Discovery of a C-S lyase inhibitor for the prevention of human body malodor formation: tannic acid inhibits the thioalcohol production in Staphylococcus hominis.

Human body odor is a result of the bacterial biotransformation of odorless precursor molecules secreted by the underarm sweat glands. In the human axilla, Staphylococcus hominis is the predominant bacterial species responsible for the biotransformation process of the odorless precursor molecule into the malodorous 3M3SH by two enzymes, a dipeptidase and a specific C-S lyase. The current solutions for malodor, such as deodorants and antiperspirants are known to block the apocrine glands or disrupt the skin microbiota. Additionally, these chemicals endanger both the environment and human health, and their long-term use can influence the function of sweat glands. Therefore, there is a need for the development of alternative, environmentally friendly, and natural solutions for the prevention of human body malodor. In this study, a library of secondary metabolites from various plants was screened to inhibit the C-S lyase, which metabolizes the odorless precursor sweat molecules, through molecular docking and molecular dynamics (MD) simulation. In silico studies revealed that tannic acid had the strongest affinity towards C-S lyase and was stably maintained in the binding pocket of the enzyme during 100-ns MD simulation. We found in the in vitro biotransformation assays that 1 mM tannic acid not only exhibited a significant reduction in malodor formation but also had quite low growth inhibition in S. hominis, indicating the minimum inhibitory effect of tannic acid on the skin microflora. This study paved the way for the development of a promising natural C-S lyase inhibitor to eliminate human body odor and can be used as a natural deodorizing molecule after further in vivo analysis.

Assessment of the Quality and Readability of Web-Based Arabic Health Information on Halitosis: Infodemiological Study.

BACKGROUND: Halitosis, characterized by an undesirable mouth odor, represents a common concern. OBJECTIVE: This study aims to assess the quality and readability of web-based Arabic health information on halitosis as the internet is becoming a prominent global source of medical information. METHODS: A total of 300 Arabic websites were retrieved from Google using 3 commonly used phrases for halitosis in Arabic. The quality of the websites was assessed using benchmark criteria established by the Journal of the American Medical Association, the DISCERN tool, and the presence of the Health on the Net Foundation Code of Conduct (HONcode). The assessment of readability (Flesch Reading Ease [FRE], Simple Measure of Gobbledygook, and Flesch-Kincaid Grade Level [FKGL]) was conducted using web-based readability indexes. RESULTS: A total of 127 websites were examined. Regarding quality assessment, 87.4% (n=111) of websites failed to fulfill any Journal of the American Medical Association requirements, highlighting a lack of authorship (authors' contributions), attribution (references), disclosure (sponsorship), and currency (publication date). The DISCERN tool had a mean score of 34.55 (SD 7.46), with the majority (n=72, 56.6%) rated as moderate quality, 43.3% (n=55) as having a low score, and none receiving a high DISCERN score, indicating a general inadequacy in providing quality health information to make decisions and treatment choices. No website had HONcode certification, emphasizing the concern over the credibility and trustworthiness of these resources. Regarding readability assessment, Arabic halitosis websites had high readability scores, with 90.5% (n=115) receiving an FRE score ≥80, 98.4% (n=125) receiving a Simple Measure of Gobbledygook score <7, and 67.7% (n=86) receiving an FKGL score <7. There were significant correlations between the DISCERN scores and the quantity of words (P<.001) and sentences (P<.001) on the websites. Additionally, there was a significant relationship (P<.001) between the number of sentences and FKGL and FRE scores. CONCLUSIONS: While readability was found to be very good, indicating that the information is accessible to the public, the quality of Arabic halitosis websites was poor, reflecting a significant gap in providing reliable and comprehensive health information. This highlights the need for improving the availability of high-quality materials to ensure Arabic-speaking populations have access to reliable information about halitosis and its treatment options, tying quality and availability together as critical for effective health communication.

Volatile sulfur compounds in asthmatic children and adolescents: A cross-sectional study in breath and saliva.

BACKGROUND: Halitosis in children implies psychosocial repercussions. Risk factors associated with this condition are unclear, and detection methods are inaccurate. AIM: To quantify the levels of sulfur-like compounds in children with asthma and healthy children from a novel validated assay, and to establish the risk factors related to halitosis. DESIGN: One hundred and twenty-eight individuals (63 healthy and 65 asthmatic) from 3 to 17 years of age were tested using a passive colorimetric sensor to measure the levels of sulfur-like compounds in breath and saliva. Information was collected on oral hygiene habits, gingival and dental health, breathing type, and dental malocclusion. RESULTS: The mean values of hydrogen sulfide were 4.0 ± 6.8 and 19.7 ± 12.2 ppbv (parts per billion in volume) in the control and asthmatic groups, respectively (p < .001). The presence of higher concentrations of sulfur compounds was significantly associated (p < .05) with the presence of gingival inflammation, tongue coating, dental plaque, mouth breathing, hypomineralization, age, tongue brushing, and the use of dental floss. CONCLUSION: The level of sulfur in breath and saliva was significantly higher in patients with asthma. These results can serve as a precedent to raise awareness among paediatricians and parents about oral hygiene care in children and adolescents.

Halitosis: etiology, prevention, and the role of microbiota.

OBJECTIVES: This study aims to review halitosis research, discuss its various causes, and propose effective interventions based on the underlying etiologies and mechanisms. The main research question is to identify the primary factors contributing to halitosis and appropriate strategies to address them. MATERIALS AND METHODS: A comprehensive literature review was conducted on halitosis and its associated causes, including oral pathological factors, oral microbial influences, microbial metabolic pathways, gastrointestinal diseases, and gut microbiota dysbiosis. RESULTS: Unhealthy eating habits and an imbalance of microorganisms in the oral cavity and gastrointestinal tract were identified as primary causes of halitosis. Dental caries, periodontal disease, xerostomia, and digestive disorders like gastritis and irritable bowel syndrome were also found to be related to the development of halitosis. Due to poor oral hygiene or antibiotic use, disruption of microbial communities can result in dysbiosis, inflammation, and halitosis. CONCLUSIONS: Halitosis is a multifactorial condition with various underlying causes, including oral and systemic diseases. Effective interventions should be tailored based on the specific etiologies and mechanisms involved. CLINICAL RELEVANCE: Understanding the factors contributing to halitosis is crucial for developing appropriate treatment strategies. Enhancing oral hygiene habits, using antimicrobial drugs, or administering probiotics may help regulate oral or intestinal flora, thereby improving halitosis and overall oral health.

Resigning oneself to a life of wound-related odour - A thematic analysis of patient experiences.

AIMS: To determine how patients with chronic wounds describe wound odour, identify what strategies they use to manage it and how effective these are. MATERIALS AND METHODS: Using a qualitative descriptive approach, semi-structured interviews were conducted between July and August 2021 with seven patients living with an odorous chronic wound at home. Data were analysed using Braun and Clarke's thematic analysis framework. RESULTS: The results were organised into two main themes: 1) becoming resigned to living with wound-related odour 2) strategies used to manage wound-related odour. Participants were sad, embarrassed and felt isolated but became resigned to living with this odour and accepting of it as a consequence of having a wound. Frequent dressing changes, household cleaning along with the use of sprays were the most frequently used tactics to manage odour none of which were deemed to be very effective. CONCLUSION: This study highlights the problem of odour management in clinical practice and how individuals develop strategies to overcome odour. Sadly, patients were resigned to living with wound odour and were accepting of it as part of daily life. This highlights the importance for healthcare professionals to recognise, assess for and ensure a better understanding of how people experience wound odour, the impact it can have on them personally. Frequent dressing changes can help manage wound odour from the patient's perspective.

Use and Abuse of Electrocautery in Adenoidectomy Hemostasis.

Background and objectives: Bipolar electrocautery is commonly used to control bleeding after cold-instrument pediatric adenoidectomy, but the surgeon should be aware of the possible side effects. OBJECTIVE: The aim of our study is to investigate the effects of bipolar electrocautery when used for bleeding control at the end of an adenoidectomy procedure. Materials and Methods: We evaluated the effect of electrocautery on postoperative pain, velopharyngeal insufficiency symptoms, postoperative nasal obstruction, and rhinorrhea in a group of 90 children undergoing adenoidectomy in our ENT department over a period of 3 months. Results: After statistically analyzing the data, we found that the duration of postoperative pain, the duration of rhinorrhea and nasal obstruction, and the duration of painkiller administration, as well as the velopharyngeal insufficiency symptoms, were significantly longer in patients in whom electrocautery was used for hemostasis. A significantly higher incidence of posterior neck pain and halitosis (oral malodor) was noted in the patients in whom electrocautery was used for adenoidectomy hemostasis. Conclusions: Bipolar electrocautery use should be limited during pediatric adenoidectomy hemostasis because of the possible side effects: longer postoperative pain, prolonged nasal obstruction, rhinorrhea and velopharyngeal insufficiency, and halitosis. We noted some side effects that were specific to electrocautery use during adenoidectomy: posterior neck pain and oral malodor. Acknowledging the risk for these symptoms can help to alleviate the anxiety of both the parents and the patients regarding the expected postoperative outcomes.

ORGANOLEPTIC AND HALITOMETRIC ASSESSMENTS DO NOT CORRELATE WELL IN INTRA-ORAL HALITOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS.

BACKGROUND: The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis? METHODS: This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random-effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot. RESULTS: A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I2 = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I2 = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I2 = 0%, P < .01. DISCUSSION: None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements.

Effectiveness of lasers and aPDT in elimination of intraoral halitosis: a systematic review based on clinical trials.

In recent years, there has been increasing interest in research showing positive results in antimicrobial photodynamic therapy (aPDT) and laser therapy (LT) in dentistry. The authors of this review tried to answer the question: "Is the effectiveness of lasers and aPDT in the elimination of intraoral halitosis possible?" For this purpose, the electronic database of PubMed and Cochrane Library were searched until September 2021 using a combination of different keywords: (bad breath OR fetor ex ore OR halitosis OR oral malodor) AND (laser OR PDT OR PACT OR photodynamic inactivation OR photodynamic therapy OR photodynamic antimicrobial chemotherapy). Initially, 83 studies were identified. A total of 9 articles were qualified after the application of the eligibility criteria. Eight works concerned aPDT treatment, and only one dedicated to the Er,Cr:YSGG laser. A significant reduction in halitosis occurred immediately after both LT and aPDT. The review found the confirmation of the effectiveness of laser therapy in reducing the number of volatile sulfur compounds (VSC) and the amount of anaerobic bacteria responsible for VSC formation. In most studies, a positive effect was observed for a 1-week follow-up. Laser therapy (aPDT, Er,Cr:YSGG) effectively eliminates microorganisms that produce volatile compounds and can effectively eliminate bad breath for the longer period of time than traditional methods of combatting this ailment.

Effects of trans-2-nonenal and olfactory masking odorants on proliferation of human keratinocytes.

Malodorous compounds induce stress responses, mood changes, an increase of skin conductance, activation of the sympathetic nervous system and other physiological changes, and it has been suggested that sensing malodors could provide warning of danger to health. Furthermore, the human body secretes various malodorous compounds as waste products of metabolism, including trans-2-nonenal ((E)-2-nonenal), the amount of which increases with aging. In the present study, we examined the effects of some endogenous malodorous compounds ((E)-2-nonenal, nonanal, pentanal, hexanal, hexanoic acid, hexylamine and isovaleric acid) on cultured human keratinocytes. (E)-2-Nonenal decreased the viability and promoted apoptosis of cultured keratinocytes. It also reduced the thickness and the number of proliferative cells in a three-dimensional epidermal equivalent model. Co-application of masking odorants (dihydromycenol, benzaldehyde, linalool, phenethyl alcohol, benzyl acetate and anisaldehyde), but not non-masking odorants (1,8-cineol, ß-damascone, and o-t-butylcyclohexyl acetate), reduced the effect of (E)-2-nonenal on keratinocyte proliferation, and restored the thickness and number of proliferative cells in a three-dimensional epidermal equivalent model.

Laser tongue debridement for oral malodor-A novel approach to halitosis.

STUDY OBJECTIVE: Malodor is a multifactorial condition with oral pathology representing the main culprit and the tongue being the first to second contributor to the malodor. Bacterial load can represent a quantifiable measure regardless of the original pathology. We hypothesize that reduction in malodor can be represented by tongue changes both in appearance, bacterial and biofilm load reduction (measured by CFU and volatile gases measurement), organoleptic measurement and subjective improvement. METHODS: A randomized controlled prospective study under IRB approval. Diagnostic criteria for enrollment and follow up were organoleptic test by 2 judges, Halimeter reading, tongue colors changes HALT questionnaire and direct aerobic and anaerobic tongue cultures measured by CFU. Patients were treated with laser tongue debridement (LTD) with an Er,Cr:YSGG solid state laser has been shown to be effective in biofilm reduction. RESULTS: 54 patients recruited with 35 available for follow up. Improvement was observed on all objective and QOL subjective parameters. Treatment was tolerated well with minimal discomfort. CONCLUSIONS: The tongue is proven to be a major contributor to oral malodor and must be addressed in treatment protocol. LTD significantly reduces malodor by subjective and objective criteria. While impossible to determine whether the tongue serves as a bacterial reservoir or is the origin for oral bacteria it is clear that LTD improves oral hygiene and reduces malodor. LTD is safe and easy to perform. We encourage LTD to be a crucial part of any oral malodor treatment protocol. TRIAL REGISTRATION: clinical trials, NCT04120948. Registered 25 September 2019 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00098SX&selectaction=Edit&uid=U0000W0Y&ts=51&cx=-elnx7e.

Risk Factors, Diagnosis, and Management of Halitosis in Children: A Comprehensive Review.

AIM: The present manuscript aims at providing a comprehensive overview of the epidemiology, risk factors, diagnostic aids, and management of halitosis in a pediatric population. BACKGROUND: Halitosis refers to bad breath from the mouth that seems unpleasant or offensive to others. This condition is prevalent worldwide, including all age-groups. However, studies on the pediatric population are limited. Self-confidence and personality development are important factors that the child builds up during their developmental stages. Halitosis may affect them both on personal and social aspects; hence, it is important to have beforehand knowledge and the modes to intercept it, paving the way to a positive growth of the child. REVIEW RESULTS: On reviewing the literature, the common risk factors for halitosis in children constituted predominantly oral factors that varied from poor oral hygiene, gingivitis, periodontal diseases, dental caries, tongue coating, mouth breathing, and so on. Their diagnosis commonly included the organoleptic test, sulfide monitoring, and gas chromatography along with the assessment of questionnaire by the parents and older children. The management was predominantly directed toward the identified source of halitosis along with instructions and counseling on the benefits of a good oral hygiene regime. CONCLUSION: The importance of cultivating a day-to-day practice of oral hygiene regime in the children will not only accustom them toward the benefits of good oral health but also help them to tackle halitosis and in turn their inhibitions associated with it. CLINICAL SIGNIFICANCE: Halitosis, though a prevalent condition experienced at various stages of life, is crucial to identify and manage, especially in the pediatric population owing to its influence on personal and on social aspects of life.

Use of Flavin-Containing Monooxygenases for Conversion of Trimethylamine in Salmon Protein Hydrolysates.

Enzymatic processing of fish by-products for recovery of peptides (hydrolysates) is a promising technology to reach food grade ingredients of high nutritional quality. Despite this, their bitter taste and "fish" odor block implementation in food products and limit their economic potential. Trimethylamine (TMA) is a known contributor to malodor in fish. Current strategies to mask or remove the odor either are not effective or give rise to undesirable side effects. As an alternative approach to remediate TMA, we propose a novel enzymatic strategy to convert TMA into the odorless trimethylamine N-oxide (TMAO) using TMA monooxygenases (Tmms). We identified a diverse set of bacterial Tmms using a sequence similarity network. Purified, recombinant enzymes were assessed for their biocatalytic capacity by monitoring NADPH consumption and TMAO generation. Selected Tmms were subjected to biochemical characterization and investigated for their ability to oxidize TMA in an industry-relevant substrate. From the 45 bacterial Tmm candidates investigated, eight enzymes from four different taxa were selected for their high activity toward TMA. The three most active enzymes were shown to vary in temperature optimum, with the highest being 45°C. Enzymatic activity dropped at high temperatures, likely due to structural unfolding. The enzymes were all active from pH 6.0 to 8.5, with functional stability being lowest around the optimal pH. All three Tmms, given sufficient NADPH cofactor, were found to generate TMAO in the TMA-rich salmon protein hydrolysate. The Tmms serve as unique starting points for engineering and should be useful for guiding process development for marine biorefineries.IMPORTANCE Enzyme-based conversion of marine biomass to high-quality peptide ingredients leaves a distinct smell of "fish" caused by the presence of trimethylamine, which limits their economic potential. We suggest an enzymatic solution for converting trimethylamine to the odorless trimethylamine N-oxide as a novel strategy to improve the smell quality of marine protein hydrolysates. Following a systematic investigation of 45 putative bacterial trimethylamine monooxygenases from several phyla, we expand the repertoire of known active trimethylamine monooxygenases. As a proof-of-concept, we demonstrate that three of these enzymes oxidized trimethylamine in an industry-relevant salmon protein hydrolysate. Our results add new oxidoreductases to the industrial biocatalytic toolbox and provide a new point of departure for enzyme process developments in marine biorefineries.

Mixture and concentration effects on odorant receptor response patterns in vivo.

Natural odors are mixtures of volatile chemicals (odorants). Odors are encoded as responses of distinct subsets of the hundreds of odorant receptors and trace amine-associated receptors expressed monogenically by olfactory sensory neurons. This is an elegantly simple mechanism for differentially encoding odors but it is susceptible to complex dose-response relationships and interactions between odorants at receptors, which may help explain olfactory phenomena such as mixture suppression, synthetic versus elemental odor processing, and poorly predictable perceptual outcomes of new odor mixtures. In this study in vivo tests in freely behaving mice confirm evidence of a characteristic receptor response pattern consisting of a few receptors with strong responses and a greater number of weakly responding receptors. Odorant receptors responsive to an odor are often unrelated and widely divergent in sequence, even when the odor consists of a single species of odorant. Odorant receptor response patterns to a citrus odor broaden with concentration. Some highly sensitive receptors respond only to a low concentration but others respond in proportion to concentration, a feature that may be critical for concentration-invariant perception. Other tests find evidence of interactions between odorants in vivo. All of the odorant receptor responses to a moderate concentration of the fecal malodor indole are suppressed by a high concentration of the floral odorant, α-ionone. Such suppressive effects are consistent with prior evidence that odorant interactions at individual odorant receptors are common.

Periodontitis and self-reported halitosis among young adults from the 1982 Pelotas Birth Cohort.

OBJECTIVE: To investigate the association between periodontitis and self-reported halitosis among young adults, and whether there is an interaction between the effects of smoking and periodontitis on halitosis. METHODS: Data from the 1982 Pelotas birth cohort, Brazil, were used. The controlled direct effect of periodontitis on self-reported halitosis, not mediated by tongue coating, was estimated using marginal structural modeling. In addition, an interaction between the effects of smoking and periodontitis on halitosis was also tested. Confounders comprised sociodemographic information, obesity, diabetes, and oral hygiene habits. RESULTS: The controlled direct effect of periodontitis on halitosis not mediated by tongue coating showed that individuals with periodontitis had 90% higher risk of self-reporting halitosis (RR 1.90) compared to healthy individuals. Individuals with mild periodontitis had twice the risk of reporting halitosis than periodontally healthy individuals (RR 2.31). We also found an interaction between the effects of smoking and periodontitis on halitosis, as noted among smokers with mild (RR 2.91) and moderate-to-severe periodontitis (RR 5.84). CONCLUSION: There is a controlled direct effect of periodontitis on halitosis not mediated by tongue coating. Additionally, an interaction between the effects of smoking and periodontitis on halitosis was also detected.

The OralChromaTM CHM-2: a comparison with the OralChromaTM CHM-1.

OBJECTIVES: Already decades ago, the diagnosis of halitosis was facilitated with the arrival of chair-side instruments to score the breath odor. These devices are used for a more objective assessment of halitosis compared with organoleptic scoring, but these too have their disadvantages. To overcome some of the drawbacks of the original model of the OralChromaTM (CHM-1), few years ago a second generation of this machine (CHM-2) was introduced. This study compared both devices in a clinical setting. MATERIALS AND METHODS: All records of the patients visiting a specialized halitosis consultation over a period of 5 years (2012-2017) were examined. The correlations of the OralChromaTM CHM-1 and CHM-2 with the organoleptic and Halimeter® measurements were analyzed. Additionally the sensitivity, specificity, and negative and positive predicted values were calculated. RESULTS: A total of 581 data points were included (CHM-1: 292, CHM-2: 289). The correlations between both models with the organoleptic measurements were not statistically significant different. The CHM-2 seemed superior to the CHM-1 in the quantification of dimethyl sulfide with a detection rate of 95% and 61%, respectively. Additionally, the CHM-2 was significantly more sensitive for dimethyl sulfide than the CHM-1. However the latter showed in turn a better sensitivity for hydrogen sulfide and methyl mercaptan. CONCLUSION: The CHM-2 showed a better sensitivity for dimethyl sulfide than its predecessor. However, its sensitivity for hydrogen sulfide and methyl mercaptan was worse. CLINICAL RELEVANCE: Dimethyl sulfide is the main volatile implicated in extra-oral blood-borne halitosis, this makes the OralChromaTM CHM-2 the instrument of choice when this is suspected.

Fecal Malodor Detection Using Low-Cost Electrochemical Sensors.

Technology innovation in sanitation is needed for the 4.2 billion people worldwide, lacking safely managed sanitation services. A major requirement for the adoption of these technologies is the management of malodor around toilet and treatment systems. There is an unmet need for a low-cost instrumented technology for detecting the onset of sanitation malodor and triggering corrective actions. This study combines sensory data with low-cost gas sensor data on malodor emanating from feces. The response of 10 commercial electrochemical gas sensors was collected alongside olfactometric measurements. Odor from fecal specimens at different relevant dilution as well as specimens with pleasant odors as a control were evaluated for a total of 64 responses. Several of the sensors responded positively to the fecal odor, with the formaldehyde, hydrogen sulfide, and ammonia sensors featuring the highest signal to noise ratio. A positive trend was observed between the sensors' responses and the concentration of the odorant and with odor intensity, but no clear correspondence with dilution to threshold (D/T) values was found. Selected sensors were responsive both above and below the intensity values used as the cutoff for offensive odor, suggesting the possibility of using those sensors to differentiate odor offensiveness based just on the magnitude of their response. The specificity of the sensors suggested that discrimination between the selected non-fecal and fecal odors was possible. This study demonstrates that some of the evaluated sensors could be used to assemble a low-cost malodor warning system.

Microbiota and Malodor-Etiology and Management.

Accumulating evidence indicates that microbiota plays a critical role in physiological processes in humans. However, it might also contribute to body malodor by producing numerous odorous molecules such as ammonia, volatile sulfur compounds or trimethylamine. Although malodor is commonly overlooked by physicians, it constitutes a major problem for many otherwise healthy people. Thus, this review aims to investigate most common causes of malodor and describe potential therapeutic options. We searched PUBMED and Google Scholar databases to identify the clinical and pre-clinical studies on bad body smell, malodor, halitosis and microbiota. Unpleasant smell might originate from the mouth, skin, urine or reproductive fluids and is usually caused by odorants that are produced by resident bacterial flora. The accumulation of odorous compounds might result from diet, specific composition of microbiota, as well as compromised function of the liver, intestines and kidneys. Evidence-based guidelines for management of body malodor are lacking and no universal treatment exists. However, the alleviation of the symptoms may be achieved by controlling the diet and physical elimination of bacteria and/or accumulated odorants.

[Efficacy of photocatalytic air purifiers in reducing dimethyl sulfide malodor following cryopreserved peripheral blood stem cell infusion].

Dimethyl sulfoxide (DMSO) is used as a cryoprotectant for peripheral blood stem cells (PBSC) preservation. Dimethyl sulfide (DMS) is a metabolite of DMSO secreted through patients' breath after PBSC infusion. It possesses malodor causing an unpleasant environment. We evaluated the efficacy of a photocatalyst environment purifier, which has the potential to lyse toxic substances, in reducing DMS malodor. High DMS concentration in the air after PBSC infusion rapidly decreased after operating the device. Our results suggest that photocatalytic reaction has the potential to reduce the DMS odor associated with PBSC infusion.

Exploring the science, safety, and benefits of air care products: perspectives from the inaugural air care summit.

Seventy-one percent of US households purchase air care products. Air care products span a diverse range of forms, including scented aerosol sprays, pump sprays, diffusers, gels, candles, and plug-ins. These products are used to eliminate indoor malodors and to provide pleasant scent experiences. The use of air care products can lead to significant benefits as studies have shown that indoor malodor can cause adverse effects, negatively impacting quality of life, hygiene, and the monetary value of homes and cars, while disproportionately affecting lower income populations. Additionally, studies have also shown that scent can have positive benefits related to mood, stress reduction, and memory enhancement among others. Despite the positive benefits associated with air care products, negative consumer perceptions regarding the safety of air care products can be a barrier to their use. During the inaugural Air Care Summit, held on 18 May 2018 in the Washington, DC, metropolitan area, multidisciplinary experts including industry stakeholders, academics, and scientific and medical experts were invited to share and assess the existing data related to air care products, focusing on ingredient and product safety and the benefits of malodor removal and scent. At the Summit's completion, a panel of independent experts representing the fields of pulmonary medicine, medical and clinical toxicology, pediatric toxicology, basic science toxicology, occupational dermatology and experimental psychology convened to review the data presented, identify potential knowledge gaps, and suggest future research directions to further assess the safety and benefits of air care products.

A Randomized Parallel Study to Assess the Effect of Three Tongue Cleaning Modalities on Oral Malodor.

OBJECTIVES: The objective of this study was to compare the effects of three tongue hygiene regimens on oral malodor. METHODS: This was a single-center, randomized, parallel design study with three treatment groups. Subjects were randomly assigned to perform tongue hygiene with either the Philips Sonicare TongueCare+ BreathRx regimen (STC), Listerine Cool Mint antiseptic rinse (LCM), or tongue brushing with an ADA reference manual toothbrush (MTB). Tooth brushing was standardized for all subjects during the study period, and no other oral or breath hygiene measures were allowed. Eligible subjects met the following criteria: aged 18-70 years, in good general and oral health, non-smoker, with an organoleptic score between 2.7 and 4.5 following a 12-18 hour oral hygiene abstention period. Subjects who had oral appliances or who had periodontal disease or excessive recession were not eligible. The primary endpoint analysis was to evaluate oral malodor based on an organoleptic (OL) score. Additional surrogate measures for oral malodor included quantification of oral hydrogen sulfide (H2S) level and counts of oral bacteria in secondary analyses. At Day 1, all three malodor endpoints were assessed prior to product use, immediately after use, and four and eight hours after use. Subjects were then provided with instructions on product use at home. Subjects returned to the clinic on Day 8 and the assessments for malodor were repeated for each of the three endpoints, i.e., prior to in-clinic use of the products, immediately after use, and four and eight hours after use. RESULTS: One hundred sixty-eight (168) subjects were randomized to three groups, with 56 per treatment group. Of these, 165 completed all study visits. Randomized subjects were comparable for baseline characteristics (OL score, age, race, and ethnicity). Overall, oral malodor based on the organoleptic score decreased for all treatment groups at all timepoints. For the primary endpoint, reduction of OL score eight hours following a single product use, the STC regimen reduced malodor per OL score by 46.67% (SE = 2.28%), the LCM value was 22.83% (SE = 2.29%), and MTB was 26.19% (SE = 2.29%). The pair-wise comparisons between STC and each of the treatment groups were statistically significant (p-values < 0.0001). Statistically significant differences were also observed between STC and both LCM and MTB groups in pair-wise comparisons at Day 8 (p-values < 0.0001). CONCLUSIONS: Reductions in malodor were evident following a single use of each product, and also following a seven-day repeat use period. The STC regimen, however, was statistically significantly superior to both LCM and MTB at improving malodor eight hours following the first use. Statistically significant differences in OL scores were sustained between STC and LCM, and STC and MTB at each efficacy timepoint following the seven-day home use period.