Low tongue pressure and depression using Kihon Checklist for assessing frailty status among community-dwelling Japanese older adults: A pilot study.

BACKGROUND: Evaluation of low tongue pressure is used to diagnose oral hypofunction. The pathophysiology of oral hypofunction is hypothesized to be associated with oral dysfunction related to ageing. Depression in older adults is a major problem and is related to handgrip strength, which is related to tongue pressure. We hypothesized that low tongue pressure could indicate depression mood in community-dwelling older adults. OBJECTIVES: This study aimed to measure maximum tongue pressure and compare it to the responses to the Kihon Checklist (KCL), which is used to check mental and physical deterioration of community-dwelling older adults. METHODS: A total of 49 community-dwelling independent older adults with stable dental condition (23 men, 26 women; median age, 79 years) answered the KCL, which contained questions on frailty status, cognitive function, nutritional and sarcopenia status. Oral function was measured to assess oral hypofunction. The relationship between tongue pressure differences and frailty status, cognitive function, nutritional and sarcopenia status was analysed using logistic regression analyses after adjusting for age and sex. RESULTS: Nine participants (6 men and 3 women; median age, 81 years) had a tongue pressure <23.0 kPa, which was the lowest limit of the standard value of maximum tongue pressure in patients aged ≥70 years. Logistic regression analyses showed that only Question 21, which is related to a lack of fulfilment in daily life, was significantly associated with low tongue pressure (p = .027). CONCLUSION: Low tongue pressure may be associated with sociopsychological factors in older adults.

Disinfectant Susceptibility of Third-Generation-Cephalosporin/Carbapenem-Resistant Gram-Negative Bacteria Isolated from the Oral Cavity of Residents of Long-Term-Care Facilities.

We have recently reported the isolation of third-generation-cephalosporin-resistant Gram-negative bacteria from the oral cavity of residents of a long-term-care facility (LTCF). Since disinfectants are often used in the oral cavity, it is important to investigate the disinfectant susceptibility of oral bacteria. Here, we evaluated the susceptibilities of Gram-negative antimicrobial-resistant bacteria (GN-ARB), including Pseudomonas, Acinetobacter, and Enterobacteriaceae, obtained from the oral cavity of residents of LTCFs to povidone-iodine (PVPI), cetylpyridinium chloride (CPC), benzalkonium chloride (BZK), and chlorhexidine chloride (CHX). We also evaluated the susceptibilities of isolates from the rectum to the same agents to compare the susceptibility profiles of oral and rectal isolates. Next, we investigated the relationship between their susceptibility and disinfectant resistance genes delineated by whole-genome sequencing of the isolates. Additionally, we evaluated the correlation between disinfectant-resistant GN-ARB and clinical information. In oral GN-ARB, the MIC of PVPI showed almost identical values across isolates, while the MICs of CPC, BZK, and CHX showed a wide range of variation among species/strains. In particular, Pseudomonas aeruginosa exhibited high-level resistance to CPC and BZK. The disinfectant susceptibility of rectal GN-ARB showed a tendency similar to that of oral GN-ARB. The presence of qacEΔ1 was correlated with CPC/BZK resistance in P. aeruginosa, while other species exhibited no correlation between qacEΔ1 and resistance. Multiple analyses showed the correlation between the presence of CPC-resistant bacteria in the oral cavity and tube feeding. In conclusion, we found that some oral GN-ARB isolates showed resistance to not only antibiotics but also disinfectants. IMPORTANCE Antibiotic-resistant bacteria (ARB) are becoming a serious concern worldwide. We previously reported the isolation of third-generation-cephalosporin-resistant Gram-negative bacteria from the oral cavity of residents of a long-term-care facility (LTCF). To prevent infection with ARB in hospitals and eldercare facilities, we must pay more attention to the use of not only antibiotics but also disinfectants. However, the effect of disinfectants on ARB is unclear. In this study, we evaluated the susceptibility of Gram-negative ARB (GN-ARB) from the oral cavity of residents of LTCFs to some disinfectants that are often used for the oral cavity; we found that some isolates showed resistance to several disinfectants. This is the first comprehensive analysis of the disinfectant susceptibility of oral GN-ARB. These results provide some important information for infection control and suggest that disinfectants should be applied carefully.

Oral and Rectal Colonization by Antimicrobial-Resistant Gram-Negative Bacteria and Their Association with Death among Residents of Long-Term Care Facilities: A Prospective, Multicenter, Observational, Cohort Study.

INTRODUCTION: The prevalence of antimicrobial-resistant bacteria (ARB) in long-term care facilities (LTCFs) remains unclear. Furthermore, the effect of ARB colonization on the clinical outcomes of LTCF residents has not been explored. METHODS: We conducted a prospective multicenter cohort study and investigated the residents (N = 178) of six Japanese LTCFs (three Welfare Facilities for the Elderly Requiring Long-term Care and three Geriatric Health Service Facilities) for oral and rectal carriage of ARB. The clinical outcomes of the residents were evaluated based on isolating bacterial strains and subjecting them to whole-genome sequencing. RESULTS: Of the 178 participants, 32 belonging to Geriatric Health Service Facilities with no information on their clinical outcome were excluded, and the remaining 146 were followed up for at most 21 months. Extended-spectrum ß-lactamases (ESBL)-producing Enterobacterales and Pseudomonas aeruginosa were detected in 42.7% (n = 76) and 2.8% (n = 5) of the rectal swabs and 5.6% (n = 10) and 3.4% (n = 6) of the oral swabs, respectively. Detection of ARB in the oral and rectal cavities showed remarkable association with enteral nutrition. Further, P. aeruginosa was significantly associated with an increase in mortality of the residents, but there were not significant association between ESBL-producing Enterobacterales and mortality. Core-genome phylogeny of P. aeruginosa revealed a wide-spread distribution of the isolated strains across the phylogeny, which included a cluster of ST235 strains with substantially higher biofilm formation ability than the other isolated P. aeruginosa strains. DISCUSSION/CONCLUSION: This study is the first to investigate the carriage of both oral and rectal ARB, genomic relatedness and determinants of antimicrobial resistance in isolated strains, and clinical outcomes of LTCF residents. Our study provides the first direct evidence for the burden of antimicrobial resistance in LTCFs.

Antimicrobial adhesive polyurethane gel sheet with cetylpyridinium chloride-montmorillonite for facial and somato prosthesis fastening.

Purpose Existing options for attaching facial and somato prostheses, such as skin adhesives, are problematic because of microbial colonization and skin irritation. This study aims to evaluate the suitability of adhesive polyurethane gel sheets containing cetylpyridinium chloride (CPC)-montmorillonite (Mont) for prosthesis fastening.Methods Adhesive gel sheets were fabricated as mixtures of base resin (99.6 wt% polyol) and hardening agent at a ratio of 3:1 with 0 (control), 2, 5, 10, or 15 wt% CPC-Mont. The controlled release of CPC, antimicrobial activity, in vitro skin irritation, and adhesive force against silicone and human skin at different blending ratios were determined. Statistical analyses of the data were performed using one-way analysis of variance (ANOVA), analysis of covariance (ANCOVA), Tukey's test, or single regression analysis, as appropriate.Results The amount of CPC released increased with the CPC-Mont blending ratio and was linearly proportional to the surface occupation area ratio of CPC-Mont. The samples with >5 wt% CPC-Mont exhibited antimicrobial activity against Staphylococcus aureus at an exposure time of 0 d, and samples with >2 wt% CPC-Mont exhibited antimicrobial activity against Candida albicans at an exposure time of 1 d. All samples were classified as non-irritant based on an in vitro skin irritation test. The adhesive force on the silicone material and human skin decreased with increasing CPC-Mont blending ratio.Conclusions Samples with 5 wt% CPC-Mont are potential candidates as antimicrobial adhesive polyurethane gel sheets for fastening facial and somato prostheses.

Effect of surface pre-treatment on durability of resin-based cements bonded to titanium.

OBJECTIVES: Titanium has in recent years become a material of great opportunities in dentistry and orthopedics. In this study, we searched for a method to effectively pre-treat titanium as part of an adhesive luting and/or resin-veneering procedure. METHODS: Ti plates were treated with two different solutions of hydrochloric acid (0.1, 1N), 37wt% phosphoric acid or kept untreated (control). The tensile bond strength of the composite cement (Panavia Fluoro Cement, Kuraray) to the untreated and pre-treated Ti plates was determined without and after 20,000 thermo-cycles. XPS was used to chemically analyze the effect of the three Ti pre-treatments, as well as the interaction of 10-methacryloxydecyl dihydrogen phosphate (10-MDP; functional monomer of Panavia Fluoro Cement) with Ti treated with 1N HCl. RESULTS: Although no significant difference in immediate tensile bond strength was measured, thermo-cycling significantly decreased the bond strength of all experimental groups except for Ti treated with 1N HCl. No difference in surface roughness was found between untreated and treated Ti. XPS demonstrated that HCl effectively decontaminated Ti in a dose-dependent manner, while H(3)PO(4) was strongly adsorbed on the Ti surface. While the latter potentially inhibits adsorption of the phosphoric groups of the functional monomer 10-MDP, Ti pre-treated with 1N HCl improved the adsorption of 10-MDP as compared to untreated Ti. SIGNIFICANCE: It is concluded that 1N HCl effectively pre-treats Ti in order to make it more receptive to resin, while H(3)PO(4) should better not be used.

New surface modification of titanium implant with phospho-amino acid.

The purpose of this study was to investigate a new biochemical surface modification technique for titanium implants using phospho-amino acid. Pure titanium disks were pretreated with 10 N HCl and ultrapure water at room temperature for 30 minutes respectively. Then these disks were modified with either L-threonine (Thr) or O-phospho-L-threonine (P-Thr) at 37 degrees C for 12 hours. X-ray photoelectron spectroscopy (XPS) chemically analyzed the modified surfaces. It was revealed that the N 1s peak which originated from Thr was not detected in the wide-scan spectrum of Thr-modified surface, whereas three peaks of N 1s, P 2s, and P 2p which originated from P-Thr were detected in the wide-scan spectrum of P-Thr-modified surface. Moreover, the P 2p peak of P-Thr which reacted with the surface significantly shifted to a lower binding energy (p < 0.05). Based on the results of this study, it was concluded that P-Thr chemically bonded to the titanium surface treated with HCl.

Evaluation of dynamic studies of MR mammography for the diagnosis of intraductal lesions with nipple discharge.

OBJECTIVES: We assessed the utility of dynamic magnetic resonance imaging (MRI) in differentiating benign from malignant lesions of the breast and then applied MRI to diagnose intraductal breast tumors with nipple discharge. METHODS: Gadolinium (Gd)-enhanced MR mammography was performed on 74 patients with breast tumors and 8 patients with nipple discharge. RESULTS: The steepest slopes of the contrast medium uptake (S slope) s from time-intensity curves were significantly different between malignant and benign lesions. At S slope threshold of 0.95% /second, malignancy was predicted with a sensitivity and specificity of 75% . Six of 8 cases with nipple discharge were successfully identified by MR ductography by injecting Gd-DTPA into discharging ducts. Among them, 2 non-invasive ductal carcinomas were differentiated from benign lesions by the S slope value. CONCLUSIONS: Dynamic MR mammography is an useful modality for differentiating breast lesions and has potential for evaluating intraductal lesions with nipple discharge.

Cytotoxicity of antimicrobial tissue conditioners containing silver-zeolite.

PURPOSE: The purpose of this study was to determine the effects of incorporating antimicrobial silver-zeolite on the in vitro cytotoxicities of five tissue conditioners against the living dermal model, which consisted of normal human dermal fibroblasts in a collagen lattice. MATERIALS AND METHODS: Samples of each tissue conditioner containing silver-zeolite (2 wt% and 5 wt%) were prepared; samples without silver-zeolite were used as a control. Cytotoxicity of each sample against the living dermal model was evaluated by cell viability with MTT assay. RESULTS: Cell viabilities for Visco-Gel, GC Soft-Liner, FITT, and SR-Ivoseal decreased with increasing silver-zeolite content. Cell viability for Shofu Tissue Conditioner showed no significant difference with degree of silver-zeolite incorporation and had higher values than other tissue conditioners. CONCLUSION: Individual compounds eluted from tissue conditioners and silver ions released from silver-zeolite might cause such cytotoxicity. The results suggest that Shofu Tissue Conditioner is a possible candidate for a novel antimicrobial tissue conditioner containing silver-zeolite because it showed the highest cell viability and the smallest influence of incorporating silver-zeolite.