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At least 127 records · Page 7Linked to original sources
PubMed2006

Methylene blue-mediated photodynamic therapy: a possible alternative treatment for oral lichen planus.

BACKGROUND AND OBJECTIVES: In this study, methylene blue-mediated photodynamic therapy (MB-PDT) was used as a possible alternative method for the treatment of oral lichen planus (OLP). STUDY DESIGN/MATERIALS AND METHODS: Thirteen patients with 26 OLP lesions were enrolled in this study. Patients were instructed to gargle a 5% methylene blue solution in water for 5 minutes. Ten minutes later, irradiation was performed by laser light (lambda = 632 nm, light exposure dose = 120 J/cm(2)). Lesions were evaluated pre and post-operatively and at follow-up sessions by changes in sign and symptom (pain) scores, and size of lesions. RESULTS: Improvement in sign scores was achieved in 16 lesions. Four keratotic lesions disappeared completely. There was a statistically significant decrease in sign and symptom scores 1 week after treatment and at follow-up sessions up to 12 weeks. Average reduction in size of lesions was 44.3%. CONCLUSION: MB-PDT seems to be an effective alternative treatment for control of OLP. In our opinion, this preliminary result warrant further studies in order to show the efficacy of MB-PDT in control of OLP for a longer period of time.

Adult↗
PubMed2004

The use of essential oils to treat snoring.

Snoring is a very common social inconvenience. This double-blind study suggests a significant reduction in snoring reported by bed partners in a group of snoring volunteers using either an essential oil spray or gargle formulation. Possible modes of action of the essential oils are discussed.

Administration, Inhalation↗
PubMedDate not supplied

Effects of cancer chemotherapy on the human aerobic oropharyngeal flora.

Since various agents used in cancer chemotherapy exhibit antimicrobial activity in vitro, we performed sequential quantitative cultures of saline gargles obtained from patients receiving cancer chemotherapy to determine if such chemotherapy alters the composition of the aerobic oropharyngeal flora. When we compared results of cultures obtained from 12 patients just before and at various times after receiving courses of cancer chemotherapy, we observed small, though significant reductions in the numbers of total bacteria, alpha-hemolytic streptococci and inhibitory streptococci two to seven days after courses of chemotherapy. A concomitant increase in the percentage of patients colonized by gram-negative bacilli occurred. Of the chemotherapeutic agents used to treat our subjects, only doxorubicin exhibited antimicrobial activity in vitro. All four alpha-hemolytic streptococci, but none of the seven strains of gram-negative bacilli examined, were inhibited by doxorubicin at concentrations of less than or equal to 12.5 mg/l. Doxorubicin had a modest enhancing effect on in vitro adherence of gram-negative bacilli to human embryonic lung cells. These data suggest that cancer chemotherapy might play a role in colonization of cancer patients by gram-negative bacilli by creating a microbiologic vacuum conducive to such colonization. In this way, cancer chemotherapy might contribute to the high incidence of gram-negative bacillary pneumonia among patients with malignant neoplasms.

Aged↗
PubMed1995

HTLV-I from Iranian Mashhadi Jews in Israel is phylogenetically related to that of Japan, India, and South America rather than to that of Africa and Melanesia.

A new endemic focus of human T-lymphotropic virus type I (HTLV-I) was recently reported among Mashhadi Jews, a group of immigrants from northeastern Iran to Israel. We extracted DNAs from fresh peripheral blood mononuclear cells (PBMCs) and/or gargle mouthwash from 10 HTLV-I carriers, who consisted of members of one family, and HTLV-I-associated myelopathy (HAM) and adult T-cell leukemia (ATL) patients. Long terminal repeat (LTR) regions of proviral DNAs were sequenced and analyzed phylogenetically. In a phylogenetic tree, all the Mashhadi HTLV-I isolates belonged to subtype A, one of the three subtypes of the cosmopolitan type of HTLV-I, and made a tight cluster distinct from the other isolates of subtype A from Japan, India, the Caribbean Basin, and South America. Although a few nucleotide substitutions were observed among the clones sequenced, no characteristic sequence variation was found in different disease manifestations, even in one family or different sources of DNA preparation.

Adult↗
PubMed2006

Innovative airway management for peritonsillar abscess.

PURPOSE: To describe innovative airway management in an adult with a peritonsillar abscess (quinsy) located atypically in the inferior pole of the palatine tonsil. CLINICAL FEATURES: A 25-yr-old male was admitted for surgical drainage of a left-sided, inferior pole peritonsillar abscess. Previous attempts at intraoral needle and scalpel drainage with topical anesthesia in the emergency department had failed. He had an interdental distance of 1.5 cm and computed tomography imaging showed narrowing of the airway diameter to 8 mm and lateral displacement of the epiglottis. He gargled 10 mL 0.5% lidocaine in the sitting position. We advanced a 3.1-mm pediatric fibreoptic bronchoscope (FOB) through an orally inserted nasopharyngeal airway to identify the glottis and sprayed 0.5% lidocaine onto the airway mucosa. We replaced the airway with a reinforced 6.5-mm internal diameter tracheal tube (TT), advanced the FOB through it until its tip was just above the carina, and then advanced the TT into the trachea. After iv induction of general anesthesia, the surgeon performed a tonsillectomy and drained the neck abscess. Postoperative direct laryngoscopy revealed a markedly improved airway lumen and tracheal extubation over a Cook Airway Exchange Catheter was uneventful. The patient was stable in the recovery room, and was discharged on the third postoperative day. CONCLUSION: We present an innovative technique of fibreoptic intubation in an awake patient with an inferior pole peritonsillar abscess.

Adult↗
PubMed2004

Carcinogenic potential of tobacco tar-resistant Staphylococcus aureus in buccal cavity.

PURPOSE: The effects of cigarette smoking on the association between inflammation and cancer were studied, since some bacteria induce the production of tumor necrosis factor-alpha (TNF-alpha), a proinflammatory cytokine and endogenous tumor promoter, in cells. METHODS: Bacteria from a gargled solution from the buccal cavity of 20 individuals were cultured in the presence of 4 mg/ml cigarette-smoke condensates. Although cigarette-smoke condensates inhibited growth of Staphylococcus aureus strongly and that of Staphylococcus warneri weakly, tobacco tar-resistant S. aureus and S. warneri were obtained. RESULTS: One tobacco tar-resistant S. aureus strain (Sa-TA10) induced expression of the TNF-alpha gene in both Bhas 42 cells (v-Ha-ras transfected BALB/3T3 cells) and human lung cancer cell line H226B, while one tobacco tar-resistant S. warneri (Sw-TA75) did not induce it significantly. Moreover, Sa-TA10 induced formation of transformed foci and soft-agar colony in Bhas 42 cells in cooperation with the v-Ha-ras gene. The results suggested that Sa-TA10 has carcinogenic potential, whereas Sw-TA75 does not. CONCLUSION: These data suggest that tobacco tar-resistant S. aureus, with carcinogenic potential, is present in the buccal cavity of some individuals, and that cigarette smoking simultaneously inhibits growth of most of the bacteria and selects carcinogenic bacteria.

3T3 Cells↗
PubMed2000

A survey of mouth pain and dryness in patients with advanced cancer.

An 11-item face-to-face survey was conducted in 99 consecutive patients with advanced cancer to determine the prevalence, intensity, reporting and treatment, presumed cause(s), and importance of mouth pain and dryness. Sixteen of the 99 patients (16%) reported experiencing mouth pain at a mean intensity corresponding to 5.5 +/- SD 2.21 on a 0 (no pain) to 10 (worst possible pain) numerical scale, and 88 (88%) patients reported dry mouth at a mean intensity corresponding to 6.2 +/- SD 2.21. Nine (56%) of the 16 patients with mouth pain and 39 (44%) of the 88 patients with mouth dryness reported these symptoms to their attending physician(s). Sixty-nine percent (27/39) of patients who reported having a dry mouth were advised by their physician(s) to pursue one or more treatments. The most common treatments recommended (and frequencies) were drinking water/taking sips of fluid (13), gargling with bicarbonate mouthwash (4), using an artificial saliva spray (4), and using an oral fungal suspension for thrush (4). The most common findings on oral examination included: possible thrush (53 patients), upper and lower dentures (33 patients), and multiple dental restorations (23 patients). The causes most frequently assumed to be responsible were ill-fitting dentures for mouth pain, and medications and possible oral fungal infections for mouth dryness. The mean values given for the importance of the symptoms of mouth pain and dryness relative to other symptoms or problems experienced by the patients were 4.4 +/- SD 1.84 and 3.6 +/- SD 1.67, respectively, on a Likert scale ranging from 1 (not important) to 7 (great importance). Mouth dryness was more frequently reported than mouth pain. The mean rating for the intensity of mouth pain was higher than that for mouth dryness, although both were of moderate importance to patients relative to other symptoms or problems experienced at the time. Patients tended to underreport mouth pain and dryness, and physicians tended to address such complaints inadequately.

Adult↗
PubMed1998

Detection of genes of RNA viruses from freshly biopsied gastric mucosa by reverse transcription polymerase chain reaction.

The reverse transcription polymerase chain reaction (RT-PCR) was performed to detect genes of RNA viruses in the freshly biopsied gastric mucosa of seven patients with low gastric acidity. Although nucleoprotein genes of Sendai virus and hemmaglutinin genes of influenza virus A were not detected, nucleoprotein genes of influenza virus B were detected in samples from three of the seven patients. The first patient had had antrectomy and vagotomy for gastric ulcer, the second patient was receiving a histamine type 2 receptor blocker for gastritis, and the third patient was receiving a proton pump inhibitor for gastric ulcer. Virus isolation from gastric mucosa and from gargles was negative for all seven patients. These findings suggest that genes of influenza viruses may exist in the gastric mucosa of patients with low gastric acidity.

Biopsy↗
PubMed2003

Reduction of potential respiratory pathogens by oral hygienic treatment in patients undergoing endotracheal anesthesia.

PURPOSE: This study was conducted to evaluate the usefulness of mechanical and chemical prophylactic oral cleansing treatments for reducing potential respiratory pathogens existing in the oral cavity. METHODS: Thirty-two patients scheduled to undergo oral and maxillofacial surgery that required endotracheal anesthesia were randomly allocated to one of the two groups, the oral cleansing group (n = 16) or the noncleansing group (n = 16). Culture and polymerase chain reaction (PCR) methods were used to detect and enumerate pathogens. Oral cleansing was carried out with an electric toothbrush capable of automatically supplying and aspirating povidone-iodine solution before surgery, followed by rinsing twice a day after surgery. Cephazolin (3 g x day(-1)) was given to all patients for 5 days after surgery. RESULTS: The PCR detection rates of Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Porphyromonas gingivalis in gargle samples before treatment were 87.5%, 68.8%, 53.1%, and 40.6%, respectively. Oral cleansing reduced the detection rates and numbers of methicillin-sensitive Staphylococcus species, S. pneumoniae, and H. influenzae. In contrast, there was no significant reduction of methicillin-resistant Staphylococcus species, S. pneumoniae, H. influenzae, or P. aeruginosa in subjects who underwent systemic cephazolin administration without oral cleansing. CONCLUSION: The combination of mechanical and chemical oral cleansing resulted in a significant reduction of potential respiratory pathogens in the oral cavity.

Adult↗
PubMed2003

Analysis of sepsis in allogeneic bone marrow transplant recipients: a single-center study.

We reviewed the records of 235 consecutive recipients of allogeneic bone marrow transplantation (allo-BMT) at our center between February 1983 and October 2000. Sepsis occurred in 25 patients (10.6%) at a median of 10 days (range, 1-280 days) after BMT. Five of the 25 patients (20%) died of sepsis. Pathogens isolated from blood culture were gram-positive cocci in 19 patients, gram-negative rods in 7, fungi in 2, and others in 1 patient. Two pathogens were detected concomitantly in 4 patients. Univariate analysis revealed that risk factors for sepsis were selective gut decontamination using lomefloxacin hydrochloride and nystatin, an unrelated donor, HLA mismatched BMT, and stomatitis. Multivariate logistic regression analysis revealed that an unrelated donor was the only significant independent risk factor, with a relative risk of 5.432. In 12 of 25 patients with sepsis, the pathogens of sepsis were sensitive to antibiotics used for gut decontamination. Selective gut decontamination significantly increased the incidence of sepsis, especially that with gram-positive cocci, but not the mortality rate of sepsis, compared with total gut decontamination using vancomycin. We also found a significant relationship between pathogens isolated from blood culture and those isolated from surveillance cultures of stool, urine, and gargled water in the period before sepsis occurred. The present study revealed an independent risk factor for sepsis (unrelated donor), the feasibility of selective gut decontamination, and the importance of surveillance culture.

Adolescent↗
PubMed2005

Community epidemiology of Chlamydia and Mycoplasma pneumoniae in LRTI in France over 29 months.

BACKGROUND: The role of Chlamydia pneumoniae (CP) and Mycoplasma pneumoniae (MP) in lower respiratory tract infections (LRTI) is still little known in community settings. METHODS: In all, 3207 adult cases of LRTI (871 with pneumonia, and 2336 with acute bronchitis) were prospectively included in the ETIIC1 ETIIC : ETude de l'Incidence des Infections respiratoires basses d'origine Communautaire dues A Chlamydia pneumoniae et Mycoplasma pneumoniae (Incidence of CP and MP in LRTI in community settings) program by 303 general practitioners and 24 hospital physicians in France between September 1997 and February 2000. The polymerase chain reaction and immunoassays were used to detect CP or MP in 3198 pharyngeal specimens obtained by gargling. RESULTS: Of these 3198 patients, 232 (7.3%), were PCR-positive for CP and/or MP. Immunoassays were far less sensitive than PCRs (Se = 2 and 13% for MP and CP). Among the 2336 patients with acute bronchitis, PCR was positive for CP in 95 (4.1%), and for MP, in 54 (2.3%). Among the 671 patients with radiologically confirmed pneumonia, PCR was positive for CP in 23 (3.4%), and for MP in 49 (7.3%). CP and MP displayed significant geographic heterogeneity. Independent clinical determinants of positive PCR for CP and/or MP were age below 45 years, previous antimicrobial therapy (especially betalactams). Clinical signs were not of practical use in distinguishing accurately between etiologic diagnoses. CONCLUSIONS: CP or MP diagnosed by PCR were found in more than 7% of patients with LRTI in community settings with a significant geographical heterogeneity and significant temporal trends in the incidence.

Adult↗
PubMed1985

Sensory blockade of smoking satisfaction.

Cigarette smokers were presented with controlled doses of cigarette smoke to determine whether the resulting reduction in cigarette craving depended upon perceiving the sensory qualities of the smoke. Cigarette craving was assessed before and after inhaling controlled doses of smoke in two conditions: (1) Local anesthesia of the upper and lower respiratory airways, induced by mouth rinsing, gargling and inhalation of a mist containing the topical anesthetic lidocaine; and (2) no-anesthesia control, in which all solutions were saline. A sham smoking procedure was presented in both conditions. Craving and ad lib smoking behavior were also assessed 30 minutes after controlled smoking. The results indicated that smoke, as opposed to sham puffs, significantly reduced reports of cigarette craving, and local anesthesia significantly blocked this immediate reduction in craving produced by smoke inhalation. Puffs were also rated as less desirable in the anesthesia condition. Thirty minutes after smoking, craving was no different in the anesthesia and saline control conditions. However, craving as well as smoking intake in both conditions was less when smoke had been given previously than in the sham smoking control. These results suggest that sensory cues accompanying inhalation of cigarette smoke are important determinants of immediate smoking satisfaction. However, the sustained effects of smoke intake on subsequent smoking behavior (30 min later) may be mediated by processes other than sensory stimulation of the respiratory tract, such as plasma nicotine levels.

Adult↗
PubMed1994

Ethanol causes decrements in airway excretion of endogenous nitric oxide in humans.

Ethanol has previously been demonstrated to inhibit excretion of endogenous nitric oxide (NO) in exhaled air from experimental animals. The aim of the present study was to elucidate if this effect also occurs in human subjects. Healthy volunteers ingested ethanol (0.25 and 1 g kg-1, 20% in orange juice). Nitric oxide in exhaled air was determined by chemiluminescence. Single-breath analysis of exhaled air was performed and peak values of NO and end expiratory levels of NO and CO2 were determined. Ethanol induced dose-dependent decrements in exhaled nitric oxide. Thus, peak values for nitric oxide in exhaled air, in the first exhalation after breath-holding for 30 s, decreased to 56 +/- 10 and 37 +/- 12% of control 60 min after ingestion of ethanol at 0.25 and 1 g kg-1, respectively. Rinsing the oral cavity (including gargling) for 15 min with 20% ethanol in juice did not significantly influence NO in exhaled air. Heart rate blood pressure and end expiratory levels of CO2 were not significantly affected by ethanol ingestion. In conclusion, ethanol decreases levels of nitric oxide in exhaled air in humans, likely by inhibition of airway formation of nitric oxide. The results might be of importance in understanding effects of ethanol and other hydrocarbons.

Adult↗
PubMed1985

Controlled comparison of topical anesthetic agents in flexible upper gastrointestinal endoscopy.

Topical anesthetics are generally part of the premedication associated with upper gastrointestinal endoscopy. Selection is not usually based on objective criteria. We performed a randomized study comparing six anesthetic agents: three sprays (Cetacaine, Hurricaine, and 10% Xylocaine spray) and three gargles (2% lidocaine, and two combinations of 2% lidocaine diluted 1:1 with mouthwash). Normal subjects, experienced in undergoing gastroscopy, underwent repeated upper gastrointestinal endoscopic examinations with a 34 F Pentax fiberscope. Topical anesthetic was the only premedication used. The parameters evaluated by the subjects were taste, effectiveness of anesthesia, and ease of scope passage. At the end of the trial each subject ranked the agents in order of preference. Although subjects differed in their preference for the different anesthetic agents (sometimes significantly), there was no single parameter such as taste, degree of anesthesia, or ease of passage of the endoscope that could be correlated with overall preference. All agents gave acceptable levels of local anesthesia, although there was a distinct subjective preference for spray forms. We recommend that if a local anesthetic is used, it should be one of the spray formulations. This recommendation is based on safety, the relative ease of application, and the lack of profound differences between agents.

Adult↗
PubMed1986

Premedication with meperidine and diazepam for upper gastrointestinal endoscopy precludes the need for topical anesthesia.

The authors conducted a prospective study in 90 patients undergoing upper endoscopic examination under sedation to determine whether there was any beneficial effect in anesthetizing the pharynx with topical anesthesia. These patients were divided into three groups of 30 patients. Group A received 39 ml of viscous lidocaine gargle (2%) diluted with 15 ml of tap water. Group B received the placebo. Group C received neither viscous lidocaine nor placebo. All patients received intravenous meperidine and diazepam titrated to produce adequate sedation for upper endoscopy. It was demonstrated that the undesirable effects of upper endoscopy, that is, gagging, sore throat, and dysphagia, did not differ significantly in any of the three study groups as evaluated by either the patients or the endoscopist. Only two patients complained that the procedure was mildly unpleasant. The authors conclude that the practice of anesthetizing the pharynx in patients receiving sedation for upper endoscopy should be abandoned since anesthesia of the pharynx is not exempt from morbidity and mortality as well as being time-consuming and expensive.

Adult↗
PubMed1990

Fatal hypernatremia from exogenous salt intake: report of a case and review of the literature.

Hypernatremia is a common electrolyte disturbance, most often caused by volume depletion. Hypernatremia due to sodium excess occurs less frequently, and fatal hypernatremia solely from ingestion of table salt is rare. We describe a 41-year-old man who had seizures and hypernatremia after ingestion of a supersaturated salt water solution intended for gargling. He had consumed approximately a third cup of table salt (approximately 70 to 90 g of salt or 1,200 to 1,500 meq of sodium). His initial serum sodium concentration was 209 meq/liter. Hypotonic fluid therapy was given to provide free water and to correct the hypernatremia gradually. Our patient, however, failed to recover from the initial insult and died 3 days later. Review of the literature revealed 10 adult and 20 pediatric cases of hypernatremia attributable to exogenous intake of salt. The type of therapy (fluid or peritoneal dialysis), the type of fluid used, and the rate of correction of hypernatremia did not influence survival. The age of the patient and the initial serum sodium concentration were the most important prognostic indicators. Both very young patients and those with lesser degrees of hypernatremia had a better rate of survival than did other patients. In addition, our review illustrates the surprisingly small amount of salt that can cause severe hypernatremia and the danger of using salt or saline as an emetic.

Adult↗
PubMed2001

Efficacy and safety of ketoprofen lysine salt mouthwash versus benzydamine hydrochloride mouthwash in acute pharyngeal inflammation: a randomized, single-blind study.

BACKGROUND: Pharyngodynia, or sore throat, is one of the symptoms most frequently reported by patients to primary care physicians. OBJECTIVE: The purpose of this study was to compare the efficacy and tolerability of mouthwash formulations of ketoprofen lysine salt (KLS), an anti-inflammatory agent, and benzydamine hydrochloride (BH), a local anesthetic, in patients with acute inflammation of the pharyngeal cavity. METHODS: In this randomized, multicenter, parallel-group, single-blind study, patients (who were blinded) were assigned to receive undiluted BH 15 mL (22.5 mg) or KLS 10 mL (160 mg) diluted in 100 mL of water. Both agents were gargled twice daily until pain remission or up to 7 days. A physical examination of the oropharyngeal cavity was performed, and severity of edema and hyperemia was assessed after 3 days of treatment and, if symptoms had not resolved, after pain remission. RESULTS: Of the 241 patients (120 KLS, 121 BH), 239 were included in the safety analysis and 232 were in the intent-to-treat population. The differences between groups in the duration of analgesic effect after the first dose of drug and the time course of pain were found to be statistically significant (P = 0.006 and P = 0.017, respectively), favoring KLS. Adverse drug-related effects reported included numbness of the tissues in the oral cavity, sensation of tingling in the tissues in the oral cavity, dry mouth, thirst, and nausea. A significantly greater proportion of BH-treated patients reported adverse events (P = 0.001 for all adverse events and drug-related adverse events). CONCLUSIONS: KLS mouthwash exerts a significantly longer first-application analgesic action with significantly greater local tolerability than BH in patients with pharyngeal pain of inflammatory and/or infectious origin.

Adolescent↗
PubMed2001

Prevalence of potential respiratory pathogens in the mouths of elderly patients and effects of professional oral care.

To evaluate the effectiveness of professional oral health care in reducing the risk of aspiration pneumonia, we examined the prevalence of potential respiratory pathogens in gargled samples from elderly persons. Samples were obtained from 54 elderly subjects over 65 years of age who required daily nursing care, from 21 healthy elderly subjects over 65 years old, and from 22 healthy young subjects under 30 as controls. The prevalence of possible pathogens was determined by culture and the polymerase chain reaction. The percentages detected in samples of Streptococcus pneumoniae, Staphylococcus species, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans from elderly patients requiring daily nursing care were 63.0, 37.0, 14.8, 5.6 and 66.7, respectively. The numbers of C. albicans cells recovered in samples from elderly subjects were significantly higher than those recovered from the healthy young group (P<0.001). Elderly patients needing daily care and receiving professional oral health care had lower prevalences and cell numbers of C. albicans than did the elderly patients without such oral care. This study showed that professional oral health care in elderly requiring daily nursing care reduced the cell numbers of potential respiratory pathogens.

Journal Article↗