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PubMed2001

Inhibitory effect of betel quid on the volatility of methyl mercaptan.

Betel quid, a popular natural masticatory in Taiwan, is mainly composed of fresh areca fruit, Piper betle (leaf or inflorescence), and slaked lime paste. People say that halitosis disappears during betel quid chewing. In this study, the removal of mouth odor during betel quid chewing was discussed by using a model system which measured its inhibition on the volatility of methyl mercaptan. Results showed that crude extracts of betel quid (the mixture of areca fruit, Piper betle, and slaked lime paste) and extracts of the mixture of areca fruit and slaked lime paste exhibited marked effects on the volatility of methyl mercaptan, and the inhibition function increased when increasing amounts of slaked lime paste were added. The same condition (increased inhibition) was also found by replacing the slaked lime paste with alkaline salts (calcium hydroxide, potassium hydroxide, or sodium hydroxide). Areca fruit, the major ingredient of betel quid, contained abundant phenolics. However, the crude phenolic extract of areca fruit did not show any inhibitory activity on the volatility of methyl mercaptan. Great inhibitory activity occurred only when the crude phenolic extract of areca fruit was treated with alkali. Further studies by using gel filtration determined that the effect probably came from the oxidative polymerization of phenolics of areca fruit after alkaline treatment.

Areca↗
PubMed2003

Prevention. Part 1: smoking cessation advice within the general dental practice.

Smoking remains the largest single preventable cause of death and disability in the UK and costs the NHS 1.7 billion pound each year. More than 120,000 people die prematurely due to smoking related diseases. Worldwide smoking is the single most important public health problem. The detrimental effects of smoking and tobacco use on oral health are well recognised. Oral cancers and pre-cancers, periodontal diseases and poor wound healing are the most significant and serious effects of smoking on the mouth. In addition, staining of the teeth, soft tissue changes and halitosis are aesthetic and social impacts of smoking directly related to oral health.

Communication↗
PubMed2000

Clinical presentation of Helicobacter pylori-positive and -negative functional dyspepsia.

BACKGROUND: A questionnaire was used to record the clinical presentation of functional dyspepsia in relation to Helicobacter pylori infection in a consecutive series of patients sent for upper gastrointestinal endoscopy. Only patients without macroscopic abnormalities in their oesophagus, stomach and duodenum were included. METHODS: The study questionnaire included two questions related to daily life, and the calculation of a symptom score. Biopsy specimens were taken from all patients for histological and microbiological examination, and immunoglobulin G antibodies were also determined. RESULTS: Two hundred and twenty-two patients were H. pylori positive and 182 patients were H. pylori negative. Loss of weight was significantly more common in the H. pylori positive group (P<0.001). Patients with H. pylori infection had a significantly higher overall symptom score compared with H. pylori-negative subjects (P<0.05). In addition, the severity of epigastric and nocturnal pain, heartburn, retrosternal heartburn, and vomiting was significantly higher in H. pylori-positive functional dyspeptic patients, and the influence on daily life and activities was significantly worse. CONCLUSIONS: The combination of retrosternal pain, weight loss, food intolerance and the absence of halitosis signified a 64% accuracy in predicting H. pylori infection. It is not possible to differentiate between H. pylori-positive and H. pylori-negative functional dyspeptics on the basis of clinical presentation and the number of complaints. However, overall symptom score and severity of several symptoms was significantly higher in the H. pylori-positive group.

Adult↗
PubMed2002

Endoscopic stapler-assisted diverticuloesophagostomy for Zenker's diverticulum: patient satisfaction and subjective relief of symptoms.

BACKGROUND: We assessed the results of endoscopic stapler-assisted diverticuloesophagostomy for Zenker's diverticulum, with emphasis on patient satisfaction and subjective relief of symptoms. METHODS: A retrospective cohort analysis was performed on all patients operated on from 1997 to 2000. Patients' charts were reviewed with respect to intraoperative and postoperative complications. The severity of preoperative and postoperative symptoms by patient self-assessment was compared by means of a 4-point scale (0-3) on a standardized questionnaire, as well as assessment of patient satisfaction (poor, fair, moderate, high). RESULTS: Thirty patients (22 men, 8 women) with a mean age of 72 years (range, 42-97 years) were part of the study. The mean follow-up was 13.2 months (range, 2-39 months). No major intraoperative or postoperative complications were observed. The most frequent preoperative symptoms were regurgitation of undigested food and dysphagia for solid consistencies (87%). Both of these preoperative symptoms were improved from a mean preoperative score of 2.2 and 2.7 to 0.1 and 0.4, respectively (P <.0001). Postprandial coughing (32%), halitosis (21%), and globus sensation (32%) were less common but also significantly improved. All but 1 patient (96%) were highly satisfied with the procedure. CONCLUSIONS: Endoscopic stapler-assisted treatment of Zenker's diverticulum offers a very low complication rate, a very high degree of symptom relief, and patient satisfaction.

Adult↗
PubMed2005

Suspected Vestia foetida poisoning in young goats.

CASE HISTORY: Two crossbred, castrated male goats, a 5-month-old and an 8-month-old, were observed ingesting Vestia foetida (Solanaceae). Later, the goats were seen standing splay-legged and apparently disoriented. CLINICAL FINDINGS: When examined, both goats were in sternal recumbency and had mydriasis; the younger goat had a diminished menace response. When the goats were made to stand, they were ataxic and had muscle fasciculations of the hindquarters and face. Both had halitosis consistent with the odour of crushed Vestia leaves. The animals were treated with a mixture of vitamins and intravenous diazepam. The older goat recovered but the younger goat died and was necropsied. This animal had severe periacinar necrosis and fatty change in the liver, as well as fatty nephrosis. DIAGNOSIS: Probable Vestia foetida poisoning. CLINICAL RELEVANCE: The introduction of Vestia foetida to New Zealand and the apparent palatability of the plant necessitate that veterinarians and owners be knowledgeable about its potential toxicity. Differential diagnoses for the liver lesions (in New Zealand) would include Cestrum poisoning, acute seneciosis, acute blue-green algal poisoning, and acute and chronic copper poisoning.

Animals↗
PubMed2004

Novel approach to management of a posterior tracheal tear complicating percutaneous tracheostomy.

We treated a patient who developed a posterior tracheal wall perforation and severe respiratory compromise following percutaneous tracheostomy, using a covered expandable metallic stent. The stent was deployed under direct vision using rigid and fibreoptic bronchoscopy. The defect was sealed and the right lung, which had been collapsed, was re-expanded. The patient was subsequently weaned from mechanical ventilation. Late complications included halitosis, which was treated with nebulized colistin sulphate, and the development of intratracheal granulation tissue, which was cleared using low power (10 W) Nd:YAG laser.

Bronchoscopy↗
PubMed2000

A prospective trial of lansoprazole triple therapy for pediatric Helicobacter pylori infection.

BACKGROUND: Triple therapy with a proton-pump inhibitor and two antibiotics is widely used in the treatment of Helicobacter pylori infection in adults. Experience with such therapy in the pediatric population is limited. This was a prospective, nonrandomized, open-label trial to evaluate safety and efficacy of a combination of lansoprazole, clarithromycin, and amoxicillin in symptomatic children with H. pylori infection. METHODS: Children with H. pylori gastritis diagnosed by endoscopy performed for persistent nausea, vomiting, recurrent abdominal pain, and diarrhea with consistent histology were treated with the regimen of 0.45 mg/kg per day lansoprazole divided into two doses (maximum dose, 15 mg twice daily), amoxicillin 40 mg/kg per day in two doses (maximum dose, 1.0 g twice daily), and 250 mg clarithromycin twice daily (<10 years old) or 500 mg twice daily (>10 years old) for 2 weeks. Pre- and posttreatment endoscopic biopsy specimens were graded for the severity of gastritis and H. pylori density by a blinded pathologist. A questionnaire for assessing the severity of symptoms at the time of initial and second endoscopy were completed by patient and/or parent. RESULTS: Thirty-two children (age range, 1-25 years; mean age, 11 years; 19 females, 13 males) were treated with this regimen during an 18-month period. H. pylori organisms with varying grades of gastritis were present in tissue specimens of all patients. Only 28 children had follow-up endoscopy, which showed eradication of H. pylori in 15 (54%) children. Histologic symptoms of gastritis improved after therapy in the whole group. Overall, symptoms of vomiting, abdominal pain, diarrhea, anorexia, and halitosis significantly improved (P < 0.05). Minor adverse effects of therapy occurred in 25% of patients. CONCLUSIONS: Symptoms, histologic, and endoscopic findings improved after triple therapy in children with H. pylori gastritis; however, eradication of bacteria was achieved in only 56% of children.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1995

Zenker's bezoar.

Zenker's diverticulum has been associated with a variety of symptoms such as dysphagia, regurgitation, aspiration, halitosis, and occasionally cough. In this case, a large Zenker's diverticulum containing a bezoar caused a persistent, debilitating cough presumably due to compression of adjacent neck structures.

Bezoars↗
PubMed1999

Insulin-dependent diabetes mellitus affects eradication rate of Helicobacter pylori infection.

BACKGROUND: Patients with insulin-dependent diabetes mellitus (IDDM) are often affected by chronic infections; however, antibiotic absorption may be influenced by the disease. Helicobacter pylori, the most common gastric infection worldwide, is the main acquired factor in the pathogenesis of gastritis and peptic ulcer. The aim of the study was to compare the H. pylori eradication rate obtained with a standard 7-day antibiotic regimen in a group of IDDM H. pylori infected patients and in a control group of infected dyspeptic patients. METHODS: Thirty-one patients (18 male, 13 female, 39+/-12 years) affected by IDDM and H. pylori infection, and 50 dyspeptic infected patients (23 male, 17 female, 37+/-10 years) were evaluated. H. pylori infection was assessed through 13C-urea breath test. A triple therapy with amoxycillin (1 g b.i.d.), clarithromycin (250 mg t.i.d.) and pantoprazole (40 mg b.i.d.) was given to both groups at the time of diagnosis for 7 days. Cure was defined as the absence of H. pylori infection, assessed by 13C-urea breath test, 6 weeks after completing anti-microbial therapy. Effects of H. pylori eradication on gastrointestinal symptoms (pyrosis, epigastric pain, belching, bloating, halitosis and nausea) were also evaluated. RESULTS: All enrolled patients completed the study. When compared to dyspeptic patients, the eradication rate was significantly lower in IDDM patients: 92% (46/50) versus 65% (20/31), respectively (P < 0.002). IDDM patients infected by H. pylori showed a different prevalence of some of the gastrointestinal symptoms assessed when compared to the infected dyspeptic patients; in particular, pyrosis, epigastric pain and belching were significantly more prevalent in the infected dyspeptic group. After H. pylori eradication, both groups showed a significant reduction of the intensity of all the gastrointestinal symptoms evaluated, except for nausea. CONCLUSIONS: IDDM patients showed a significantly lower H. pylori eradication rate when compared to that observed in dyspeptic subjects. The dosage and/or the duration of a standard eradication regimen does not appear to be sufficient to eradicate the infection in IDDM patients. The impairment of the gastrointestinal mucosa microvasculature with a reduction of antibiotic absorption, or the frequent use of antibiotics for other infections with development of resistant strains, may be the mechanisms underlying the observation.

Adult↗
PubMed2003

Post-cholecystectomy alkaline reactive gastritis: a randomized trial comparing sucralfate versus rabeprazole or no treatment.

OBJECTIVE: At present there are no well-established pharmacological approaches in the management of post-cholecystectomy alkaline reactive gastritis. The aim of this study was to assess the effect of sucralfate versus rabeprazole or no treatment on dyspeptic symptoms and endoscopic/histological signs in a population of patients with a history of cholecystectomy and evidence of alkaline reactive gastritis. METHODS: Sixty dyspeptic patients fulfilling the following criteria of inclusion took part in this study: (1) a history of cholecystectomy; (2) no use of anti-inflammatory steroidal and non-steroidal drugs, or abuse of alcohol; (3) evidence of abundant gastric bile reflux at endoscopy; (4) endoscopic signs of chronic gastritis; (5) histological signs of chronic gastritis; and (6) absence of Helicobacter pylori infection. Dyspeptic symptoms were evaluated by means of a self-administered validated questionnaire. Patients included in the study were randomly assigned to one of three treatment groups for 3 months: sucralfate, rabeprazole, observation. Patients were re-evaluated at the end of the treatment. RESULTS: Sucralfate and rabeprazole therapies were both able to significantly reduce epigastric pain, heartburn, bloating and halitosis. Endoscopic/histological signs were lower in both treatment groups compared to the observation group. CONCLUSION: Both sucralfate and rabeprazole therapies are effective treatment options in the patients with alkaline gastritis when compared with observation.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1992

Topical tretinoin: a new treatment for black hairy tongue (lingua villosa nigra).

Black hairy tongue is the name given to the appearance of an abnormal coating of the tongue and occurs only in adults. It is the result of hyperkeratosis of the filiform lingual papillae which, on gross examination appear hair-like with a variable tinctorial aspect from yellow-brown to black. The pathogenesis is unknown and often no definite cause can be identified. A number of aetiologic factors have been implicated including the administration of topical or systemic antibiotics, poor oral hygiene, smoking, alcohol and the use of mouthwashes. Often there are no symptoms other than the aesthetic or anxiety over its aetiology. Some patients complain of gagging, nausea, alteration of taste or halitosis. The condition may be very persistent and recognized treatments include brushing with a soft tooth brush which is enhanced by the prior application of a 40% solution of urea, scraping, topical triamcinolone acetonide, gentian violet, thymol, salicylic acid, vitamin B complex, and surgical excision of the papillae.

Administration, Topical↗
PubMed2006

Herpes simplex virus infection, with particular reference to the progression and complications of primary herpetic gingivostomatitis.

Primary herpetic gingivostomatitis (PHGS) represents the clinically apparent pattern of primary herpes simplex virus (HSV) infection, since the vast majority of other primary infections are symptomless. PHGS is caused predominantly by HSV-1 and affects mainly children. Prodromal symptoms, such as fever, anorexia, irritability, malaise and headache, may occur in advance of disease. The disease presents as numerous pin-head vesicles, which rupture rapidly to form painful irregular ulcerations covered by yellow-grey membranes. Sub-mandibular lymphadenitis, halitosis and refusal to drink are usual concomitant findings. Following resolution of the lesions, the virus travels through the nerve endings to the nerve cells serving the affected area, whereupon it enters a latent state. When the host becomes stressed, the virus replicates and migrates in skin, mucosae and, in rare instances, the central nervous system. A range of morbidities, or even mortality, may then occur, i.e., recurrent HSV infections, which are directly or indirectly associated with PHGS. These pathological entities range from the innocuous herpes labialis to life-threatening meningoencephalitis.

Disease Progression↗
PubMed2004

Should upper gastrointestinal endoscopy be part of the evaluation for supraesophageal symptoms of GERD?

The past decade has witnessed increasing interest in the supraesophageal (ear, nose, and throat (ENT)) symptoms potentially caused by gastroesophageal reflux disease (GERD). Hoarseness, halitosis, problems with vocal presentations, excessive phlegm, frequent throat clearing, globus sensation, sore throat, cough, aspiration, laryngospasm, and laryngeal carcinoma are some, but not all of the ENT symptoms that have been attributed to GERD (1). The availability of highly effective medical and surgical therapies allows for control of these symptoms in many patients adding to the importance of accurately diagnosing GERD.

Esophagoscopy↗
PubMed1991

Public health aspects of periodontal diseases in Europe.

There is relatively little severe periodontal disease in populations in Europe. The public health significance is therefore debateable. The fact that the costs of treating the disease are high because of the organization of dental care, qualifies it as a dental public problem. In addition, the symptoms of periodontal diseases such as bleeding, halitosis, gingival recession and tooth loss have an impact on many people, and we have sufficient information to control the common forms of the disease. The goals for dental health can be expressed in terms of health, disease, health education and health promotion and training. A reasonable objective is to achieve a rate of loss of attachment compatible with maintaining at least upper and lower shortened arches for a lifetime. 4 strategies are considered: a high risk, a population, a secondary prevention strategy or a combination of the three. A combination of the 3 is needed to achieve the objective of maintaining a functional, aesthetically and socially acceptable natural dentition for the lifespan of most people. The balance of effort should be heavily weighted towards the population strategy. If the strategy is adopted, the need for treatment will be reduced and treatment will be more successful.

Europe↗
PubMed2006

Airsacculitis in fourteen juvenile southern Bornean orangutans (Pongo pygmaeus wurmbii).

BACKGROUND: Airsacculitis is a clinical condition which has been reported in a range of primates species, including orangutans. METHODS: This report describes the occurence and management of airsacculitis in fourteen juvenile Southern Bornean orangutans (Pongo pygmaeus wurmbii) that presented beween January 1st 1999 and January 31st 2001 at the Orangutan Care Center and Quarantine (OCC&Q), Kalimantan Tengah, Indonesia (S 2 degrees 43' 49.2"; E 111 degrees 38' 54.2"). Details of the signalment, clinical history, presenting clinical signs, clinicopathological findings and bacterial isolates in each case were reviewed. RESULTS: Cough, halitosis and nasal discharge were the most frequently observed clinical signs. A range of Gram-negative bacteria were isolated from infected air sacs, including Pseudomonas sp., Enterobacter sp. and Klebsiella pneumoniae. A simple drainage and lavage technique was used in cases where surgical intervention was indicated, in combination with local and systemic antibiotic therapy. CONCLUSIONS: The importance of early diagnosis, prompt management and antibiotic selection, based on bacterial culture and sensitivity profiles, is outlined.

Air Sacs↗
PubMed1980

Clinical and epidemiological features of 15 incidents of severe infectious bovine rhinotracheitis.

Fifteen incidents of infectious bovine rhinotracheitis (IBR) were studied in herds distributed widely throughout northern Britain. Fattening beef animals (10 outbreaks), dairy cattle (four outbreaks) and suckler beef cows (one outbreak) were affected and all bar one incident occurred in housed cattle during the winter. The first signs of illness noticed were a reduced appetite, dullness, coughing and oculonasal discharge. In 13 of the incidents they were observed in cattle purchased from a market within the previous four weeks. In every outbreak, affected animals developed a serous nasal discharge which became purulent in severe cases. In the early stages the nasal mucosa was congested but later yellow-brown diphtheritic plaques developed. In such animals halitosis was always detected. Soft coughing was frequently heard but pneumonia was rarely confirmed ante mortem. Conjunctivitis and ocular discharge were a major finding in 13 incidents and, in severely affected cases, conjunctival oedema was seen. The drooling of saliva was noticed in 14 incidents but congestion of the oral mucous membranes was the only abnormality found on examination of the oral cavity. Diarrhoea was a consistent feature in one outbreak. As a result of contracting this disease beef cattle failed to put on weight for a period of one to eight weeks and the milk yield of lactating dairy cattle decreased markedly. The morbidity rate was high, being more than 90 per cent in 10 incidents. The mortality rate varied considerably but 7 to 8 per cent of the animals died, or were culled, in three outbreaks. The clinical signs were most severe on intensive units with a high turnover of cattle.

Animals↗
PubMed2006

Metallic foreign bodies in the tongues of 16 horses.

The history, clinical signs, results of diagnostic imaging, treatment methods and outcome of 16 adult horses with a metallic foreign body in the tongue are reviewed. All the horses had a swollen tongue, they salivated excessively and were partially to completely anorexic. Less common clinical signs were fever, an enlarged and painful intermandibular space, dysphagia, unilateral tongue paralysis and halitosis. Most of the horses had shown clinical signs for less than 24 hours. The foreign bodies were diagnosed by oral examination, radiography and ultrasonography; they were removed from the tongue of four of the horses during the initial oral examination, and were removed surgically from nine others; the other three horses were treated medically without attempts being made to extract the foreign bodies. Twelve of the bodies were small pieces of wire and one was a hypodermic needle. All the horses received a combination of antimicrobial and non-steroidal anti-inflammatory drugs and they all made an uneventful recovery. Feeding hay and the use of cable-framed tractor tyres as feeders were commonly associated with the cases.

Animals↗
PubMedDate not supplied

Clinical outcome of laryngotracheal separation for intractable aspiration pneumonia.

OBJECTIVES: To confirm that laryngotracheal separation (LTS) is a satisfactory treatment for patients with intractable aspiration pneumonia, even though it does not require tracheoesophageal anastomosis. STUDY DESIGN: Retrospective. METHODS: Nine patients with intractable aspiration pneumonia underwent LTS at our institution from 1996 to 1999. Two patients underwent postoperative barium swallow radiography. RESULTS: Neither halitosis nor stimulation of the cough reflex occurred due to pooled secretions in the blind pouch of the proximal tracheal segment. Barium swallow radiography confirmed that the secretions drained within 40 min by swallowing or a change in patient position. CONCLUSION: LTS is a satisfactory solution to the problem of chronic aspiration. Neither pooled secretions in the proximal tracheal segment nor fistula formation were significant postoperative problems.

Adolescent↗