The needs of patients with noncancer diseases and their families from hospital-based specialized palliative care teams in Japan.

BACKGROUND: Hospital-based specialized palliative care teams (HSPC) are important for symptom management and ethics support, especially during complex decision-making, but the needs of patients with noncancer diseases and their families from the HSPC are unclear. This study aimed to (I) compare the prevalence of symptom between patients with and without cancer and explore changes in symptom intensity after HSPC consultation in patients with noncancer; (II) determine factors related to ethics support; and (III) compare the percentage of request contents from patients and their families when a certified nurse specialist in gerontological nursing (geriatric care nurse below) is present in the HSPC to that when a certified nurse specialist in palliative care (palliative care nurse below) is present in the HSPC. METHODS: We utilized a retrospective cohort study to analyze 761 patients (360 with noncancer and 401 with cancer) referred to our HSPC at the National Center for Geriatrics and Gerontology using 10-year data (since 2011) available in an electronic medical record database. (I) Symptom scores of the Support Team Assessment Schedule were compared between noncancer and cancer groups and between initial and 1-week assessments for noncancer patients. (II) Ethics support was compared between noncancer (including dementia) and cancer. The presence or absence of ethics support requests, which was set as the objective variable, was examined using logistic regression analysis. (III) The percentage of request contents selected from nine items defaulted on the electronic medical record when a geriatric care nurse was present in our HSPC were compared to those when a palliative care nurse was present in our HSPC. RESULTS: Compared to those with cancer, patients with noncancer suffered more from dyspnea and sputum accumulation. More than 10% of patients with noncancer had suffered from pain, dyspnea, sputum accumulation, and anorexia that required treatment, with symptom scores showing improvement after 1 week of HSPC involvement, except for the sputum accumulation. Moreover, for anorexia, symptom scores improved, but >10% of these patients continued to suffer. Patients with noncancer diseases, including dementia, received ethics support than those with cancer without dementia. More requests for ethics support were received when a geriatric care nurse was in the HSPC than when a palliative care nurse was in the HSPC. Logistic regression analysis revealed that requests for ethics support were more frequent from patients or families with impaired decision-making capacity or when the patient lacked an advocate. CONCLUSIONS: The needs of patients with noncancer diseases and families from the HSPC in Japan included (I) symptom management for intractable conditions, such as sputum accumulation; (II) ethics support for patients with noncancer diseases, including dementia, with impaired decision-making capacity, and without advocates; and (III) advice on ethics issues from a geriatric care nurse.

Path pattern and movement during mastication on habitual and non-habitual chewing sides.

PURPOSE: To clarify the presence or absence of differences in path pattern and movement during mastication between the habitual and non-habitual chewing sides. METHODS: Participants were 225 healthy adults with natural dentition. Mandibular movement while chewing gummy jelly on each side was recorded, and masticatory path pattern was classified into five types (one normal and four abnormal). The frequency of each pattern was measured and compared between chewing sides. The amount, rhythm, velocity, and stability of movement and masticatory performance were measured and compared between chewing sides. RESULTS: A normal pattern was observed on the habitual chewing side in 84.4% of participants. There was a significant difference between chewing sides in masticatory path pattern (χ2 = 35.971, P < 0.001). Values of parameters regarding the amount and velocity of movement and masticatory performance were significantly higher on the habitual chewing side. Values of parameters regarding rhythm and stability of movement were significantly lower on the habitual chewing side. CONCLUSION: The present findings of functional differences between chewing sides in terms of path pattern and movement during mastication suggest that these factors should be analyzed on the habitual chewing side.

Linoleic acid and squalene are oxidized by discrete oxidation mechanisms in human sebum.

Previous studies suggest that squalene (SQ) in sebum is oxidized by a photooxidation mechanism (i.e., singlet oxygen oxidation) to create SQ hydroperoxide (SQOOH), a compound that causes adverse skin conditions. However, oxidation of other lipids in sebum, such as linoleic acid (LA), has not been fully understood. Elucidating their oxidation, especially its mechanisms, may lead to a further understanding of the relationship between sebum oxidation and skin conditions. In this study, using HPLC-MS/MS, we aimed to detect LA hydroperoxide (LAOOH) directly from sebum and identify the oxidation mechanism of LA in sebum through analysis of LAOOH isomers. We developed extraction and HPLC-MS/MS analysis conditions that can sufficiently quantify each LAOOH isomer in sebum. Using this method, LAOOH was detected in samples from healthy individuals, demonstrating the presence of LAOOH in human sebum. Moreover, isomer analysis of LAOOH and SQOOH indicated that LA and SQ are oxidized in sebum by discrete oxidation mechanisms (LA oxidized by free radical oxidation, whereas SQ oxidized by singlet oxygen oxidation). Such results may further lead to the development of mechanism-specific ways to prevent oxidation of sebum via a selection of appropriate antioxidants, ultimately leading to the promotion of skin health.

Comparison of two dental prescale systems used for the measurement of occlusal force.

The purpose of this study was to clarify the relationship between two types of dental prescale systems. Forty healthy subjects were asked to maximally clench for about 3 s, and the maximum occlusal force before and after cleaning was calculated using an Occluzer FPD707 for dental prescale (P1) and a bite force analyzing system for dental prescale II (P2). The maximum occlusal forces measured by P1 and P2 were compared before cleaning and after cleaning. Next, the relationship between the maximum occlusal force by P1 and maximum occlusal force by P2 was investigated. In addition, comparisons were made between males and females. The maximum occlusal force after cleaning was significantly smaller than before cleaning for both P1 and P2. The reduction rate of the occlusal force was 4.1% for P1 and 25.9% for P2. Significant linearity was observed between the maximum occlusal forces of P1 and P2 (regression linear equation: y = 1.191x - 30.521, r = 0.980, p < 0.001). The maximum occlusal forces measured by P1 and P2 were both significantly larger in males than in females. It was suggested that there was a certain relationship between the maximum occlusal forces measured by dental prescale and dental prescale II, suggesting that it is possible to compare the results of both by applying corrections using a regression equation.

Relationship between masticatory performance using a gummy jelly and food intake ability in Japanese complete denture wearers.

Twenty patients wearing complete dentures were asked to chew a gummy jelly, and their glucose extraction was measured. Two types of masticatory scores (MS1 and MS2) were calculated using a food intake questionnaire. The relationship between masticatory scores and glucose extraction was investigated. The values of masticatory scores were large when the amount of glucose extraction was also large, and there were significantly positive correlations between the two. There was also a positive correlation between MS1 and MS2. It was suggested that the food intake ability was high when the masticatory performance using a gummy jelly was high.

Micro-tensile and micro-shear bond strengths of current self-etch adhesives to enamel and dentin.

PURPOSE: To evaluate the micro-tensile and micro-shear bond strengths of self-etch adhesives to enamel and dentin. METHODS: Extracted human molars were ground to expose flat enamel or dentin surfaces using wet #600 grit SiC paper. The enamel and dentin surfaces were assigned to four groups of four adhesives: three one-step self-etch adhesives (Clearfil S3 Bond; AQ Bond Plus, G-Bond) and a two-step self-etch adhesive (Clearfil SE Bond). Each of the adhesives were applied to the enamel or dentin surfaces in accordance with the manufacturers' instructions and restored with resin composite (Clearfil AP-X). The bonded teeth were then prepared for either micro-tensile or micro-shear bond strength tests. After storage in saline at 37 degrees C for 24 hours, specimens were stressed at a crosshead speed of 1 mm/minute. Mean bond strengths and modes of failure were analyzed using one-way ANOVA followed by Scheffe's F test and the Chi-square test, respectively, at a 95% level of confidence. RESULTS: SE Bond produced significantly higher values than the one-step adhesives in the micro-shear bond test to enamel (P< 0.05), while no significant differences were found among the adhesives in the micro-tensile bond test (P> 0.05). For dentin, SE Bond showed the highest bond strengths in both micro-tensile and micro-shear bond tests; values were significantly higher than both AQ Bond Plus and G-Bond (P< 0.05).