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1.
J Periodontal Res ; 52(1): 114-121, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27028150

RESUMO

BACKGROUND AND OBJECTIVE: The association between periodontal disease and nutrient intake was examined using linked data from the 2005 National Health and Nutrition Survey, the Comprehensive Survey of Living Conditions and the Survey of Dental Diseases from the same year 'using linked data from the National Health and Nutrition Survey, the Comprehensive Survey of Living Conditions and the Survey of Dental Diseases, all from 2005'. There has been increasing focus on the importance of nutritional factors in disease in recent years, but very few studies in Japan have looked at the association between periodontal disease and nutrients. Therefore, in the present study we investigated factors associated with periodontal disease, particularly in terms of nutrient intake. MATERIAL AND METHODS: Data from 3043 individuals, ≥ 20 years of age (the original study sample comprised 4873 individuals, but those younger than 20 years of age and pregnant women were excluded from the present study) were compiled from linked responses to these three surveys from the same year. Permission to use the data was obtained from the Lifestyle-Related Diseases Control General Affairs Division of the Ministry of Health, Labor, and Welfare, Japan. Information including basic attributes, family structure, economic status, physical condition, lifestyle habits, diet, dental habits, blood data, intake of foods (including the categories of food) and nutrient-related information were obtained from the linked data. The individual maximum Community Periodontal Index (CPI) was used as an index of periodontal disease. Subjects were divided, according to maximum CPI, into groups in which CPI = 0-2 or CPI = 3-4, and associations between CPI and basic attributes, family structure, economic status, physical condition, lifestyle habits, diet, blood data and food intake were analyzed. RESULTS: Multivariate analysis revealed that the percentage of calories from fat was a nutrient factor associated with periodontal disease, with the percentage of calories from fat being significantly lower in the group with advanced periodontal disease. CONCLUSION: The results suggest that a low-fat, high-carbohydrate diet is related to periodontal disease. A more detailed analysis of this topic will be conducted in the future using different indices of periodontal disease.


Assuntos
Gorduras na Dieta/efeitos adversos , Doenças Periodontais/etiologia , Adulto , Complicações do Diabetes/epidemiologia , Feminino , Humanos , Japão/epidemiologia , Estilo de Vida , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estado Nutricional , Doenças Periodontais/epidemiologia , Fatores de Risco , Adulto Jovem
2.
Eur J Gynaecol Oncol ; 36(3): 290-3, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26189255

RESUMO

PURPOSE: To investigate the prognostic factors for survival in uterine cervical cancer patients who developed bone metastasis. MATERIALS AND METHODS: Cervical cancer patients with bone metastasis who were treated at the present institute from April 1996 to September 2010 were identified from the authors' institutional tumor registries. Primary disease, follow-up, and recurrence data were collected and retrospectively reviewed. Univariate and multivariate analyses of prognostic factors for survival were performed. RESULTS: A total of 37 patients that developed cervical cancer bone metastasis were included in the authors' database. The median survival time after recurrence was 12 months. Univariate analysis revealed that patients with a disease-free interval (DFI) of ten months or less achieved significantly shorter survival after bone metastasis detection than those with a DFI of 11 months or more (median: 8.5 months versus 17 months, p < 0.0001). Multivariate analysis also showed that DFI of ten months or less was a significant predictor of short survival (p = 0.0018). CONCLUSIONS: The DFI was found to be independent prognostic factors for survival in cervical cancer patients who developed bone metastasis.


Assuntos
Adenocarcinoma/secundário , Neoplasias Ósseas/secundário , Carcinoma Adenoescamoso/secundário , Carcinoma de Células Escamosas/secundário , Neoplasias do Colo do Útero/patologia , Adenocarcinoma/mortalidade , Adenocarcinoma/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias Ósseas/terapia , Carcinoma Adenoescamoso/mortalidade , Carcinoma Adenoescamoso/terapia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Cuidados Paliativos , Prognóstico , Estudos Retrospectivos , Terapia de Salvação , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/terapia
3.
J Thromb Haemost ; 13(4): 508-19, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25581687

RESUMO

BACKGROUND: Although recombinant human soluble thrombomodulin (rhTM) is a widely used novel anticoagulant agent for disseminated intravascular coagulation (DIC) in Japan, its clinical efficacy in sepsis-induced DIC has not been demonstrated convincingly. OBJECTIVE: To assess the benefits and harms of rhTM in sepsis-induced DIC patients. METHODS: We conducted a systematic review and meta-analysis of rhTM therapy for sepsis-induced DIC for both randomized controlled trials (RCTs) and observational studies (retrospective case-control studies and/or prospective cohort studies) separately. All-cause mortality (28-30 days) as efficacy and serious bleeding complications as adverse effect were measured as primary outcomes. We assessed body of evidence quality at the outcome level by using the Grading of Evidence, Assessment, Development and Evaluation (GRADE) approach. RESULTS: We analyzed 12 studies (838 patients/3 RCTs; 571 patients/9 observational studies). Pooled relative risk was 0.81 (95% CI, 0.62-1.06) in the RCTs, indicating non-significant reduction in mortality, and 0.59 (95% CI, 0.45-0.77) in the observational studies. Meta-regression analysis revealed a significant negative slope between effect size of rhTM therapy and baseline mortality rate in individual studies (P = 0.012), suggesting that probability of a beneficial effect with rhTM therapy increases with increasing baseline risk. Risk of serious bleeding complications was not significantly different between rhTM and control groups. We judged the quality of evidence as moderate for mortality and serious bleeding. CONCLUSIONS: The rhTM was associated with a trend in reduction of mortality at 28-30 days in sepsis-induced DIC patients. Further large rigorous trials are needed to confirm or refute these findings before implications for practice are clear.


Assuntos
Anticoagulantes/uso terapêutico , Coagulação Intravascular Disseminada/tratamento farmacológico , Sepse/tratamento farmacológico , Trombomodulina/uso terapêutico , Anticoagulantes/efeitos adversos , Distribuição de Qui-Quadrado , Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/mortalidade , Hemorragia/induzido quimicamente , Humanos , Razão de Chances , Proteínas Recombinantes/uso terapêutico , Fatores de Risco , Sepse/sangue , Sepse/diagnóstico , Sepse/mortalidade , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
4.
Gene Ther ; 22(2): 127-37, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25503692

RESUMO

Age-related macular degeneration (AMD) is a vision-threatening disease characterized by choroidal fibrovascular membrane (FVM) formation, choroidal neovascularization (CNV) and choroidal fibrosis. No safe and effective therapeutic method has been developed for the choroidal fibrosis, although anti-vascular endothelial growth factor therapy can partially shrink the CNV. We recently reported that periostin (POSTN), which is produced by retinal pigment epithelial cells, has an important role in the formation of preretinal FVMs, but its role in choroidal FVMs has not been determined. In this study, we used Postn knockout mice to investigate the role played by POSTN in choroidal FVM formation. In addition, we used a new class of RNA interference (RNAi) agent (NK0144) that targets POSTN and determined its effect on choroidal FVM development. Genetic ablation of Postn had an inhibitory effect not only on CNV formation but also on choroidal fibrosis in a mouse CNV model. NK0144 also had a greater inhibitory effect on both the CNV and choroidal fibrosis than control RNAi with no apparent adverse effects. These findings suggest a causal relationship between POSTN and choroidal FVM formation, and also a potential therapeutic role of intravitreal NK0144 for AMD.


Assuntos
Moléculas de Adesão Celular/genética , Neovascularização de Coroide/terapia , Degeneração Macular/terapia , Interferência de RNA , Animais , Sequência de Bases , Adesão Celular , Moléculas de Adesão Celular/metabolismo , Movimento Celular , Proliferação de Células , Células Cultivadas , Corioide/irrigação sanguínea , Corioide/patologia , Técnicas de Silenciamento de Genes , Terapia Genética , Humanos , Injeções Intravítreas , Camundongos Endogâmicos C57BL , Camundongos Knockout , Dados de Sequência Molecular , RNA Interferente Pequeno/administração & dosagem , RNA Interferente Pequeno/genética , Epitélio Pigmentado da Retina/patologia , Epitélio Pigmentado da Retina/fisiologia , Receptor 3 Toll-Like/metabolismo
5.
J Dent Res ; 91(7 Suppl): 52S-58S, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22699669

RESUMO

If it is to be effective, preventive dental treatment must be based on an individual's risk of caries and periodontal disease. However, hitherto, preventive treatment has been generally conducted without proper caries-risk assessment because of lack of knowledge about an individual's caries risk. This study sought to identify high-risk adult patients and examine the effectiveness of preventive programs. Data for 442 patients from a single general practice who met the inclusion criteria were analyzed. Multiple logistic-regression analysis showed that high levels of mutans streptococci (SM) correlated with the onset of primary and secondary caries, with odds ratios of 2.34 (95%CI: 1.15-4.76, p = 0.019) and 2.22 (95%CI: 1.06-4.62, p = 0.034), respectively. Lactobacilli (LB) also correlated with secondary caries, with an odds ratio of 3.34 (95%CI: 1.35-6.85, p = 0.007). When the patients were checked after three years of a preventive program, the correlation with SM and LB disappeared. Survival analyses by Cox regression models and Kaplan-Meier methods showed that secondary caries was difficult to control by conventional preventive programs alone in patients with high levels of cariogenic bacteria. In conclusion, cariogenic bacteria play an important role in the incidence of caries, and additional intensive preventive treatment should be considered for high-risk patients.


Assuntos
Assistência Odontológica , Cárie Dentária/prevenção & controle , Profilaxia Dentária , Adulto , Carga Bacteriana , Soluções Tampão , Cariostáticos/uso terapêutico , Índice CPO , Assistência Odontológica/normas , Cárie Dentária/microbiologia , Suscetibilidade à Cárie Dentária , Placa Dentária/prevenção & controle , Profilaxia Dentária/normas , Raspagem Dentária , Comportamento Alimentar , Feminino , Fluoretos Tópicos/uso terapêutico , Seguimentos , Humanos , Lactobacillus/isolamento & purificação , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Periodontite/prevenção & controle , Recidiva , Medição de Risco , Saliva/metabolismo , Saliva/microbiologia , Saliva/fisiologia , Taxa Secretória/fisiologia , Streptococcus mutans/isolamento & purificação , Adulto Jovem
6.
J Hosp Infect ; 78(2): 97-101, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21474201

RESUMO

Healthcare-associated infection by meticillin-resistant Staphylococcus aureus (MRSA) is still a great concern in an intensive care unit (ICU). Our surveillance data in the ICU revealed that intubated patients were at eight times higher risk of acquiring MRSA than non-intubated patients, so we hypothesised that pre-emptive contact precautions for all intubated patients would prevent healthcare-associated infection by MRSA in the ICU. Patients staying in our ICU for >2 days were included in this study. The study period was divided into two periods. During 2004 (1st period), contact precautions were performed only for patients with MRSA. During 2005-2007 (2nd period), contact precautions were applied to all intubated patients regardless of MRSA infection status. Patients were defined as MRSA-positive on admission when MRSA was detected by surveillance or clinical culture on enrolment. Other MRSA-positive results were defined as healthcare-associated MRSA (HA-MRSA) transmission. HA-MRSA infection was diagnosed according to the National Nosocomial Infections Surveillance Manual. The 1st period comprised 415 patients, and the 2nd period comprised 1280 patients. In intubated patients, HA-MRSA infection rate decreased significantly in the 2nd period (1st period 12.2%, 2nd period 5.6%; P=0.015). HA-MRSA infection of all patients decreased from 3.6 to 2.3 incidents per 1000 patient-days (P<0.05), despite a significant increase in the rate of patients MRSA positive on admission in the 2nd period (1st period 2.9%; 2nd period 6.1%). Pre-emptive contact precautions for intubated patients would be helpful in reducing HA-MRSA infection in ICU.


Assuntos
Infecção Hospitalar/prevenção & controle , Unidades de Terapia Intensiva , Intubação Intratraqueal/efeitos adversos , Infecções Estafilocócicas/prevenção & controle , Precauções Universais/economia , Adulto , Idoso , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , Feminino , Humanos , Incidência , Tempo de Internação , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pessoa de Meia-Idade , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/transmissão , Precauções Universais/métodos
7.
Community Dent Health ; 28(4): 274-9, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22320065

RESUMO

OBJECTIVES: Very little is known about dentist-patient communicative behaviours in actual practice. This study evaluated dentist and patient perceptions of dentist-patient communication and patient outcome. PARTICIPANTS: The subjects were 171 dentist-patient pairs in Kitakyushu, Japan. RESEARCH DESIGN: Dentists and patients answered the same questionnaire items using the same response categories to evaluate dentist-patient communication. Based on the scores of patient and dentist perceptions with respect to dentist-patient communication, patient-dentist pairs were categorised into one of 3 groups. Data analyses used one-way ANOVA, multiple linear regression analysis, and multiple logistic regression analysis. RESULTS: We found that, with respect to dentist-patient communication, patients in the 'patient better' group (i.e., the patient's evaluation was more positive than the dentist's evaluation) were more likely to have a positive outcome (e.g., 'improvement of health and fear,' 'satisfaction with care') than those in the other two groups. Patients in the 'doctor better' group (i.e., the dentist's evaluation was the more positive) were more likely to have a negative outcome than those in the other two groups. CONCLUSIONS: A positive patient outcome is more likely when the patient's evaluation is better than a dentist's evaluation with respect to dentist-patient communicative behaviours. The method based on patient and dentist perceptions with respect to dentist-patient communication might be effective in evaluating dentist-patient communication.


Assuntos
Comunicação , Relações Dentista-Paciente , Odontólogos/psicologia , Pacientes/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Criança , Compreensão , Ansiedade ao Tratamento Odontológico/prevenção & controle , Ansiedade ao Tratamento Odontológico/psicologia , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Satisfação do Paciente , Adulto Jovem
8.
Eur Respir J ; 36(3): 503-8, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20413534

RESUMO

Although inflammation is an important component of atherosclerosis, it is unknown whether inhaled corticosteroids (ICS) as anti-inflammatory drugs prevent atherosclerosis. In the present study, carotid atherosclerosis was evaluated by ultrasonography in 150 asthmatic patients who had been regularly treated with ICS, and in 150 matched nonasthmatic controls, with an assessment of atherosclerotic risk factors. Carotid intima-media thickness was significantly lower in the asthmatic patients than in the controls. The prevalence of carotid plaque tended to be lower in the asthmatic patients than in the controls. Defined carotid atherosclerosis was diagnosed in 51 of the asthmatic patients, who were older, with a higher prevalence of males, a higher prevalence of dyslipidaemia and a lower mean daily dose of ICS than the 99 patients without carotid atherosclerosis. Stepwise multiple logistic regression analysis identified age, male sex and dyslipidaemia as positive risk factors for carotid atherosclerosis. The mean daily dose of ICS was a negative risk factor. Carotid atherosclerosis is reduced in asthmatic patients treated with ICS compared with matched controls. This study suggests that ICS may have protective effects against atherosclerosis.


Assuntos
Corticosteroides/uso terapêutico , Asma/complicações , Asma/tratamento farmacológico , Doenças das Artérias Carótidas/complicações , Idoso , Anti-Inflamatórios/uso terapêutico , Doenças das Artérias Carótidas/fisiopatologia , Dislipidemias/patologia , Feminino , Humanos , Inflamação , Masculino , Pessoa de Meia-Idade , Prevalência , Análise de Regressão , Fatores de Risco , Resultado do Tratamento
9.
J Oral Rehabil ; 36(11): 808-13, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19744262

RESUMO

Although the number of sound or decayed teeth has been reported to be associated with cognitive function in elderly populations with dementia, little is known about this association in elderly populations without dementia. We evaluated this relationship, with adjustment for confounding factors, in Japanese populations of 60-year-old (n = 270; 120 males and 150 females) and 65-year-old (n = 123; 57 males and 66 females) individuals residing in Fukuoka Prefecture of Japan. Dental examinations were performed in all subjects, along with the Mini-mental state examination (MMSE) for assessing cognitive function. Among the total of 393 subjects, the mean MMSE score was 27.9 +/- 1.9, and 391 subjects scored 24 or higher. The mean numbers of sound and decayed teeth were 12.0 +/- 6.3 and 0.5 +/- 1.2, respectively. Associations were found between the numbers of sound and decayed teeth and MMSE in total subjects and males, but not in females, by multiple regression analysis adjusted for gender, age, level of education, marital status, smoking, alcohol drinking, working status, systolic blood pressure and blood glucose. An association was also found between MMSE and the number of sound teeth in a logistic regression analysis. In conclusion, associations were found between normal-range cognitive function and the numbers of sound and decayed teeth, after adjustment for various confounding factors, in an elderly Japanese population.


Assuntos
Transtornos Cognitivos/epidemiologia , Cárie Dentária/epidemiologia , Higiene Bucal/normas , Doenças Periodontais/epidemiologia , Autocuidado/normas , Idoso , Pressão Sanguínea/fisiologia , Transtornos Cognitivos/complicações , Inquéritos de Saúde Bucal , Feminino , Indicadores Básicos de Saúde , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/etiologia , Características de Residência
10.
Parkinsonism Relat Disord ; 15(6): 440-4, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19103505

RESUMO

OBJECTIVES: A new system consisting of an accelerometer and touch sensor was developed to find objective parameters for the finger tapping (FT) test in patients with Parkinson's disease (PD). METHODS: We recruited sixteen patients with PD and thirty-two age-matched healthy volunteers (HVs). By using this new system, various parameters related to velocity, amplitude, rhythm and number in the FT test were measured in patients with PD and examined in comparison with those of HVs on the basis of the Unified Parkinson's Disease Rating Scale (UPDRS) FT score. RESULTS: The new system allowed us to measure fourteen parameters of FT movement very easily, and a radar chart showed obvious differences in most of these parameters between HVs and patients with PD. Principal component analysis showed that fourteen parameters were classified into three components: (1) both mean and standard deviation (SD) of both amplitude and velocity, (2) number of FT for 60s and mean FT interval, and (3) SD of FT interval. The first (velocity- and amplitude-related parameters) and third (rhythm-related parameters) components contributed to discrimination of PD from HVs. Maximum opening velocity (MoV) was the best of these parameters because of its sensitivity and association with the UPDRS FT score. CONCLUSIONS: A novel system for the FT test, which is compact, simple and efficient, has been developed. Velocity- and amplitude-related parameters were indicated to be valuable for evaluation of the FT test in patients with PD. In particular, we first propose that MoV is a novel marker for the FT test.


Assuntos
Dedos/fisiologia , Movimento/fisiologia , Doença de Parkinson/fisiopatologia , Desempenho Psicomotor/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Avaliação da Deficiência , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Análise de Componente Principal , Índice de Gravidade de Doença , Tato/fisiologia
11.
Spinal Cord ; 47(2): 161-5, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18542086

RESUMO

STUDY DESIGN: Organotypic coculture model using brain cortex and spinal cord of neonatal rats was used to test the effect of chondroitinase ABC (ChABC) on corticospinal axon growth. OBJECTIVE: Chondroitin sulfate proteoglycan (CSPG) is neurite outgrowth inhibitory factor that combines with reactive astrocyte at the lesion site to form a dense scar that acts as a barrier to regenerating axons. ChABC is a bacteria enzyme that digests the glycosaminoglycan side chain of CSPG. We investigated the effect of ChABC on corticospinal axon growth quantitatively using the organotypic cocultures of brain cortex and spinal cord. SETTING: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University. METHOD: We used organotypic cocultures with neonatal brain cortex and spinal cord as an in vitro assay system for assessing axon growth. After administering ChABC, we counted the number of axons passing through a reference line running parallel to the junction between the brain cortex and spinal cord 500 and 1000 microm from the junction. The immunoreactivity of CSPG was assessed. RESULT: The average number of axons after ChABC administration was significantly greater than in the control group. Administration of ChABC decreased CSPG expression in this coculture system. CONCLUSION: ChABC induces axonal regeneration by degrading CSPG after central nerve system injury. ChABC has great potential for future therapeutic use in spinal cord-injured patients.


Assuntos
Axônios/efeitos dos fármacos , Condroitina ABC Liase/farmacologia , Tratos Piramidais/citologia , Fatores Etários , Animais , Animais Recém-Nascidos , Córtex Cerebral/fisiologia , Técnicas de Cocultura , Relação Dose-Resposta a Droga , Proteína Glial Fibrilar Ácida/metabolismo , Técnicas de Cultura de Órgãos , Ratos , Ratos Sprague-Dawley , Medula Espinal/fisiologia , Versicanas/metabolismo
12.
Gerontology ; 54(6): 354-60, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18460865

RESUMO

BACKGROUND: Little is known about the association between physical fitness and cognitive function in very elderly people (over 80 years of age). OBJECTIVES: To evaluate that relationship in 85-year-old community-dwelling individuals. METHODS: Out of 207 participants (90 males, 117 females) who were 85 years old and community-dwelling, 205 completed the Mini-Mental State Examination (MMSE) for evaluating cognitive function. The numbers of subjects who completed physical fitness measurements such as hand-grip strength, isometric leg extensor strength, one-leg standing time, stepping rate, and walking speed were 198, 159, 169, 168, and 151, respectively. RESULTS: There were significant associations in MMSE with hand-grip strength (right or left hand), isometric leg extensor strength, stepping rate, and walking speed by simple regression analysis. MMSE was still significantly associated with hand-grip strength (beta = 0.305, p = 0.005 for right side; beta = 0.309, p = 0.004 for left side), stepping rate (beta = 0.183, p = 0.046), and walking speed (beta = -0.222, p = 0.014) by multiple regression analysis after adjustments for the amount of education, gender, smoking, drinking, complication of stroke, body weight, body height, regular medical care, serum albumin, blood HbA1c, and marital status. By logistic regression analysis, the prevalence of a normal MMSE score (MMSE >or=24) was increased by 9% with each 1-kg increase in hand-grip strength of the left hand (OR 1.087, 95% CI 1.003-1.179, p = 0.042), and was increased by 6% with each step per 10 s in stepping rate (OR 1.060, 95% CI 1.000-1.122, p = 0.048). CONCLUSION: In a very elderly population of 85-year-olds, cognitive function was associated with some physical fitness measurements, independent of confounding factors.


Assuntos
Cognição/fisiologia , Avaliação Geriátrica/estatística & dados numéricos , Força da Mão/fisiologia , Aptidão Física/psicologia , Idoso de 80 Anos ou mais , Fatores de Confusão Epidemiológicos , Estudos Transversais , Feminino , Seguimentos , Humanos , Contração Isométrica/fisiologia , Japão/epidemiologia , Modelos Logísticos , Masculino , Entrevista Psiquiátrica Padronizada , Atividade Motora/fisiologia , Aptidão Física/fisiologia , Características de Residência
13.
J Dent Res ; 87(4): 334-9, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18362314

RESUMO

Although poor oral health influences the occurrence of pulmonary infection in elderly people, it is unclear how the degree of oral health is linked to mortality from pulmonary infection. Therefore, we evaluated the relationship between oral health and four-year mortality from pneumonia in an elderly Japanese population. The study population consisted of 697 (277 males, 420 females) of the 1282 individuals who were 80 years old in 1997. Data on oral and systemic health were obtained by means of questionnaires, physical examinations, and laboratory blood tests. One hundred eight of the study persons died between 1998 and 2002. Of these, 22 deaths were due to pneumonia. The adjusted mortality due to pneumonia was 3.9 times higher in persons with 10 or more teeth with a probing depth exceeding 4 mm (periodontal pocket) than in those without periodontal pockets. Therefore, the increase in teeth with periodontal pockets in the elderly may be associated with increased mortality from pneumonia.


Assuntos
Saúde Bucal , Pneumonia Aspirativa/mortalidade , Idoso de 80 Anos ou mais , Glicemia/análise , Índice de Massa Corporal , Candida/isolamento & purificação , Colesterol/sangue , Deglutição/fisiologia , Transtornos de Deglutição/epidemiologia , Prótese Total/estatística & dados numéricos , Prótese Parcial/estatística & dados numéricos , Feminino , Seguimentos , Nível de Saúde , Humanos , Japão/epidemiologia , Masculino , Bolsa Periodontal/epidemiologia , Bolsa Periodontal/mortalidade , Pneumonia Aspirativa/microbiologia , Albumina Sérica/análise , Fatores Sexuais , Fumar/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Língua/microbiologia , Perda de Dente/epidemiologia
14.
Kyobu Geka ; 61(2): 135-7, 2008 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-18268951

RESUMO

A 78-year-old woman who had undergone double valve replacement 13 years before was referred to our department because of postoperative wound dehiscence and exudate. Although the result of exudate culture was negative, the wound was disinfected continuously for 4 weeks and showed a transient remission. However, the exudate was observed again 3 weeks later. By chest computed tomography (CT), a highly bright shadow was revealed in the mediastinum, which was suspected to be a foreign body and, therefore, the cause of the exudate. Considering the possibility of infection, the patient underwent an operation. Following incision of the epigastric region and the resection of the xiphoid process, ePTFE membrane with poor granulation tissue was found. The membrane was removed, the lesion was washed with warm saline, and then the wound was closed. The postoperative course was uneventful without recurrence. This complication was considered to be caused by biological reaction to a foreign body.


Assuntos
Parede Abdominal , Fístula/etiologia , Corpos Estranhos/complicações , Doenças do Mediastino/etiologia , Mediastino , Politetrafluoretileno/efeitos adversos , Idoso , Feminino , Fístula/cirurgia , Corpos Estranhos/cirurgia , Reação a Corpo Estranho/etiologia , Reação a Corpo Estranho/cirurgia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Doenças do Mediastino/cirurgia , Mediastino/cirurgia , Membranas Artificiais , Resultado do Tratamento
15.
Acta Neurochir (Wien) ; 150(1): 15-22; discussion 22, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18180867

RESUMO

BACKGROUND: The levodopa responsiveness of motor, particularly axial symptoms is a good predictor of the effectiveness of subthalamic nucleus (STN) stimulation in patients with Parkinson's disease (PD). However, many Japanese PD patients are intolerant of higher doses of antiparkinsonian drugs and some aspects of their axial symptoms may remain unresponsive to treatment. We retrospectively investigated the effects of bilateral STN stimulation on the axial signs unresponsive to levodopa in Japanese patients with PD. METHODS: We enrolled 29 consecutive patients into this study. Six independent axial symptoms, i.e. falling, freezing, gait, standing, posture, and postural instability, were scored on the Unified Parkinson's Disease Rating Scale (UPDRS), before and 3 months after bilateral STN stimulation and differences were statistically analysed. FINDINGS: Postoperatively, the mean levodopa dosage was decreased by 27%. The preoperative responsiveness to antiparkinsonian drugs with respect to freezing, gait, posture, and postural instability were positively correlated with postoperative off-medication improvement (p < 0.05). For each individual axial symptom, some patients showed an excellent response to STN stimulation, despite preoperative unresponsiveness to levodopa. These selected patients were not always treated with lower doses of antiparkinsonian drugs preoperatively, but they had milder preoperative scores on the UPDRS with respect to daily activities and overall axial function. CONCLUSIONS: The axial symptoms of PD unresponsive to levodopa were ameliorated by bilateral STN stimulation in patients manifesting a milder degree of preoperative axial signs. Our findings suggest that STN stimulation exerted a definite but limited effect on levodopa-unresponsive axial features, pointing to the need to identify different target structures that control axial functions via non-dopaminergic systems.


Assuntos
Estimulação Encefálica Profunda , Hipocinesia/prevenção & controle , Rigidez Muscular/prevenção & controle , Doença de Parkinson/terapia , Núcleo Subtalâmico , Tremor/prevenção & controle , Atividades Cotidianas , Idoso , Antiparkinsonianos/efeitos adversos , Antiparkinsonianos/uso terapêutico , Discinesias/etiologia , Eletrodos Implantados , Feminino , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/prevenção & controle , Humanos , Hipocinesia/etiologia , Levodopa/efeitos adversos , Levodopa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Rigidez Muscular/etiologia , Doença de Parkinson/complicações , Postura , Psicoses Induzidas por Substâncias/etiologia , Estudos Retrospectivos , Tremor/etiologia
16.
Community Dent Health ; 25(4): 243-7, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19149303

RESUMO

OBJECTIVES: To investigate influence of dental status on systemic oxidative stress, we evaluated the association between number of teeth and serum lipid peroxide, an oxidative stress index, in 85-years old residents of Japan. METHODS: In October 2003, 207 subjects 85-years old agreed to participate in the present follow-up study after five years from the 8020 Data Bank Survey of Fukuoka prefecture in 1998. Dental health condition including number of teeth was examined by dentists. Data from 204 subjects (88 male, 116 female) who completed nonfasting venous blood examination including lipid peroxide and blood chemistry were analyzed. The examination included a medical questionnaire regarding smoking history, physical activity, alcohol consumption, educational duration, and regular dental care, anthropometric and manometric measurements. RESULTS: Albumin, lipids, and lipid peroxide in serum all were within the normal range. Number of teeth correlated positively with height and white blood cell count, and correlated negatively with lipid peroxide. In a multiple regression analysis to adjust for confounding factors, tooth number retained this correlation with lipid peroxide. By analysis of variance with a Bonferroni-Dunn correction, edentulous subjects showed significantly higher lipid peroxide than those retaining 20 teeth or more. CONCLUSION: The negative association between number of teeth and lipid peroxide links more teeth remaining with less oxidative stress in an 85-year-old population; this may decrease risk of atherosclerotic complications.


Assuntos
Peróxidos Lipídicos/sangue , Boca Edêntula/metabolismo , Estresse Oxidativo , Perda de Dente/metabolismo , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Japão , Peroxidação de Lipídeos , Lipídeos/sangue , Masculino , Boca Edêntula/sangue , Análise de Regressão , Albumina Sérica/análise , Inquéritos e Questionários , Perda de Dente/sangue
17.
J Neurol ; 254(10): 1427-32, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17934878

RESUMO

In elderly persons, it is thought that maintenance of masticatory function may have a beneficial effect on maintenance of cerebral function. However, few studies on cerebral circulation during mastication exist. This study aimed to verify a possible increase in cerebral circulation and the presence of cerebral hemispheric dominance during gum chewing. Twelve healthy, young right-handed subjects with normal dentition were enrolled. Bilateral middle cerebral arterial blood flow velocities (MCAV), heart rate, and arterial carbon dioxide levels were measured during a handgrip exercise and gum chewing. During gum chewing, electromyography of the bilateral masseter muscle was recorded.MCAV and heart rate significantly increased during exercise compared to values at rest. During gum chewing, there were no differences in the rate of increase in MCAV between the working and non-working sides, but during the handgrip exercise, the rate of increase in MCAV was significantly greater for the non-working side than for the working side. During gum chewing,muscle activity on the working side was significantly greater than that on the non-working side. These results suggest that during gum chewing, cerebral circulation increases bilaterally and does not show contralateral dominance, as it does during the handgrip exercise.


Assuntos
Circulação Cerebrovascular/fisiologia , Goma de Mascar , Lateralidade Funcional , Mastigação/fisiologia , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Dióxido de Carbono/metabolismo , Eletromiografia/métodos , Feminino , Força da Mão/fisiologia , Frequência Cardíaca/fisiologia , Humanos , Masculino , Músculo Masseter/fisiologia , Artéria Cerebral Média/diagnóstico por imagem , Artéria Cerebral Média/metabolismo , Artéria Cerebral Média/fisiologia , Ultrassonografia Doppler Transcraniana/métodos
18.
Oral Dis ; 13(2): 214-9, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17305625

RESUMO

OBJECTIVE: Poor oral health has been reported to be a risk indicator of mortality, however, few data are available regarding the relationship between chewing ability and mortality. We examined the relationship between self-assessed chewing ability and mortality in elderly subjects. DESIGN: Prospective study. SUBJECTS AND METHODS: Participating in the study were 697 people (277 males, 420 females) from 1282 individuals (80 years old) residing in Fukuoka Prefecture, Japan. Data on oral and systemic health status through questionnaires, accompanied by physical and laboratory blood examinations were obtained. Chewing ability was assessed based on the number of types of food each subject reported as able to chew by questionnaire. RESULTS: A total of 108 subjects died between 1998 and 2002. Those with the lowest number of chewable foods were associated with higher risk of mortality than those with the ability to chew all of the 15 types of food surveyed [hazard ratio (HR) = 2.38, 95% confidence interval (95% CI) = 1.07-5.29], though other parameters including current smoking, low serum albumin, and poor physical health status were more significant. Further, reduced chewing ability of soft foods increased the risk (HR = 2.65, 95% CI = 1.20-5.87). CONCLUSION: Chewing ability was associated with mortality in a population of 80-year-old community residents, and may be a predictor for survival rate.


Assuntos
Mastigação/fisiologia , Mortalidade , Idoso de 80 Anos ou mais , Análise Química do Sangue , Índice de Massa Corporal , Colesterol/sangue , Estudos de Coortes , Feminino , Seguimentos , Alimentos/classificação , Previsões , Nível de Saúde , Humanos , Japão/epidemiologia , Masculino , Saúde Bucal , Exame Físico , Vigilância da População , Estudos Prospectivos , Medição de Risco , Albumina Sérica/análise , Fumar
19.
Neurology ; 65(12): 1954-7, 2005 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-16291929

RESUMO

Studies on the clinical course of familial ALS suggest that the duration of illness is relatively consistent for each mutation but variable among the different mutations. The authors analyzed the relative amount of mutant compared with normal SOD1 protein in the erythrocytes from 29 patients with ALS with 22 different mutations. Turnover of mutant SOD1 correlated with a shorter disease survival time.


Assuntos
Esclerose Lateral Amiotrófica/genética , Esclerose Lateral Amiotrófica/fisiopatologia , Predisposição Genética para Doença/genética , Mutação/genética , Superóxido Dismutase/genética , Adulto , Idade de Início , Idoso , Esclerose Lateral Amiotrófica/metabolismo , Sistema Nervoso Central/metabolismo , Sistema Nervoso Central/patologia , Sistema Nervoso Central/fisiopatologia , Análise Mutacional de DNA , Progressão da Doença , Feminino , Testes Genéticos , Humanos , Masculino , Pessoa de Meia-Idade , Neurônios Motores/metabolismo , Neurônios Motores/patologia , Valor Preditivo dos Testes , Prognóstico , Superóxido Dismutase/metabolismo , Superóxido Dismutase-1 , Taxa de Sobrevida , Fatores de Tempo
20.
Gerodontology ; 22(2): 91-7, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15934350

RESUMO

OBJECTIVE: The aim of this study was to evaluate the relationship between number of remaining teeth and health-related quality of life in community-dwelling elderly. SUBJECTS: A total of 207 participants who were community-dwelling, 85 years of age. Data were from a population-based study of age-related general and oral health in Fukuoka Prefecture, Japan. MEASUREMENTS: The Japanese version of the Short Form 36 Health Survey (SF-36). RESULTS: The mental component score for the participants, from the SF-36, was higher than the Japanese national norm for those aged > or = 70 years. There were no significant differences in the mean of any scores on the SF-36 by having spouse, living with family, or education level. The mean of the SF-36 scores of physical functioning (PF) and of the physical component scores were significantly higher in the 85-year-old participants with > or = 20 teeth than in those with < or = 19 teeth (p < 0.05 and p < 0.01 respectively). In addition, a significant difference (p < 0.05) was observed between the mean of participants with > or = 20 teeth and those with < or = 19 teeth after adjustment for region where the participant lived, activities of daily living (ADL), and sex. The PF (p < 0.001), role-physical (p < 0.005), bodily pain (p < 0.001), vitality (p < 0.001), social functioning (p < 0.05), and physical component (p < 0.001) scores were significantly higher in participants with a good activities of daily living (ADL) assessment. However, ADL was not associated with the number of teeth. CONCLUSIONS: The findings of the present study indicated that 85-year-old participants with > or = 20 teeth had better subjective physical health than those with < or = 19 teeth.


Assuntos
Idoso de 80 Anos ou mais/psicologia , Idoso de 80 Anos ou mais/estatística & dados numéricos , Avaliação Geriátrica/estatística & dados numéricos , Qualidade de Vida , Perda de Dente/psicologia , Atividades Cotidianas , Idoso , Feminino , Humanos , Japão , Modelos Logísticos , Masculino
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