Dental treatment procedures for periodontal disease and the subsequent risk of ischaemic stroke: A retrospective population-based cohort study.

AIM: To investigate the association between specific dental therapy for periodontal disease and the risk of ischaemic stroke. MATERIALS AND METHODS: We conducted a population-based cohort study that used data from the Taiwan National Health Insurance Research Database 2005 for the period of 2000-2013. Our observations focused on patients with the diagnoses of gingivitis or periodontitis with and without specific treatment and subsequent incidence of ischaemic stroke. Dental care services include dental scaling, intensive treatment (subgingival curettage and root planing) and tooth extraction. Multivariate Cox regression analysis was used to estimate the hazard ratios and corresponding 95% confidence intervals (95% CI). RESULTS: Compared with those in the gingivitis cohort, patients with periodontitis have a higher risk of ischaemic stroke and a lower survival rate of stroke over the 10-year follow-up period. After integrative dental care, both dental scaling and intensive treatment, the risk was reduced, especially in patients with periodontitis, while patients with periodontal disease may have an increased risk of stroke after tooth extraction therapy. CONCLUSIONS: Our study showed that periodontitis is a risk factor for ischaemic stroke. Both dental scaling and intensive treatment for periodontal disease are associated with a lower risk of further ischaemic stroke events.

Geriatric Functional Impairment Using the Integrated Care for Older People (ICOPE) Approach in Community-Dwelling Elderly and Its Association with Dyslipidemia.

BACKGROUND: The World Health Organization (WHO) proposed the integrated care for older people (ICOPE) screening tool to identify functional impairment. We explore the association of geriatric functional impairment and hypertension, diabetes, dyslipidemia in the community-dwelling elderly. METHODS: We enrolled individuals aged at least 65 with hypertension, diabetes, or dyslipidemia; or those aged at least 75 from May to July 2019. We applied ICOPE tools to evaluate six function assessments: cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms. Factors were analyzed using stepwise multivariable linear regression for ICOPE scores and logistic regression for geriatric functional impairment. All analyses were adjusted for age and glomerular filtration rate. RESULTS: We enrolled 457 participants including 303 (66.3%) participants with hypertension, 296 (64.8%) diabetes, and 221 (48.4%) dyslipidemia. Seventy-eight (17.1%) participants have at least one geriatric functional impairment, including 41 (25.9%) participants aged ≥ 75 and 37 (12.4%) aged 65-74. The ICOPE score (0.4 ± 0.6) of participants aged at least 75 was higher than that (0.1 ± 0.4) of the participants aged 65-74 (p < 0.001). Dyslipidemia (p = 0.002) was positively associated with ICOPE score. Dyslipidemia (odds ratio: 2.15, 95% confidence interval: 1.27-3.70, p = 0.005), not hypertension (p = 0.3) and diabetes (p = 0.9), was associated with geriatric functional impairment. Visual impairment was the most common function impairment. Female was linked to limited mobility, renal function was associated with mobility (p < 0.001) and nutrition (p = 0.02). CONCLUSION: Dyslipidemia but not hypertension, diabetes is linked to geriatric functional impairment in community-dwelling elderly. Lower renal function is associated with decreased mobility and nutrition. More studies are needed to determine if treatment of dyslipidemia reduces geriatric functional impairment.

Chemical characterization of PM2.5 emissions and atmospheric metallic element concentrations in PM2.5 emitted from mobile source gasoline-fueled vehicles.

Fine particulate matter with an aerodynamic diameter of <2.5 µm (PM2.5), particularly from the in-use gasoline-fueled vehicles, is a leading air quality pollutant and the chemical composition of PM2.5 is vital to the practical issues of climate change, health effects, and pollution control policies, inter alia. These atmospheric fine particulate matters (PM2.5) emitted from the exhausts of mobile source gasoline-fueled vehicles constitute substantial risks to human health through inhalation, and most importantly, affect urban air quality. Therefore, in order to explicitly determine the inhalation risks of PM2.5 which could potentially contain a significant amount of chemicals and metallic elements (MEs) concentration, we investigated the chemical composition (comprising of carbonaceous species and metallic elements) of PM2.5 emissions from mobile source gasoline-fueled vehicles. To further examine the chemical composition and metallic elements concentration in PM2.5 from the exhausts of mobile source gasoline-fueled vehicles, we systematically investigated PM2.5 emission samples collected from the exhausts of fifteen (15) mobile source gasoline-fueled vehicles. Our study has equally also determined the chemical compositions based on carbonaceous species (organic carbon - OC and elemental carbon - EC). Furthermore, the concentrations of PM2.5 and metallic elements (Ca, Al, Zn, K, Ca, Fe, Mg and Cr) in PM2.5 were analyzed with the help of Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). The details of the tested gasoline-fueled vehicles cover the model years, consisting of the vehicles registered from 2000 to 2017 from several vehicle manufacturers (or brands) with various running mileages ranging from 123.4 to 575,844 km (average 123,105 km). Our results established that elemental carbon (EC) and organic carbon (OC) were the most significant concentrations of carbonaceous species. The concentration of metallic elements in PM2.5 and chemical characterization were studied by their relationship with atmospheric PM2.5 and the results showed that the metallic elements concentration in PM2.5 were in descending order as follows: Ca > Al > Zn > K > Fe > Mg > Cr. These results will help us to further understand how PM2.5 emissions from the exhausts of in-use gasoline-fueled vehicles contribute to both chemical and atmospheric metallic elements concentration in the ambient air.

Effect of air pollutants and toxic emissions from various mileage of motorcycles and aerosol related carcinogenicity and mutagenicity assessment.

This research investigates the mileage and the health risk assessment of aerosol carcinogenicity and mutagenicity emitted by ten in-use motorcycles. The total p-PAHs emission factor of ten in-use motorcycles are 676.3 µg km-1 with average of 67.6 ± 13.6 µg km-1. Naphthalene (Nap) shows the largest emission factors, followed by phenanthrene (PA) and fluoranthen (FL). The mileage present high correlation coefficient (Rsp = 0.681) with CO. CO is associated with cumulative mileage leading to bad combustion efficiency, which caused low to high relationship for total p-PAHs (Rsp = 0.388), PM2.5 (Rsp = 0.680) and NOx (Rsp = 0.799). Both PM2.5 and total p-PAHs are generally generated via incomplete combustion and the results expressed the moderate to high correlation (Rsp = 0.578, 0.898) with NOx. Taking into consideration of high-mileage motorcycles (30,001-50,000 km), the toxic equivalent of carcinogenicity and mutagenicity exhaust are about 4.67, 1.99 and 3.89, 2.0 times higher than low (10,001-20,000 km) and middle (20,001-30,000 km) cumulative mileages, respectively. Therefore, in the conclusion of our study in compared with that of other research directed the fact that lower carcinogenicity and mutagenicity emission factor were found at lower cumulative mileages motorcycles however, the impact increases with the high cumulative mileage motorcycles.

Assessment of PM2.5 and PAH content in PM2.5 emitted from mobile source gasoline-fueled vehicles in concomitant with the vehicle model and mileages.

This study investigates the PM2.5 emission and analyses the PAHs content in PM2.5 emitted from gasoline-fueled vehicles. Outflow from the vehicles appear to be the ultimate source of PAHs in metro urban communities since the emission from gasoline vehicle increases the wellbeing hazard due to contiguity of exposure to gasoline exhaust. In this study, fifteen vehicles were randomly taken for sampling, where sixteen priority PAHs concentration were investigated. The study was performed on the vehicles with different Euro standard emission by taking into consideration the European legislative levels for vehicles on the toxic gaseous emission. Among all the PAHs outflow components of PM2.5 radiated in the exhaust of gasoline engines, the average concentration of total PAHs discharged was 0.377ng/L-fuel, while the total BaPeq concentration was 0.00993ng/L-fuel.

Characterization and quantification of PM2.5 emissions and PAHs concentration in PM2.5 from the exhausts of diesel vehicles with various accumulated mileages.

Road traffic is one of the main sources of particulate matter in the atmospheric environment. Notwithstanding its significance, there are noteworthy challenges in quantitative assessment of its contribution to the concentrations of airborne. This study reports on the characterization and quantification of PM2.5 emissions and PAHs concentration in PM2.5 from the exhausts of on-road diesel vehicles with various accumulated mileages in Kaohsiung City, Taiwan. Urban areas could be a subject matter not just in connection to deprived air quality, but similarly to pollution of other significant environmental media by air contaminants. To that end, our study intends to estimate the PM2.5 emissions from diesel vehicles using diesel fuels and to analyze the PM2.5 emissions and PAHs concentration in PM2.5. In this study, particulate matters (PM2.5) were characterized and quantified from a place impacted by diesel vehicles fueled with diesel in Kaohsiung City, Taiwan. The tested diesel vehicles with various accumulated mileages overs the model year comprising of the vehicles registered from 1984 to 2012 from different manufacturers (or brands) ranging from 8733 to 965,026 km (average 445,433 km) accumulative mileages. Exhaust constituents include CO, NOx, PM2.5 and particle phase PAHs. The concentrations of twenty-one (21) priority polycyclic aromatic hydrocarbons (PAHs) were studied in the samples by their relationship with atmospheric PM2.5. However, in relations to cumulative mileages, lower cumulative mileage (mileage <20,000 km) has the lowest CO and NOx emission factors. The mileage ranged from 20,001 to 30,000 km had an increased CO and NOx emission factors, respectively. Interestingly, with the increased high number of mileages ranged from 30,001 to 50,000 km, CO and NOx emission factor was observed to be declining, respectively. This could be attributed to the technological changes on new diesel vehicle models. But nonetheless, the trend of CO emission factor was found to be higher with an increasing of cumulative mileages as compared to the mileage that reached lower than 30,000 km.