Improvement of drug-induced gingival overgrowth and cerebrovascular related dementia after dental treatments.

Drug-induced gingival overgrowth can occur as a side effect of specific drugs and lead to poor oral function. Appropriate dental management of the overgrowth may improve oral function and improve cognitive deficits after cerebrovascular accidents.

Study on the preventive effect of ramelteon on the onset of sleep disorder after general anesthesia in patients with autism spectrum disorder: A study protocol.

BACKGROUND: The persistent loss of consciousness caused by general anesthesia without the existence of repeated 90-minute cycles of non-REM and REM sleep might significantly disturb and suppress the cycle of normal physiological sleep in postoperative periods after general anesthesia. Patients with autism spectrum disorders (ASD) with existing circadian rhythm disorder are reported to rapidly deteriorate due to acute sleep disorder during the perioperative period after general anesthesia.A melatonin receptor agonist, ramelteon (Rozerem), which is a sleep cycle regulator, is used as a therapeutic drug for patients with sleep disorders, but there are no studies on the prevention of postoperative sleep disorder after general anesthesia.In this study, we investigate whether prophylactic administration of a sleep-inducing substance, a melatonin receptor agonist, is effective against sleep disorder after general anesthesia in patients with ASD. METHODS/DESIGN: This study is intended for patients with ASD aged 12 years and above who undergo treatment at Nagasaki University Hospital, Isahaya General Hospital Dentistry, and Sasebo City General Medical Center Dentistry and undergo dental treatment under general anesthesia. A melatonin receptor agonist (Rozerem) will be taken 7 days prior and 7 days postsurgery in patients diagnosed with insomnia. A randomized comparison will be made between 2 groups: an experimental group that is additionally administered Rozerem and a control group.The primary endpoint is the incidence of NREM-REM sleep disorders that occur within 3 to 5 days after general anesthesia. The secondary endpoint is the incidence of circadian rhythm sleep disorders (rate of occurrence of sleep-retardation syndrome with drowsiness and strong fatigue). DISCUSSION: Postoperative sleep disorders after general anesthesia has been reported in patients with ASD; however, effective preventive pharmacological treatments have not been established. A sleep cycle regulator, ramelteon (Rozerem), is used as a therapeutic drug for patients with sleep disorders by decreasing the difficulty of falling asleep in insomnia. If sleep disorder can be prevented after the administration of general anesthesia in patients with ASD, we can support social participation while maintaining their quality of life. TRIAL REGISTRATION: The study was registered with the jRCT1071200030.

The pilot study examining the effects of swallowing position on lung volume fraction and the coordination between respiration and non-nutritive swallowing reflex.

BACKGROUND: Body position might affect the coordination between respiration and swallowing. This study was carried out to test the hypothesis that during swallowing, coordinated movements of muscle groups such as the diaphragm and rectus abdominis muscles are important to control normal swallowing apnea. OBJECTIVE: To investigate this hypothesis, respiratory parameters, swallowing apnea and muscle activity were measured in each of four body positions: sitting position with feet on the floor, 30° reclining position, lateral position, and standing position. METHODS: All measurements were performed in nine healthy subjects. Nasal airflow was measured using a pneumotachometer and muscle activity was measured using an electromyograph. All lung volume fraction parameters were measured using spirometer and swallowing apnea time was calculated. RESULTS: The maximum inspiratory volume was 2.76 ± 0.83 L in the 30° reclining position, which was significantly larger than that in the other positions (p = .0001). The preliminary expiratory volume was 1.05 ± 0.42 L in the 30° reclining position, which was significantly smaller than that in the other positions (p < .0001). The swallowing apnea time during water swallowing was 1.17 ± 0.35 sec in the lateral position and 0.87 ± 0.28 sec in the 30° reclining position, which tended to be longer than the 0.78 sec in the sitting position. CONCLUSION: We conclude that both lateral and reclining positions require a longer period of swallowing apnea compared to the sitting and standing positions. Differences in body position may significantly influence the coordination between respiration and swallowing.