scholarly journals Upright epiglottis prevents aspiration in patients with nasopharyngeal carcinoma post-chemoradiation

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261110
Author(s):  
Susyana Tamin ◽  
Marlinda Adham ◽  
Arfan Noer ◽  
Nana Supriana ◽  
Saptawati Bardosono

NPC is the most widely found malignant tumor in the head and neck region in Indonesia. Chemoradiation therapy for NPC can induce swallowing disorders (dysphagia) that adversely affects a patients quality of life. This study aimed to assess the swallowing process by flexible endoscopic evaluation of swallowing in patients with nasopharyngeal carcinoma after chemoradiation. Thirty-nine patients with NPC who had chemoradiation therapy more than one month previously underwent flexible endoscopic evaluation of swallowing and were assessed for oral transport time, sensation, standing-secretion, pre-swallowing leakage, residue, penetration, aspiration, and silent aspiration. The most common structural abnormalities were an upright and swollen epiglottis (89.4%), poor oral hygiene, and velopharyngeal closure defects (56.4%). This examination also revealed a mild degree of standing secretion (38.5%) and aspiration (10.3%). No penetration was observed in 64.1% of the patients, and no silent aspiration was observed in any of the patients. A severe degree of residue (45.7%) was observed when administering oatmeal, while the residue was mild to moderate when administering gastric rice, crackers, and milk. The residue changed to a mild degree (32.3%–51.4%) in all food administrations after the watering maneuver. The highest penetration was noted after oatmeal administration (42.8%), and the highest aspiration was found after milk administration (8.6%). Standing secretion in almost all patients was caused by hyposensitivity of the hypopharynx. Persistent residue and hyposensitivity of the hypopharynx led to aspiration. The low percentage of aspiration and silent aspiration might have been caused by the upright and swollen epiglottis that prevented aspiration. Poor oral hygiene and a dry mouth led to prolonged oral transport. Therefore, most patients had hypopharyngeal abnormalities in the form of a swollen and upright epiglottis. Secretion and food residue were also detected. Drinking helps to expedite the swallowing process by facilitating oral phase transport and reducing residues.

2021 ◽  
Vol 10 (13) ◽  
pp. 2873
Author(s):  
Cornelia Melinda Adi Santoso ◽  
Fera Ketti ◽  
Taufan Bramantoro ◽  
Judit Zsuga ◽  
Attila Nagy

Emerging evidence has linked poor oral hygiene to metabolic syndrome (MetS), but previously, no summary of evidence has been conducted on the topic. This systematic review and meta-analysis aims to evaluate the associations of oral hygiene status and care with MetS. A systematic search of the PubMed and Web of Science databases from inception to March 17, 2021, and examination of reference lists was conducted to identify eligible observational studies. A random-effects model was applied to pool the effects of oral hygiene status and care on MetS. Thirteen studies met the inclusion criteria and had sufficient methodological quality. Good oral hygiene status (OR = 0.30 (0.13–0.66); I2 = 91%), frequent tooth brushing (OR = 0.68 (0.58–0.80); I2 = 89%), and frequent interdental cleaning (OR = 0.89 (0.81–0.99); I2 = 27%) were associated with a lower risk of MetS. Only one study examined the association between dental visits and MetS (OR = 1.10 (0.77–1.55)). Our findings suggested that there might be inverse associations of oral hygiene status, tooth-brushing frequency, and interdental cleaning with MetS. However, substantial heterogeneity for tooth-brushing frequency and inconsistent results for oral hygiene status in subgroup analyses were observed. There was insufficient evidence for the association between dental visits and MetS. Further longitudinal studies are needed to investigate these associations.


Dysphagia ◽  
2021 ◽  
Author(s):  
Mozzanica Francesco ◽  
Pizzorni Nicole ◽  
Scarponi Letizia ◽  
Bazzotti Claudia ◽  
Ginocchio Daniela ◽  
...  

AbstractOnly limited and inconsistent information about the effect of mixed consistencies on swallowing are available. The aim of this study was to evaluate the location of the head of the bolus at the swallow onset, the risk of penetration/aspiration, and the severity of post-swallow pharyngeal residue in patients with dysphagia when consuming mixed consistencies. 20 dysphagic patients underwent a Fiberoptic Endoscopic Evaluation of Swallowing (FEES) testing five different textures: liquid, semisolid, solid, biscuits-with-milk and vegetable-soup. The location of the head of the bolus at the onset of swallowing was rated using a five-points scale ranging from zero (the bolus is behind the tongue) to four (the bolus falls into the laryngeal vestibule), the severity of penetration/aspiration was rated using the Penetration Aspiration Scale (PAS), the amount of pharyngeal residue after the swallow was rated using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) in the vallecula and pyriform sinus. When consuming biscuits-with-milk and liquid the swallow onset occurred more often when the boluses were located in the laryngeal vestibule. Penetration was more frequent with biscuits-with-milk, while aspiration was more frequent with Liquid, followed by biscuits-with-milk and vegetable-soup, Semisolid and Solid. In particular, no differences in penetration and aspiration between liquids and biscuits-with-milk were found as well as among vegetable-soup, semisolid and solid. No significant differences in the amount of food residue after swallowing were demonstrated. The risk of penetration-aspiration for biscuits-with-milk and liquid is similar, while the risk of penetration-aspiration is lower for vegetable-soup than for liquid.


2021 ◽  
Vol 9 (2) ◽  
pp. 12
Author(s):  
Javzan Badarch ◽  
Suvd Batbaatar ◽  
Edit Paulik

Brushing at least twice a day is one of the most effective methods for the prevention of dental caries and oral diseases. The aim of the present study was to determine the prevalence and correlates of poor oral hygiene in Mongolian school-going students. A secondary analysis of nationally representative data from the 2013 Mongolian Global School-based Health Survey (GSHS) was performed. In the survey, a questionnaire was completed by 5393 students aged 12–16 years old. The prevalence of poor oral hygiene and its association with some independent variables were analyzed by frequency distribution, chi-squared test, and logistic regression. The overall prevalence of poor oral hygiene was 33%. In the multivariate analysis, male students, inadequate fruit and vegetable intake, parents’ smoking, being exposed to second-hand smoke, poor parental supervision and connectedness, physical inactivity, and sedentary behavior were significantly associated with poor oral hygiene. Meanwhile, students who ate fast food and drank carbonated soft drink were found to be less likely to be poor tooth-brushers in 2013. Various determinants were identified in connection with poor oral hygiene. Based on these findings, it is recommended that an oral health promotion program should be combined with general health promotion and lifestyle intervention programs for this target population.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Reham AL Jasser ◽  
Mohammed AlSarhan ◽  
Dalal Alotaibi ◽  
Saleh Aloraini ◽  
Pradeep Koppolu ◽  
...  

AbstractRisk indicators of peri-implantitis is still contradictory and somehow unclear in present literature therefore efforts should be done for better understanding of the exact etiology of peri-implant disease progression. The present study aimed to assess risk indicators associated with peri-implantitis by observing the changes in several periodontal parameters after implant placement. This cross-sectional study included 213 female and 271 male patients aged 26–87 years, who received 484 titanium implants (Straumann, Switzerland) at King Saud University’s Dental College, Saudi Arabia. Patients were called for dental visits. During these visits; full clinical and radiographic assessment of implants were done. The periodontal pocket depth (PPD) was greater around implants placed at grafted sites than non-grafted sites and around bone-level implants than tissue-level implants. The plaque index (PI) was associated with poor oral hygiene. There was a strong association between graft (yes/no) and bleeding on probing (BOP). Patients with good oral hygiene showed high radiographic bone stability. Keratinized tissue width < 2 mm was associated with a higher PPD, higher PI, higher BOP, more edematous gingiva, and more exposed implant threads on radiography. In patients receiving implants, poor oral hygiene status and inadequate keratinized tissue level can be proposed as risk indicators for developing periimplantitis due to strong association found between them and developments of peri-implantitis.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Arisara Poosari ◽  
Thitima Nutravong ◽  
Prakasit Sa-ngiamwibool ◽  
Wises Namwat ◽  
Supaporn Chatrchaiwiwatana ◽  
...  

Abstract Background Previous studies have shown the association between Campylobacter species infection and that environmental factors, poor oral hygiene in particular, are linked to an increased risk of esophageal cancer (EC). However, no study has reported on these factors in Thailand. Thus, this study’s objective was to evaluate the impact of the relationship between Campylobacter infection and environmental factors on EC incidence in the population of Thailand. Methods Data from a case–control study were collected from 105 newly diagnosed EC cases and 105 controls recruited from 2007 to 2017. Infection with Campylobacter spp. was detected in the formalin-fixed paraffin-embedded (FFPE) tissue of EC taken from gastroesophageal biopsy specimens obtained from the participants, and evaluated using TaqMan® real-time PCR. Multivariable logistic regression was performed to calculate the odds ratios (ORs) and perform data analysis. Results Smoking, alcohol use, a family history of cancer, history of gastroesophageal reflux disease, poor oral hygiene and Campylobacter spp. infection were shown to be significant risk factors for EC (p  <  0.05). The combination of poor oral hygiene and infection with Campylobacter spp. constituted significant risk for EC (p  <  0.001). In addition, the risk of EC in subjects co-infected with C. rectus and C. concisus that practiced poor oral hygiene was even higher and was significant (ORadj  =  4.7; 95% CI 2.41–9.98; p  =  0.003). Conclusions In Thailand, the major risk factors for EC are smoking status, alcohol drinking, family history of cancer, GERD, poor oral hygiene and Campylobacter spp. infection. This study found Campylobacter spp. prevalence to be associated with EC and appears to be enhanced by poor oral hygiene, suggesting that a combination of poor oral hygiene and Campylobacter species infection may together act as an important etiological risk factor for EC.


2021 ◽  
Vol 9 ◽  
pp. 232470962110206
Author(s):  
Folake J. Lawal ◽  
Stephanie L. Baer

Odontogenic bacteremia, most commonly involving gram-positive oral flora, can result from daily self-care practices or professional dental procedures. Though usually transient and quickly cleared by the immune system, the presence of periodontal disease increases the frequency of exposure and risk of persistence of oral-systemic infections. Comorbidities such as asplenia, alcoholism, and immunocompromise increase the risk of complications of hematogenous spread and severe systemic illness. Capnocytophaga is a genus of anaerobic fastidious gram-negative bacilli, which is a common member of human oral flora, and its density is proportional to mass of dental plaques and periodontal diseases. Capnocytophaga spp that colonize humans are less virulent and are uncommon causes of bacteremia when compared with the Capnocytophaga typical of canines. C gingivalis has been rarely reported as a cause of disease in immunocompromised or immunocompetent hosts. In this article, we present a case of an immunocompromised 70-year-old man with poor oral hygiene, on methotrexate and prednisone for rheumatoid arthritis and sarcoidosis, who was admitted for chronic obstructive pulmonary disease exacerbation and developed C gingivalis bacteremia and septic shock after an episode of upper gastrointestinal bleeding. Poor oral hygiene in our patient is believed to have increased his risk as an immunocompromised patient to developing C gingivalis bacteremia. This case highlights the importance of oral care in immunocompromised patients especially while hospitalized, and those about to receive transplant, chemotherapy, or on immune modulators.


2005 ◽  
Vol 41 (6) ◽  
pp. 109-113 ◽  
Author(s):  
Recep Orbak ◽  
Cigdem Bayraktar ◽  
Fahri Kavrut ◽  
Cemal Gündogdu

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Haben Fesseha ◽  
Mesfin Mathewos ◽  
Friat Kidanemariam

Background. Gastrointestinal helminth parasite infection is a major influencing factor against profitability of working equines all over the world. Objectives. A study was conducted from October 2016 to May 2017 in and around Hosaena to determine the efficacy of benzimidazole (BZ) and avermectin (AVM) chemical groups against strongyle nematodes in working donkeys. Methods. A total of 230 donkeys from Hosaena, Soro, Anlemo, and Gombora were randomly allocated into 5 groups of 46 donkeys in each group. All groups, except group 1 (control), were treated with ivermectin 1%, ivertong 10%, fenbendazole, and Fenacure 750 mg, respectively. Fecal samples were collected perrectally before treatment (day 0) and after treatment (day 14), and an egg per gram (EPG) value of >200 was used as a cutoff for inclusion to assess the efficacy of anthelmintics. Results. Accordingly, the study revealed that AVM was effective against strongyle nematodes of donkeys with the mean fecal egg count reduction (FECR) of 100% in three study areas and 97.2% in one study area, respectively, whereas BZ resistance was suspected in the areas where the drug was tested, with the mean FECR of less than 94% in the three study areas. The study also revealed that 73% of the donkeys were affected with a severe degree of strongyle infection as determined by EPG, while 10.4% of donkeys were affected with a mild degree of Parascaris equorum infection. Conclusions. The findings of the present study are expected to serve as baseline data for future investigations and control actions to design realistic control programs to minimize factors that favor emergence of anthelmintic resistance and improve the overall health of the donkeys. Thus, further detailed studies are needed to determine the factors that reduce anthelmintic efficacy and increase anthelmintic resistance in donkeys.


2017 ◽  
Vol 4 (1) ◽  
pp. 56
Author(s):  
Addina Aimana Sabila ◽  
Ade Ismail A.K ◽  
Rochman Mujayanto

Background: Nosocomial infections can develop in the oral cavity due to poor oral hygiene. Oral Candidiasis is one of the most frequent nosocomial infection in oral cavity. The objective of this study is to describe the oral hygiene and oral candidiasis in hospitalized patients. Method: This analitical observational study used cross sectional design. Subject of the study were 74 adult patients aged 20-65 who are hospitalized at the Sultan Agung Islamic Hospital Semarang. Oral hygiene assessed from the presence of debris and calculus on the tooth surface using Simplified Oral Hygiene Index (OHIS) that were grouped in three categories (good, moderate, bad). Oral candidiasis diagnosed through clinical examination and swab procedure of suspicious lesions, and identified the presence of its spores and hyphae under a microscope observation. Kendal Tau test is used to analyze the correlation between oral hygiene with oral candidiasis. Results: Results showed patients with oral candidiasis in the poor and moderate oral hygiene were 29.7% and 1.4%, whereas patients without oral candidiasis in the poor and moderate oral hygiene were 60.8% and 8.1%. Kendall Tau correlation test results p value of 0.235 (p> 0.05). Conclusion: Conclusion of this study showed there is no association between oral hygiene with oral candidiasis.


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