Oral health and cardiovascular disease risk factors and mortality of cerebral haemorrhage, cerebral infarction and unspecified stroke in elderly men: A prospective cohort study

Oral anaerobe bacteria-a common risk for cardiovascular disease and mortality and some forms of cancer?

This review explores the results of research on oral health concerning cardiovascular diseases and some forms of cancer and is based on results from published systematic reviews and some studies. The research results will have a strong focus on exploring the relationship between different aspects of oral infections. The relationship between oral health parameters, cardiovascular diseases (CVD), and certain cancers was examined from different angles, including prospective analyses, in a population-based health study in Oslo from the year 2000 (Oslo II study). A major finding was that low levels of antibodies to the oral anaerobe Tannerella forsythia predict both CVD mortality in men with a history of myocardial infarction and incidence of bladder cancer in a random sample of men in the study. Low levels of antibodies to Treponea denticola predict the incidence of bladder and colon cancer in a random sample of men in the study. Both anaerobe bacteria are part of the so-called red complex of bacteria in chronic periodontitis together with Pophyromonas gingivalis. These three bacteria have different properties and are causal in chronic periodontitis. They migrate into the local tissues by adhering to the oral epithelium, break down soft and hard tissues, and spread via the circulation to organs distant from the mouth. This paper will give an overview of which oral health measures have been explored and associated with different CVD and cancer diagnoses and what scientific literature supports or contravenes our hypothesis. The oral microbiome is described with the most relevant bacteria related to microbiology, serum, autopsies, and associated causes such as alcohol. There will be a mention of the possibilities and limitations of different study designs. There seems to be a causal relationship between oral anaerobe bacteria and systemic diseases regulated by the immune system. This is seen alongside other well-known risk factors, especially for CVD. The prospective finding of a relation to the incidence of certain cancers and CVD is particularly intriguing. However, further research is needed to determine the biological mechanisms underpinning these associations.

Oral Health Clearance Outcomes for Cardiovascular Surgery

Objective

To determine the risk of morbidity and mortality in patients receiving dental extractions before planned cardiovascular surgery (CVS) and examine factors that may affect the chance of oral health clearance.

Patients and Methods

A retrospective medical record review was performed of patients who underwent dental screening before CVS from January 1, 2015, to December 31, 2021, at a major medical institution. A total of 496 patients met the inclusion criteria and were divided into 2 groups. Group 1 patients were cleared to advance to planned CVS (n=390). Group 2 patients were not cleared for surgery and subsequently underwent dental extractions before planned CVS (n=106).

Results

Six patients (5.7%) experienced postoperative complications after dental extraction that resulted in an emergency room visit. No deaths occurred after dental extraction before CVS. However, 4 patients died within 30 days of CVS, 3 from Group 1 (0.77%) and 1 from Group 2 (0.94%). Dental extraction before planned CVS showed a borderline significant association with death based on unadjusted (P=.06) and age-adjusted analysis (P=.05). Patients who reported seeing a dentist routinely had a significantly higher chance of oral health clearance (P <.001). No differences were noted between the 2 groups with regard to age, sex, or 30-day hospital readmission rate.

Conclusion

Patients who had dental extractions completed before planned CVS may be at an increased risk of mortality. Further studies are needed to examine this relationship. Emphasis should be on prioritization of routine dental visits before planned CVS.

Analysis on application effect and prognostic factors of medical care combined with nursing in the elderly with T2DM and Cerebral Infarction based on targeted management mode

To explore the analysis on application effect and prognostic factors of medical care combined with nursing in the elderly with type 2 diabetes mellitus (T2DM) and cerebral infraction (CI) based on targeted management mode. The clinical data of 180 elderly patients with T2DM and CI in our hospital from August 2017 to August 2019 were selected for retrospective analysis. Their cognitive function and daily living ability before and after intervention were evaluated, using the National Institutes of Health Stroke Scale (NIHSS) to evaluate their prognosis. They were divided into good prognosis group (n = 134) and poor prognosis group (n = 46) according to the score. Binary Logistic regression analysis was adopted to analyze the prognostic factors of such patients. After intervention, patients had visibly lower indexes of blood glucose fluctuation and lower average scores of ADL and MMSE (P < 0.001), with differences in body mass index, systolic pressure, diastolic pressure, fasting blood glucose and triglyceride in both groups (P < 0.001). Binary Logistic regression analysis showed that systolic pressure, diastolic pressure and triglyceride were risk factors affecting patients' prognosis (P < 0.05). Medical care combined with nursing based on targeted management mode has a remarkable control effect on blood glucose, and has a positive effect on improving cognitive function and living ability of elderly patients with T2DM and CI. In addition, attention should be paid to monitoring systolic and diastolic blood pressures, and triglyceride in patients to improve the prognosis.

The blood microbiome and its association to cardiovascular disease mortality: case-cohort study

Background

Little is known about the association between bacterial DNA in human blood and the risk of cardiovascular disease (CVD) mortality.

Methods

A case-cohort study was performed based on a 9 ½ year follow-up of the Oslo II study from 2000. Eligible for this analysis were men born in 1923 and from 1926 to 1932. The cases were men (n = 227) who had died from CVD, and the controls were randomly selected participants from the same cohort (n = 178). Analysis of the bacterial microbiome was performed on stored frozen blood samples for both cases and controls. Association analyses for CVD mortality were performed by Cox proportional hazard regression adapted to the case-cohort design. We used the Bonferroni correction due to the many bacterial genera that were identified.

Results

Bacterial DNA was identified in 372 (82%) of the blood samples and included 78 bacterial genera from six phyla. Three genera were significantly associated with CVD mortality. The genera Kocuria (adjusted hazard ratio (HR) 8.50, 95% confidence interval (CI) (4.05, 17.84)) and Enhydrobacter (HR 3.30 (2.01, 5.57)) indicate an association with CVD mortality with increasing levels. The genera Paracoccus (HR 0.29 (0.15, 0.57)) was inversely related. Significant predictors of CVD mortality were: the feeling of bad health; and the consumption of more than three cups of coffee per day. The following registered factors were borderline significant, namely: a history of heart failure; increased systolic blood pressure; and currently taking antihypertensive drugs now, versus previously.

Conclusions

The increasing levels of two bacterial genera Kocuria (skin and oral) and Enhydrobacter (skin) and low levels of Paracoccus (soil) were associated with CVD mortality independent of known risk factors for CVD.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12872-022-02791-7.

Mortality-and Health-Related Factors in a Community-Dwelling of Oldest-Older Adults at the Age of 90: A 10-Year Follow-Up Study

Mortality is obviously intended for epidemiological studies of community-dwelling older adults. There are several health-related factors associated with nutritional status and mortality. The aim of this study was to elucidate the risk factor for mortality in community-dwelling oldest-older adults at the age of 90 and clarify the structure of health-related factors associated with mortality. A 10-year follow-up study was performed for 93 subjects at the age of 90. The mean and median of their survival days were 2373 and 2581 days for women, and 1694 and 1793 days for men. By Cox's proportional hazards model, health-related factors associated with mortality were self-assessed for chewing ability, activities of daily living (ADLs), serum albumin, total cholesterol, serum creatinine, and gripping power for women but not for men. These factors interacted with each other, and the association of these factors was different in women and men. Self-assessed chewing ability was a powerful risk factor for mortality in women at the age of 90. It acted independently from nutritional status. For older adults, addressing healthy food choices together with improved oral functions is useful. However, risk factors for mortality may depend on the life stage of subjects. To investigate the risk factor for the mortality, the life course approach is necessary.