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PubMed1990

The relationship of resting ventilation to mouth occlusion pressure. An index of resting respiratory function.

In order to examine the relationship of mouth occlusion pressure (MOP), an index of central inspiratory neuromuscular drive, to age and sex and to resting ventilation (VE), measurements were made in the seated posture in 84 healthy, normal subjects (38 men, 46 women; ages 18-72 years, mean +/- SD = 39.8 +/- 14.5 years) and in 79 patients with either airways obstruction (n = 63) or restrictive lung disease (n = 16). In the normal subjects, there was no significant relationship between age or sex and MOP (expressed as P0.1), which is the mouth pressure developed against a complete occlusion at 0.1 s after the beginning of inspiration, and dP/dtmax, the maximal rate of rise of this pressure; mean +/- SD for P0.1 = 0.75 +/- 0.32 cmH2O, and dP/dtmax = 19.41 +/- 10.10 cmH2O/s. Similarly, there was no significant relationship between age or sex and VE/P0.1 or VE/dP/dtmax. In 99 percent of normal subjects (83 of 84), VE/P0.1 was greater than 8.0 L/min/cmH2O, whereas in only 1 of the 79 patients was the value greater than 7.9 L/min/cmH2O. While the mean values of P0.1 and dP/dtmax were significantly different between normal subjects and patients, there was considerable overlap, whereas the ratio VE/P0.1 or VE/dP/dtmax provided excellent differentiation between normal subjects and patients with lung disease. This index, which is easily measured and requires minimal patient cooperation, provides valuable information in the clinical assessment of ventilatory drive and lung mechanics.

Adult↗
PubMed1989

[Simultaneous occurrence of enterotoxigenic Staphylococcus aureus on the hands, mouth and feces of asymptomatic carriers].

One hundred and twelve asymptomatic individuals were analysed with regard to the simultaneous incidence of Staphylococcus aureus on their hands and in their nose, mouth and stools, in the city of S. Paulo (Brazil). A total of 40 (35.7%) individuals were detected as carriers of this microorganism. Among these carriers, 27 (67.5%) were positive in only one of the four niches studied, 8 (20.0%) in two and 5 (12.5%) in three niches. They were identified 113 Staphylococcus aureus strains, and 28 (24.8%) of these strains, isolated from 9 (22.5%) carriers, produced enterotoxin. Of these strains, 7 (25.0%) produced type A enterotoxin, 6 (21.4%) of type B, 11 (39.3%) type C and 4 (14.3%) produced both type A and C. The phage typing of the 113 Staphylococcus aureus strains revealed the predominance of the strains lysed by phages belonging to the Group I/III/NC (16.8%). The results obtained did not demonstrate the simultaneous incidence of Staphylococcus aureus strains in samples collected from mouth, hands and stools of the group studied.

Carrier State↗
PubMedDate not supplied

Echovirus 4 associated to hand, foot and mouth disease.

Hand, foot and mouth disease (HFMD) is a contagious enteroviral infection occurring primarily in children and characterized by vesicular palmoplantar eruptions and erosive stomatitis. Echovirus 4 (EV-4) has been commonly associated with aseptic meningitis. The association of HFMD with EV-4 has not been reported previously. Two samples of a 14-month child who presented mild fever, sores in the mouth, rash with blisters on the palm of hands and soles of feet were sent to Enteric Viruses Laboratory of Adolfo Lutz Institute. Clinical samples were inoculated in three different cell lines, and those which presented cytopathic effect (CPE), were submitted to Indirect Immunofluorescence Assay (IFA) and "one step" RT-PCR. Agarose gel electrophoresis from RT-PCR product, showed a product with 437 bp, which is characteristic of Enterovirus group. Echovirus 4 was identified by IFA. Although HFMD is a viral infection associated mainly with Enterovirus 71 (HEV-71) and Coxsackievirus A16 (CV-A16), our results demonstrate a diversity of serotype related to HFMD and stress the importance of epidemiological surveillance to this disease and its complications.

Electrophoresis, Agar Gel↗
PubMed2004

Effect of cadmium on the floor of the mouth on rats during lactation.

Cadmium (Cd) present in the air, drinking water and food has the potential to affect the health of people, mainly those who live in highly industrialized regions. Cd affects placental function, may cross the placental barrier and directly modify fetal development. It is also excreted into milk. The body is particularly susceptible to Cd exposure during perinatal period. The effect on rat oral epithelium (floor of the mouth) after continuous exposure to drinking water containing low levels of Cd during lactation was studied. Female rats were supplied with ad libitum drinking water containing 300 mg/l of CdCl2 throughout the whole lactation period. Control animals received a similar volume of water without Cd. Lactating rats (21 day-old) were killed by lethal dose of anesthetic. The heads were retrieved, fixed in "alfac" solution (alcohol, acetic acid and formaldehyde) for 24 h, serially sectioned in frontal plane, at the level of the first molars. The 6 micro m sections were then stained with hematoxylin and eosin. Nuclear epithelium parameters were estimated, as well as cytoplasm and cell volume, nucleus/cytoplasm ratio, numeric and surface densities, and epithelial thickness. Mean body weight was 34.86 g for the control group and 18.56 g for the Cd-treated group. Histologically, the floor of the mouth epithelium was thinner in the treated group, with smaller and more numerous cells. In this experiment, Cd induced epithelial hypotrophy, indicating a direct action in oral mucosa cells, besides retarded development of the pups.

Animals↗
PubMed2006

Atrophic glossitis from vitamin B12 deficiency: a case misdiagnosed as burning mouth disorder.

BACKGROUND: Glossodynia, or painful sensation of the tongue, can have a spectrum of etiologies, such as local infection, trauma, nerve damage, glossitis, or the enigmatic neuropathic pain syndrome, burning mouth disorder (BMD; also known as burning mouth syndrome). Careful history-taking, physical examination, and appropriate laboratory screening can differentiate these causes of glossodynia and direct further therapy. METHODS: A 73-year-old woman presented with several months of glossodynia having previously been diagnosed by her primary care physician with primary BMD. Subsequently, she consulted an otolaryngologist, who pursued further diagnostic evaluation. RESULTS: Examination revealed the presence of a beefy, red, smooth tongue, and further laboratory evaluation yielded a low serum vitamin B(12) level and macrocytosis. Three months of oral vitamin B(12) supplementation led to partial restoration of serum vitamin B(12) levels and a modest improvement in symptoms. Her final diagnoses were atrophic glossitis and glossodynia secondary to vitamin B(12) deficiency, most likely due to pernicious anemia. CONCLUSIONS: The results of this case have important clinical implications for the diagnostic evaluation and management of patients with glossodynia and apparent BMD. Pathogenic mechanisms of nutrient deficiency in atrophic glossitis are discussed.

Aged↗
PubMed1993

Field and laboratory analysis of an outbreak of foot and mouth disease in Bulgaria in 1991.

In July 1991, an outbreak of foot and mouth disease (FMD) occurred near Stefan Karadjovo village in Boliarovo (south-east Bulgaria, close to the Turkish border). The virus isolated was identified in Bulgaria as serotype O and this was subsequently confirmed by the World Reference Laboratory for Foot and Mouth Disease in Pirbright (United Kingdom). Serological studies using bovine sera and monoclonal antibody analysis were made. In addition, the sequence of approximately 170 nucleotides at the 3' end of the 1D gene was determined for the field isolate and for vaccine strains used in Bulgaria. These were compared with other sequences of type O FMD viruses from outbreaks in the Middle East. Serum samples were taken from domestic animals in the region close to the outbreak and examined for anti-FMD virus antibodies to assess the extent (if any) of spread of the virus before or after the outbreak. No evidence of infection was found in these animals. The virus involved in the Bulgarian outbreak was antigenically similar to the O1 vaccine strains but probably did not originate from these strains. The virus was closely related genetically to a group of viruses isolated in the Middle East since 1987, suggesting that it may have been introduced into Bulgaria from an area in the Middle East by unidentified means.

Animals↗
PubMed1993

Epizootiology of foot and mouth disease in Saudi Arabia: II. Current status on dairy farms and control measures in operation.

Specifically-designed questionnaires were distributed to the managers and/or veterinarians of all dairy farms in Saudi Arabia in order to obtain data on the occurrence of foot and mouth disease (FMD) on these farms from 1971 to 1989, as well as data on current control measures. Of 39 farms, 27 responded to the questionnaire and 15 (56%) reported FMD outbreaks. Notification and collection of samples for diagnosis were not performed consistently. Laboratory tests were undertaken at the World Reference Laboratory for Foot and Mouth Disease, Pirbright, United Kingdom. FMD virus serotypes O, A and C were isolated. Epizootiological factors contributing to the occurrence of FMD in Saudi dairy farms and recommendations for improving control of the disease are discussed in depth.

Animals↗
PubMed1995

Multiple-infected diagnostic specimens from foot and mouth disease endemic regions.

The current routine diagnostic procedures for foot and mouth disease (FMD) virus antigen detection combine the use of an indirect sandwich enzyme-linked immunosorbent assay (ELISA) with virus isolation and amplification on cell culture. Several field samples recently received by the World Reference Laboratory for Foot and Mouth Disease which were initially diagnosed as containing a single virus type have subsequently been found to contain an additional virus type. Examples are given of the results of ELISAs performed on certain Saudia Arabian samples; these examples illustrate the problem which such multiple-infected samples present for laboratory diagnosis.

Animals↗
PubMed1998

Implementation of quality assurance in national foot and mouth disease laboratories, based on the guidelines of the Office International des Epizooties.

The final act of the Uruguay Round of the General Agreement on Tariffs and Trade, 1994, contains the Agreement on the Application of Sanitary and Phytosanitary Measures, which aims to reduce the negative effects of health barriers on international trade to a minimum. Therefore, the Office International des Epizooties (OIE) Regional Commission for Europe proposed that an accreditation system based on the EN 45000 standard should be applied to achieve international recognition of certificates and testing laboratories. To this end, the OIE Standards Commission published a series of guidelines for the evaluation of laboratory quality and proficiency testing. In 1995, the Food and Agriculture Organization European Commission for the Control of Foot and Mouth Disease recommended that the OIE proposal should be applied in all foot and mouth disease (FMD) diagnostic laboratories in Europe. This review summarises the EN 45001 standard and the OIE guidelines, and proposes that these guidelines should be taken as a basis for the implementation of a quality assurance programme in FMD laboratories.

Accreditation↗
PubMed2002

Review of the status of foot and mouth disease in countries of South America and approaches to control and eradication.

Since the signing in 1987 of the Hemispheric Plan for the Eradication of Foot-and-Mouth Disease (PHEFA) by the countries of South America, clinical cases of foot and mouth disease (FMD) have decreased significantly throughout the continent. During the early 1990s, national laboratories diagnosed an average of 766 cases per year in South America. By the late 1990s, this continent-wide average had fallen to 130. By the end of the 1990s, the international community recognised Argentina, Chile, Guyana and Uruguay as free of FMD without vaccination. In 1999, clinical signs of FMD were absent in 60% of all cattle of the continent. These cattle represented 41% of all herds in South America and extended over 60% of the geographical area of the continent. However, in the spring of 2001, FMD re-appeared in certain countries of the Southern Cone. This widespread re-occurrence of the disease in Argentina, Uruguay and the State of Rio Grande do Sul in Brazil called into question the basic premise of the PHEFA--that countries in South America can achieve and maintain FMD-free status, with or without vaccination. The authors suggest that these countries can regain their FMD-free status by supporting the PHEFA. A successful disease eradication strategy relies on high levels of vaccination, effectiveness of outbreak responses, and control of animal movement. This strategy must have a regional, not national, focus and must be based on risk analysis methodology. The multilateral administration of vaccination campaigns and field activities to ensure wide and simultaneous vaccine application, along with primary prevention and joint border activities, is the key to eradicating FMD and maintaining areas free of the disease.

Animals↗
PubMed2002

The position of the Dutch Farmers' Union on lessons learned and future prevention and control of foot and mouth disease.

Foot and mouth disease (FMD) has devastated animal husbandry in The Netherlands frequently in the past and still constitutes a threat. The use of vaccination reduced the number of outbreaks in The Netherlands in the 20th Century. However, the desire of some member states of the European Community not to use vaccination led to a new strategy based on stamping-out of infected and contagious farms and to strict transportation regulations. In 2001, this proved very disruptive to the wider rural economy, such as the recreational and tourism sectors. The policy also caused severe animal welfare problems and psychological problems among farmers and their families. This raised questions about the wider, and not only veterinary or agricultural, implications of control strategies of foot and mouth disease virus (FMDV). The technology seems to be in place for a return to the use of protective vaccination against FMDV during an outbreak, provided the Office International des Epizooties (OIE: World organisation for animal health) and European Commission (EC) receive data that substantiate the reliability of differentiating tests such as the 3ABC enzyme-linked immunosorbent assay (ELISA) for use in individual animals. Research is in progress but may not be able to produce these data until 2003 or 2004. High potency vaccines should be used to elicit sufficient immunity within three to four days. During an FMD crisis, farmers should be assisted to find markets for products from areas affected by FMDV. The human dimension of any FMD outbreak must be dealt with sufficiently in any contingency plan.

Agriculture↗
PubMed2003

Identification of geographic factors associated with early spread of foot-and-mouth disease.

OBJECTIVE: To explore whether early analysis of spatial data may result in identification of variables associated with epidemic spread of foot and mouth disease. SAMPLE POPULATION: 37 farms with infected cattle (ie, case farms) reported within the first 6 days of the 2001 Uruguayan foot-and-mouth disease epidemic. PROCEDURE: A georeferenced database was created and retrospective analysis was performed on case farm location in relation to farm density, cattle density, farm type (ie, beef vs dairy cattle production), road density, case farm distance to the nearest road, farm size, farm ownership, and day of infection. Mean or median results of 1 to 3 day versus 4 to 6 day spatial data were compared. Spatial-temporal associations were investigated by correlation analysis. RESULTS: Comparison of mean or median values between the first 3 days and days 4 to 6 of the epidemic and results of correlation analysis indicated a significant increase in road density, cattle density, and dairy cattle production and a significant decrease in farm size and case farm distance to the nearest road that developed over time. A route that linked most case farms by the shortest possible distance and also considered significantly associated variables was created. It included 86.1% of all case farms reported by 60 days into the epidemic. CONCLUSIONS AND CLINICAL RELEVANCE: Epidemic direction can be assessed on the basis of road density and other spatial variables as early as 6 days into an epidemic. Epidemic control areas may be more effectively identified if local and regional georeferenced data are considered.

Agriculture↗
PubMed2001

Comparison of F1 Bos indicus x Hereford cows in central Texas: II. Udder, mouth, longevity, and lifetime productivity.

Postpartum udder characteristics, aged mouth condition scores, and cow survival, longevity, and productivity were evaluated for 15 yr on F1 cows in central Texas (temperate winters and subtropical summers). The cows (n = 116) were progeny of Angus, Gray Brahman, Gir, Indu-Brazil, Nellore, and Red Brahman sires and Hereford dams. Crossbred cows sired by Nellore had smaller (P < 0.05) postpartum teat length than cows of all other crossbred groups and smaller (P < 0.10) postpartum teat diameter than Indu-Brazil and Red Brahman crossbreds. The Nellore crossbred cows had larger (P < 0.10) postpartum udder support scores (more well-supported udders) than Gir, Indu-Brazil, and Red Brahman crossbreds. As 14-yr-old cows, Angus crossbreds had lower (P < 0.05) mouth scores (indicative of one or more missing incisors) than Bos indicus crossbreds. Under actual and artificial (records were removed) culling procedures, Nellore crossbreds had the highest cow survival to age 14 and the highest longevity. Indu-Brazil crossbreds tended to be the lowest for both survival and longevity. Curves were fitted by nonlinear regression procedures to the adjusted frequencies of cows remaining at each age; scale and shape parameters were estimated and compared for the different breed groups. Breed group cow survival rates, calf crop weaned, and calf weaning weights were used 1) to construct population projection and production matrices for each breed group and 2) to generate breed group vectors containing projected age distributions and production information. Cows sired by Nellore and Gir were projected to require the fewest purebred cows to generate replacement heifers and to have the most calves and the largest total calf weight sold per year.

Animals↗
PubMed1995

Personality characteristics of patients with resistant burning mouth syndrome.

The personality characteristics in 32 patients with resistant burning mouth syndrome (BMS) after treatment of diagnosed medical and odontologic diseases were examined and compared with a sex- and age-matched control group. After evaluation of burning mouth symptoms, the personality, the psychologic functioning, and the quality of life were determined by using the Karolinska Scales of Personality (KSP), an additional Personality Scale (PS), a Psychological Functioning Scale (PFS), and a Quality of Life Scale (QLS). The result showed that, compared with a control group, the patients with resistant BMS had a significantly lower score in socialization scale and significantly higher scores in somatic anxiety, muscular tension, and psychasthenia scales. Furthermore, the patients with resistant BMS were significantly more easily fatigued and more sensitive and showed a tendency to be more concerned about their health. With regard to the psychologic functioning, the BMS patients had significantly more problems taking the initiative, more easily became dizzy, and had more sad thoughts. They also showed a tendency to report palpitations and/or indigestions more often. The observed significant differences in personality and psychologic functioning might suggest that the burning sensations are psychosomatic symptoms in these patients. We recommend that patients with resistant BMS should undergo psychologic investigation. If psychologic and/or psychosocial disturbances are diagnosed, adequate treatment should be offered.

Adult↗
PubMedDate not supplied

Nose/mouth distribution of respiratory airflow in 'mouth breathing' children.

Oro-nasal distribution of respiratory airflow was determined in 120 'mouth breathing' children by a minimally invasive computer-assisted method that employed a modified CPAP nasal mask/pneumotach and a head-out body plethysmograph. Resulting measurements were reproducible but clinical assessments correlated poorly with these values. Airflow distribution was almost identical in inspiration and expiration. 100% nasal breathing was found over a wide range of nasal resistances, many subjects with lips apart. Overall, the nasal fraction was negatively correlated with resistance and it was increased by topical decongestant. Decreasing nasal resistance with increasing age was confirmed, but corresponding changes in airflow distribution were not demonstrated. Quantitative assessment is advocated in clinical management of 'mouth breathers'.

Airway Resistance↗
PubMed2003

Foot and mouth disease and cryptosporidiosis: possible interaction between two emerging infectious diseases.

During 2001, a large outbreak of foot and mouth disease occurred in the United Kingdom, during which approximately 2,030 confirmed cases of the disease were reported, >6 million animals were slaughtered, and strict restrictions on access to the countryside were imposed. We report a dramatic decline in the reported incidence of human cryptosporidiosis in northwest England during weeks 13-38 in 2001, compared with the previous 11 years. This decline coincided with the period of foot and mouth restrictions. No similar reduction occurred in the other 26 weeks of the year. We also noted a substantial decline in the proportion of human infections caused by the bovine strain (genotype 2) of Cryptosporidium parvum during weeks 13-38 in that year but not during the other weeks.

Animals↗
PubMed1998

[Result of treatment of squamous cell carcinoma of the tongue and floor of the mouth].

A statistical analysis was performed on 40 patients with squamous cell carcinoma of the tongue and mouth floor, which could be followed for 6 months or more after initial treatment in the Department of Otorhinolaryngology, School of Medicine, Keio University during the 14 years from 1983 to 1996. The 5-year survival rate determined by the Kaplan-Meier method for each stage was 100% for Stage I, 77.8% for Stage II, 60.0% for Stage III and 44.4% for Stage IV. Thirteen suffered a relapse after initial treatment and patients with relapses among them have all survived after the subsequent salvage surgery. In contrast, in nine patients with cervical relapse, however, the 5-year survival rate was 11.1% with an unfavorable prognosis. This confirmed that suppressing cervical relapses is important for treating tongue and floor mouth cancers. The treatment strategy in our department is characteristic of positive enforcement of prophylactic neck dissection in the surgery and introduction of neoadjuvant chemotherapy (NAC) in the chemotherapy. Prophylactic neck dissection was performed in the 17 patients and no relapse was observed on the side of prophylactic neck dissection. NAC was performed on 26 patients in consideration of suppressed minute metastases and preserved function and 24 determinable cases were statistically analyzed. Among patients who had received NAC, the oral function was successfully preserved without surgical intervention in six patients both patients who showed complete response (CR) and four out of 14 patients who had a partial response (PR) following NAC. This may indicate that the oral function could be preserved in those patients who exhibited CR following NAC, but that preservation could be difficult in patients who exhibited PR. In addition, concerning the accumulated 5-year survival rate in relation to the effect of NAC, responders (CR + PR) accounted for 90.9% and non-responders (no change + progressive disease following NAC) for 15.0% with a very good outcome noted in the responder group. These figures suggest that responders may have a significantly good prognosis in the multivariant analysis including additional background factors before treatment as well. Accordingly, the present therapeutic measures for non-responders must be reexamined and performed more carefully and accurately as compared with those for responders.

Adult↗
PubMed2002

Comparative efficacy of SSRIs and amisulpride in burning mouth syndrome: a single-blind study.

INTRODUCTION: Although a significant amount of evidence indicates the efficacy of some antidepressants in treating psychogenic pain and somatoform disorder, very few studies have investigated their possible therapeutic action in burning mouth syndrome (BMS). The purpose of this 8-week, single-blind study was to provide preliminary data on the efficacy and tolerability of amisulpride and the selective serotonin reuptake inhibitors (SSRIs) paroxetine and sertraline for patients with BMS. METHOD: Seventy-six patients with BMS (diagnosed according to the criteria in the literature and integrating the Diagnostic Interview Schedule-Revised for a complete psychiatric assessment), with no possible local or systemic causes and without concurrent major depression, were randomly assigned to receive amisulpride (50 mg/day), paroxetine (20 mg/day), or sertraline (50 mg/day). Efficacy assessments included a visual analogue scale (VAS) for pain intensity, the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), and the Clinical Global Impressions scale (CGI). RESULTS: All 3 treatment regimens resulted in a significant improvement from baseline in burning mouth symptoms at week 8 as demonstrated by the quantitative (mean reduction in VAS, HAM-D, and HAM-A scores) and qualitative (percentage of responders) analyses. Amisulpride showed a shorter response latency than the SSRIs. No serious adverse events were reported, and the incidence of side effects did not differ among the 3 groups. None of the patients who received amisulpride withdrew from the trial, whereas withdrawal from the trial occurred within the first week of treatment in 11.5% of patients (N = 3) treated with paroxetine and in 21.7% of patients (N = 5) treated with sertraline. CONCLUSION: The data suggest that amisulpride and SSRIs may be effective treatments for BMS; they are equally effective and equally well tolerated in the short-term treatment of BMS. Amisulpride is associated with better compliance within the first week of treatment and with a shorter response latency in comparison with SSRIs. This finding may indicate that amisulpride is especially useful at the beginning of drug therapy of BMS. Double-blind, placebo-controlled trials are needed to further document the efficacy of amisulpride and SSRIs in the treatment of BMS.

Amisulpride↗