilla Carissimo
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| | - Giulia Zumbo
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| | - Carla Ferrara
- Public Health and Infectious Diseases Department, Section Health Statistics, Sapienza University of Rome, 00185 Rome, Italy;
| | - Antonella Polimeni
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
| | - Iole Vozza
- Oral and Maxillo-Facial Sciences Department, Sapienza University of Rome, 00185 Rome, Italy; (F.C.); (C.C.); (A.P.); (I.V.)
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Manchery N, Henry JD, Nangle MR. A systematic review of oral health in people with multiple sclerosis. Community Dent Oral Epidemiol 2019; 48:89-100. [PMID: 31815299 DOI: 10.1111/cdoe.12512] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/24/2019] [Accepted: 11/18/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Despite more than 25 years of research focused on this topic, it remains unclear whether people with multiple sclerosis are more likely to present with oral health problems. The aim of this study was to provide the first systematic review of this literature. METHODS A literature search for studies focused on oral health and multiple sclerosis was conducted using PRISMA guidelines. Electronic databases (PubMed, Scopus, Web of Science, MEDLINE and CINAHL) were searched up until February 2019. Two independent coders extracted data, and study quality graded using the Newcastle-Ottawa Scale (NOS). RESULTS From 1281 articles identified, 17 met all the eligibility criteria. Of the seventeen studies, more than half included a nonclinical control group, and the majority were observational studies. The included studies were of poor to moderate quality. Taken together, the results provided only very limited evidence that people with multiple sclerosis are more likely to present with dental caries and gingival disease. There was suggestive evidence that people with multiple sclerosis may be at higher risk of periodontal disease and present with poorer oral hygiene, and moderate evidence for an association between multiple sclerosis and temporomandibular disorders. CONCLUSIONS This systematic review provides evidence of an association between multiple sclerosis and at least some oral health problems. When temporomandibular disorders and periodontal status specifically have been assessed, most studies provide evidence of an association with multiple sclerosis. However, this review also clearly highlights the need for further, high-quality studies in this area.
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Affiliation(s)
- Nithin Manchery
- School of Dentistry, The University of Queensland, Brisbane, Qld, Australia
| | - Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, Qld, Australia
| | - Matthew R Nangle
- School of Dentistry, The University of Queensland, Brisbane, Qld, Australia
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Safari H, Anani Sarab G, Naseri M. Artemisia dracunculus L . modulates the immune system in a multiple sclerosis mouse model. Nutr Neurosci 2019; 24:843-849. [PMID: 31665978 DOI: 10.1080/1028415x.2019.1681742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Multiple sclerosis along with its animal model, experimental autoimmune encephalomyelitis (EAE), are chronic inflammatory and degenerative diseases of the central nervous system (CNS). Due to the unknown cause of the disease, the most common treatments of MS are targeted for the reduction of inflammation and the repairment of CNS tissue damage, especially myelin restoration. Due to the immune protective nature of herbs, it may be useful to evaluate the impact of herbs in the diet regimen of MS patients along with their immune-mediated effects. The purpose of this study was to investigate the effect of an aqueous extract of Artemisia dracunculus (Tarragon) on the treatment of EAE in C57BL/6 mice.Methods: In this experimental study, mice were divided into the following control, untreated EAE, and A. dracunculus treated EAE groups. EAE was induced by myelin oligodendrocyte glycoprotein (MOG35-55) in female C57BL/6 mice. The symptoms of the disease and the weight of the mice were recorded daily. On day 33 after EAE induction, the mice were sacrificed and the specimens were collected. Cell proliferation and cytokine release (TGF-β, IL-17 and IL-23) from mice cultured spleen cells was measured by 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) and ELISA respectively.Results: Administration of the extract of A. dracunculus mitigated EAE symptoms (P < 0.05). Furthermore, there was a reduction in the levels of inflammatory cytokines including IL-17 (P = 0.009) and IL-23 (P = 0.012) and confirmed increased serum antioxidant levels in A. dracunculus treated EAE mice (P = 0.008).Conclusions: These observations indicate that A. dracunculus extracts could reduce inflammatory cytokines and attenuate certain signs of EAE, suggesting the potential of a useful adjuvant therapy for MS.
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Affiliation(s)
- Hamidreza Safari
- Department of Immunology, Birjand University of Medical Sciences, Birjand, Iran
| | - Gholamreza Anani Sarab
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohsen Naseri
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Christogianni A, Bibb R, Davis SL, Jay O, Barnett M, Evangelou N, Filingeri D. Temperature sensitivity in multiple sclerosis: An overview of its impact on sensory and cognitive symptoms. Temperature (Austin) 2018; 5:208-223. [PMID: 30377640 DOI: 10.1080/23328940.2018.1475831] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/07/2018] [Indexed: 10/28/2022] Open
Abstract
Multiple sclerosis (MS) is an autoimmune neurodegenerative disease characterized by demyelination of the central nervous system (CNS). The exact cause of MS is still unknown; yet its incidence and prevalence rates are growing worldwide, making MS a significant public health challenge. The heterogeneous distribution of demyelination within and between MS patients translates in a complex and varied array of autonomic, motor, sensory and cognitive symptoms. Yet a unique aspect of MS is the highly prevalent (60-80%) temperature sensitivity of its sufferers, where neurological symptoms are temporarily exacerbated by environmental- or exercise-induced increases (or decreases) in body temperature. MS temperature sensitivity is primarily driven by temperature-dependent slowing or blocking of neural conduction within the CNS due to changes in internal (core) temperature; yet changes in skin temperature could also contribute to symptom exacerbation (e.g. during sunlight and warm ambient exposure). The impact of temperature sensitivity, and particularly of increases in core temperature, on autonomic (e.g. thermoregulatory/cardiovascular function) and motor symptoms (e.g. fatigue) is well described. However, less attention has been given to how increases (and decreases) in core and skin temperature affect sensory and cognitive symptoms. Furthermore, it remains uncertain whether changes in skin temperature alone could also trigger worsening of symptoms. Here we review the impact of temperature sensitivity on MS sensory and cognitive function and discuss additional factors (e.g. changes in skin temperature) that potentially contribute to temperature-induced worsening of symptoms in the absence of alteration in core temperature.
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Affiliation(s)
- Aikaterini Christogianni
- THERMOSENSELAB, Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
| | - Richard Bibb
- Loughborough Design School, Loughborough University, Loughborough, UK
| | - Scott L Davis
- Department of Applied Physiology & Wellness, Southern Methodist University, Dallas, TX, USA
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
| | - Michael Barnett
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Nikos Evangelou
- Queens Medical Centre, University of Nottingham, Nottingham, UK
| | - Davide Filingeri
- THERMOSENSELAB, Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
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Gonçalves MLL, Kalil Bussadori S, Dadalti Fragoso Y, da Silva VVB, Melo Deana A, da Mota ACC, Horácio Pinto E, Horliana ACR, Miranda França C. Effect of photodynamic therapy in the reduction of halitosis in patients with multiple sclerosis: clinical trial. J Breath Res 2017; 11:046006. [PMID: 28742057 DOI: 10.1088/1752-7163/aa8209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Smell and odours play a vital role in social interaction. Halitosis is a social problem that affects one third of the population, causing a negative impact on the quality of life. There is little knowledge on the prevalence and management of halitosis in multiple sclerosis (MS) patients. The present study aims to evaluate the presence of halitosis in patients with MS when compared to a control group, and also evaluate treatment of the problem with antimicrobial photodynamic therapy (aPDT). This is a case-control clinical study in which 60 patients were evaluated: 30 MS patients in treatment at the Specialties Clinic School of Medicine, and 30 healthy patients, matched in age and gender for the control group. Data was collected on the duration of the disease as well as the degree of disability and medication use in the MS group. For all patients, halitosis was assessed with Oral Chroma™. Individuals with halitosis underwent treatment with tongue scraping and aPDT. The photosensitizer was methylene blue (0.005%) and a THERAPY XT-EC® laser (660 nm, 9 J, 100 mW for 90 s per point, 320 J cm-2, 3537 mW cm-2) was used. Six points 1 cm apart from each other were irradiated in the tongue dorsum. There was a positive correlation between the disability and disease duration. No parameter was correlated with halitosis. Patients with MS have higher levels of SH2 compounds when compared to the control group (p = 0.003, Mann-Whitney), but after aPDT both groups significantly reduced the levels to under the halitosis threshold. The aPDT scraping treatment was effective in the immediate reduction of halitosis in both groups.
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Affiliation(s)
- Marcela Leticia Leal Gonçalves
- Postgraduate Program on Biophotonics Applied to Health Sciences, Nove de Julho University, Vergueiro Street, 235/249, Liberdade, ZIP 01504-001, São Paulo, SP, Brazil
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