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PubMed2004

Diagnosis of chronic rhinosinusitis.

Chronic rhinosinusitis is a multifactorial disease defined as inflammation of the nasal cavity and paranasal sinuses with a history of at least 12 weeks in duration. The major symptoms include facial pressure or pain, nasal obstruction, discharge or purulence, and hyposmia or anosmia. The minor symptoms include fever, halitosis, fatigue, and dental pain. Microorganisms play a significant role in the persistence and origination of the inflammatory process, although the exact role of these organisms in the pathogenesis of chronic rhinosinusitis is unclear. The clinical diagnosis relies heavily on the patient history and physical examination, which may include nasal endoscopy and computed tomography. Diagnostic techniques are here reviewed.

Bacterial Infections↗
PubMed2006

Parental use of the term "Hot Qi" to describe symptoms in their children in Hong Kong: a cross sectional survey "Hot Qi" in children.

BACKGROUND: The Chinese term "Hot Qi" is often used by parents to describe symptoms in their children. The current study was carried out to estimate the prevalence of using the Chinese term "Hot Qi" to describe symptoms in children by their parents and the symptomatology of "Hot Qi". METHOD: A cross sectional survey by face-to-face interview with a semi-structured questionnaire was carried out in a public hospital and a private clinic in Hong Kong. The parental use of the term "Hot Qi", the symptoms of "Hot Qi" and the remedies used for "Hot Qi" were asked. RESULTS: 1060 pairs of children and parents were interviewed. 903 (85.1%) of parents claimed that they had employed the term "Hot Qi" to describe their children's symptoms. Age of children and place of birth of parents were the predictors of parents using the term "Hot Qi". Eye discharge (37.2%), sore throat (33.9%), halitosis (32.8%), constipation (31.0%), and irritable (21.2%) were the top five symptoms of "Hot Qi" in children. The top five remedies for "Hot Qi" were the increased consumption of water (86.8%), fruit (72.5%), soup (70.5%), and the use of herbal beverages "five-flower-tea" (a combination of several flowers such as Chrysanthemum morifolii, Lonicera japonica, Bombax malabaricum, Sophora japonica, and Plumeria rubra) (57.6%) or selfheal fruit spike (Prunella vulgaris) (42.4%). CONCLUSION: "Hot Qi" is often used by Chinese parents to describe symptoms in their children in Hong Kong. Place of birth of parents and age of the children are main factors for parents to apply the term "Hot Qi" to describe symptoms of their children. The common symptoms of "Hot Qi" suggest infections or allergy.

Adult↗
PubMed1993

Functional endoscopic surgery in children: a retrospective analysis of results.

The impact of chronic sinusitis on children has become more apparent as the awareness of the disease has increased. Consequently, the knowledge of its effect in the pediatric patient has expanded dramatically. Functional endoscopic sinus surgery (FESS) has become the primary surgical modality for treatment of this illness in children who have not responded to optimal medical management. A retrospective study was conducted in patients from 7 months to 17 years of age who were treated with FESS for chronic sinusitis refractory to medical therapy. Using a comprehensive parental questionnaire and a review of the medical charts, results were analyzed from these post-FESS children. Parents of the children were interviewed with a mean follow-up time of 21.8 months postoperatively. Factors discussed included chronic nasal obstruction, purulent nasal discharge, postnasal drip, chronic cough, halitosis, headaches, behavioral problems, allergies, and asthma symptoms. This preliminary investigation suggests that FESS is effective in treating medically recalcitrant severe chronic sinusitis in children.

Adolescent↗
PubMedDate not supplied

Biliopancreatic diversion with transitory gastric restriction and duodenal bulb preservation: 88 patients since 1992.

BACKGROUND: Over 10 years, 88 patients underwent biliopancreatic diversion with transitory gastric restriction (BPD-TGR) as a first choice operation or after gastric restrictive procedures. METHODS: From 1992 to 1999, BPD-TGR was performed on 71 patients as a first choice operation (Group 1 - BMI 41.9 +/- 6.5). The TGR was achieved by a polydioxanone (PDS) band. The duodenal bulb was maintained to 5 cm distal to the pylorus, constructing an end-to-side antecolic isoperistaltic duodeno-ileal anastomosis. Since 1993, a further 17 patients underwent BPD-TGR as a correction for restrictive procedures (Group 2 - BMI 37.4, range 27.2-61.0). RESULTS: Results in weight loss in Group 1 were similar to those in our previous classical BPD. Percent excess weight loss (%EWL) was 68.0 +/- 18.4, 75.9 +/- 12.3, and 75.4 +/- 12.0 at 1,5 and 10 years respectively. No patient had severe dysproteinemia (only 3% of patients had hypoalbuminemia of 3.0-3.4 g/dl). There was no case of diarrhea or halitosis. Anastomotic ulcers occurred in 2% of the patients. In Group 2, the patients had weight loss already present from the first operation, which continued after BPD-TGR with great variability from patient to patient. %EWL was 35.1 (range 0 to 72.5) and 35.2 (range 18.4 to 43.2) at 1 and 5 years. CONCLUSIONS: BPD-TGR appears to be an effective operation with few complications and also a satisfactory correction for failed gastric restrictive procedures, or even a sequential operation in the super-obese.

Adult↗
PubMed1997

Biliopancreatic diversion with transitory gastroplasty preserving duodenal bulb: 3 years experience.

BACKGROUND: The authors have performed 521 bariatric surgery operations (319 restrictive procedures and 202 malabsorptive procedures). METHODS: During the last few years we have introduced an evolution of biliopancreatic diversion (BPD): BPD with transitory gastroplasty, preserving the duodenal bulb (53 cases). From a technical point of view, the operation consists of a BPD, coupled with a gastroplasty which is transitory due to the use of a polydioxanone (PDS) band. In the last few cases, instead of a VBG (with PDS band) in order to make the operation completely reversible without any suture on the stomach, we made a gastric pouch by banding with PDS calibrated with the same tube as for the Lap-band (20 cc). We maintained completely the duodenal bulb (5 cm from the pylorus), making an end-to-side duodeno-ileal isoperistaltic anastomosis. RESULTS: With this anastomosis, only 2% of patients developed an anastomotic ulcer. With this new procedure, results have been good in terms of weight loss (similar to that of BPD-AHS) and in nutritional complications. No patient has had hypoalbuminemia, diarrhea or halitosis. CONCLUSION: BPD with temporary gastric restriction has provided satisfactory results.

Adult↗
PubMed2006

Microbiota of the dorsum of the tongue after plaque accumulation: an experimental study in humans.

BACKGROUND: The purpose of the present investigation was to determine the effect of the absence of tongue hygiene on the microbiota of the dorsum of the tongue. METHODS: Ten volunteers (aged 19 to 22 years) entered the study at baseline and were instructed to abstain from tongue cleaning for 7 days, followed by a period of 3 days without any kind of oral hygiene. Subsequently, a period of 21 days of washout was employed, and this protocol was repeated three times. Microbiological samples were obtained from the dorsum of the tongue at baseline and at the end of the period of coating accumulation and analyzed using the checkerboard DNA-DNA hybridization technique. RESULTS: The species found in highest mean counts at baseline and day 10 were Prevotella melaninogenica and Veillonella parvula. The mean bacterial total counts enhanced significantly during the study (from 17.1x10(6) to 33.7x10(6)). Proportions of red and blue complexes and levels of 18 species also increased after the period of coating accumulation, including several periodontal pathogens, such as Prevotella intermedia, Prevotella nigrescens, Streptococcus constellatus, Tannerella forsythensis, Porphyromonas gingivalis, Treponema denticola, and P. melaninogenica. CONCLUSION: The tongue surface could be an important reservoir for periodontal pathogens and may play a role in the recolonization of tooth surfaces and in the etiology of oral halitosis.

Actinobacillus↗
PubMed1999

MR imaging of Tornwaldt's cysts.

OBJECTIVE: The purpose of this study was to assess the characteristics of Tornwaldt's cysts as revealed by routine MR studies. MATERIALS AND METHODS: We retrospectively reviewed MR images of the brain in 1208 consecutive subjects who ranged in age from 3 weeks to 93 years (mean, 57.1 years). The signal intensity, shape, and size of Tornwaldt's cysts were assessed. Patients with Tornwaldt's cysts were then questioned about the presence of persistent nasal discharge, occipital headaches, and halitosis and an unpleasant taste in the mouth and about a history of adenoidectomy. RESULTS: Tornwaldt's cysts were found in 23 patients (1.9%) who ranged in age from 39 to 78 years (mean, 57.3 years). Of the 23 Tornwaldt's cysts, all were isointense to CSF on T2-weighted images and hyperintense to gray matter on the fluid-attenuated inversion-recovery images. The cysts showed high signal intensity compared with muscle on T1-weighted images. Nineteen cysts were round and four were oval. The mean size of the lesions was 6.0 mm in the major axis and 5.5 mm in the minor axis. Two patients with Tornwaldt's cysts had persistent nasal discharge and occipital headaches, and another patient had occipital headaches alone. None of the patients had undergone an adenoidectomy. CONCLUSION: Lesions consistent with Tornwaldt's cysts were found in 1.9% of the routine MR studies of the brain. The cysts had high signal intensity on T1-weighted, T2-weighted, and fluid-attenuated inversion-recovery images.

Adolescent↗
PubMed1998

[Rhinosinusitis in children]

OBJECTIVES: To review the pathogenic mechanisms and treatment of sinusitis in children.METHODS: Mucopurulent secretion and halitosis are important signs and symptoms for the diagnose of sinusitis. The radiographic and computorized tomography investigations confirm the sinusal disease.RESULT: The identification of the main pathogens involved in the acute and chronic sinusitis is fundamental to give a better therapeutic control to these patients. CONCLUSIONS: Rhinosinusitis is one of the most reported diseases among the general population, and its prevalence has been rising in the last years. Many questions remain unanswered about its cause, pathophysiology and optimal treatment, especially in the pediatric population, generating health care costs and a high rate of morbidity.

Journal Article↗
PubMed2005

A comparative study of oral health attitudes and behaviour using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) between dental students in Britain and China.

The aim of this study was to compare oral health attitudes and behaviour between British and Chinese dental students. A cross-national survey using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) was completed at the University of Leeds in Britain and West China University of Medical Sciences in China. In Britain and China, 192 of 266 and 180 of 303 dental students answered English and Chinese versions of the HU-DBI questionnaire, respectively. Data were statistically analyzed by logistic regression and the following results were obtained: 1) Self-reported gingival bleeding was more prevalent in Chinese students than in British students, although the number of students who had professional oral hygiene instruction was higher in China than in Britain; 2) 29% of Chinese students believed wearing dentures in old age was inevitable, whereas 7% of British students believed so; 3) Chinese students were substantially more concerned about the appearance of their teeth, gums and halitosis; and 4) 54% of Chinese students seek dental care only when symptoms arise, as compared to 13% of British students. In conclusion, bilateral comparison of countries using HU-DBI revealed interesting differences in oral health attitudes and behaviour, while the logistic regression model made it possible to differentiate British from Chinese students with a probability of nearly 95%.

Attitude of Health Personnel↗
PubMed1994

Tornwaldt's disease.

Tornwaldt's disease was first described by Tornwaldt as one of the causes of epipharyngitis, and is an inflammation or abscess of the embryonic remnant cyst of the pharyngeal bursa appearing at the posterior median wall of the nasopharynx. Although many cases are symptom-free, symptoms can often be caused by nasal tamponade, trauma, adenotomy, or other mechanical stimuli. Only a few cases have been reported in Japan between 1929 and 1992. At about the 10th week of embryonic development, the pouch, which forms by adhesion of the pharyngeal ectoderm to the notochord at the most cranial end of the notochord, becomes closed at the orifice (cystic type), or crusts adhere to the orifice without closing (crust type). Symptoms are those of upper respiratory tract infection with obstinate occipital pain, purulent choanal discharge, nasal obstruction, halitosis, feeling of ear fullness, clearing of the throat, etc. Posterior rhinoscopy, simple lateral view X-ray tomography, nasopharyngeal fiberoscopy, CT scan and MRI are useful in showing adhesion to the cervical vertebrae. While complete extirpation via a transpalatal approach is desirable, incision or excision of the cyst can also be performed.

Cysts↗
PubMedDate not supplied

Endoscopic retrieval of a large, nasopharyngeal foreign body.

A 1.5-year-old golden retriever was presented for stertorous respiration, reverse sneezing, halitosis, and a bilateral mucopurulent nasal discharge. A bone-density, nasopharyngeal foreign body was visualized on lateral radiographs of the skull. The foreign body was removed using a videoendoscope and a basket retrieval forcep. The dog's clinical signs resolved following foreign body removal.

Animals↗
PubMedDate not supplied

Salivary gland neoplasia in the dog and cat: survival times and prognostic factors.

Twenty-four dogs and 30 cats with histopathologically confirmed salivary gland neoplasia were retrospectively reviewed in a multi-institutional study. The predominant presenting complaint for animals with salivary gland neoplasia was that of a mass being noted by the owner; other common complaints included halitosis, dysphagia, and exophthalmia. Siamese cats were overrepresented, indicating a possible breed predisposition. The most common histopathological type was simple adenocarcinoma. Cats had more advanced disease at diagnosis than did dogs, and clinical staging was prognostic in dogs. The median survival times for dogs and cats were 550 days and 516 days, respectively.

Adenocarcinoma↗
PubMed1999

Xerostomia: a prevalent condition in the elderly.

Although xerostomia is associated with aging, studies have determined that salivary gland function is well preserved in the healthy geriatric population. Therefore, dry mouth is probably not a condition of aging, but most likely one of systemic or extrinsic origin. Saliva seems to undergo chemical changes with aging. As the amount of ptyalin decreases and mucin increases, saliva can become thick and viscous and present problems for the elderly. One of the most prevalent causes of xerostomia is medication. Anticholinergics, such as psychotropic agents and antihistamines, and diuretics can dry the oral mucosa. Chronic mouth breathing, radiation therapy, dehydration, and autoimmune diseases, such as Sjögren's, can also diminish salivation, as can systemic illness such as diabetes mellitus, nephritis, and thyroid dysfunction. Xerostomia can lead to dysgeusia, glossodynia, sialadenitis, cracking and fissuring of the oral mucosa, and halitosis. Oral dryness can affect denture retention, mastication, and swallowing. Dry mouth symptom can be treated with hydration and sialagogues or with artificial saliva substitutes. Because patients are at risk for dental caries, they should be referred to a dentist for preventive care. In patients with Sjögren's syndrome and in those who have undergone radiation therapy, pilocarpine has been used recently with good results.

Aged↗
PubMedDate not supplied

In vitro toxicity assessment of mouthwashes in the pollen tube growth test: first results.

Mouthwashes are widespread used to treat halitosis or minor oral infections. Adverse effects of mouthwashes were recognized, e.g. desquamation of the oral mucosa and stomatitis. The acute toxicity of mouthwashes was tested in an in vitro system, the pollen tube growth test (PTG-test). In the PTG-test the acute toxicity of mouthwashes exceeds the toxic effect of alcohol. Consumers should be informed about the number and amounts of mouthwash ingredients, and their toxic potential. These declarations would provide the basis for testing the carcinogenic effects of mouthwashes.

Ethanol↗
PubMed2000

[The usefulness of sucralfate in postoperative improvement of children's tonsillectomy].

INTRODUCTION: Sucralfate is an effective agent in the treatment of peptic ulcer, mixing up the fibrinous exudate of duodenal ulcer to form a protective barrier promoting its healing. Similarly the deprived muscle in the tonsillar bed results protected and consequently bring down the post-surgical morbidity. OBJECTIVE: The aim of this study has been to ascertain the suitability of sucralfate in alleviating symptoms after tonsil's removal. MATERIAL AND METHODS: 205 children were included in the study and randomly postoperative treated with sucralfate. A lot of different parameters were controlled afterwards such as days with pain, taken of analgesics, return to normal diet, fever, bloody saliva, halitosis or vomits. RESULTS: There was a significant association between the use of sucralfate and less days with sore throat, less pain and analgesia required. CONCLUSIONS: The use of sucralfate means and efficient measure in order to alleviate the pain and postoperative discomfort associated with tonsils removal, being a cheap drug and without having topical after-effects.

Anti-Ulcer Agents↗
PubMed2001

[Periodontitis: a hidden chronic infection].

Periodontitis is a chronic inflammatory disease of the tooth supporting tissues which has a prevalence of 35% in the adult population. Risk factors are dental plaque, calculus, smoking, diabetes mellitus, stress and genetic traits. In parallel with chronic intestinal inflammatory diseases and stomach cancer, gene polymorphisms in the interleukin-I gene family are associated with severity of periodontitis. Periodontitis is usually painless. Symptoms of the disease are bleeding, redness and swelling of the gums, suppuration and migration of teeth. Halitosis may be present. Treatment of periodontitis involves supra- and subgingival mechanical debridement, oral hygiene instruction and surgical elimination of residual deepened and bleeding pockets on indication. Microbiological testing can be used to select patients who may benefit from additional systemic antimicrobial therapy. Periodontal lesions may act as a portal of entry for dissemination of periodontal bacteria into the blood stream, which may result in extraoral infections. For this reason it is recommended to include diagnosis of periodontitis in focal examination. Associations have been documented between periodontitis and cardiovascular diseases, arthritis and premature low birth weight infants.

Adult↗
PubMed2001

[Lung cancer metastasis to the gingiva].

A 70-year-old man was referred to our hospital complaining of left gingival tumors with bleeding, halitosis and impediments to eating and speaking. Tumors were also found in both lungs, the stomach, the intestines and the right adrenal gland. Biopsies of the gingiva and the stomach pointed to undifferentiated carcinoma. Although the patient was treated with carboplatin plus 5-fluorouracil, the gingival tumors did not change in size. Subsequently, the gingival tumors were irradiated with a total dose of 39 Gy, and disappeared completely. The patient died 78 days later of hemorrhage of the digestive tract. Postmortem examination revealed that the primary tumor was in the left lung. Nineteen cases of lung cancer metastatic to the gingiva have been reported. The prognosis in all was very poor, and the QOL was compromised. However, several cases have improved with therapy to the gingiva. We believe that initial therapy should be directed at metastatic gingival tumors of the lung.

Adenocarcinoma↗
PubMed2000

Tobacco and oral diseases--report of EU Working Group, 1999.

Smoking often results in discolourations of teeth and dental restorations. Halitosis, diminished taste and smell acuity are common side effects of smoking. Periodontal disease is increased both in prevalence and severity in smokers. Smoking cessation may halt the disease progression and improve the outcome of periodontal treatment. Oral cancer and precancer occurs much more frequently in smokers than in non-smokers. Smoking cessation significantly decreases the increased risk of oral cancer within 5-10 years. Dental implant failure rates are significantly higher in smokers than in non-smokers. The entire dental team should be aware of the relationship between smoking and dental problems and should convey the message that non-smoking is the norm. Smoking counselling should be a fundamental part of the dental curriculum and any practice prevention programme.

Dentists↗