Search

Objective: To assess the associations between oral health status and short-term functional outcomes in hospitalized patients aged over 65 years with acute ischemic stroke. Materials and methods: This retrospective observational analysis included older adult patients (age, ≥ 65 years) admitted for acute ischemic stroke. The oral health status at admission was evaluated using the Oral Health Assessment Tool (OHAT). Patients were categorized into the normal oral health (OHAT score, 0–2) or poor oral health (OHAT score, ≥ 3) group. Stroke severity, Functional Oral Intake Scale (FOIS), and medical history were compared. Multivariate analysis was used to determine the association between the OHAT score and modified Rankin Scale (mRS) score at discharge, FOIS score at discharge, and length of hospital stay. Results: The study comprised 129 patients (mean age: 78.8 ± 7.7 years). The poor oral health group (n = 22) had a higher stroke severity and lower FOIS scores than the normal oral health group (n = 107). The poor oral health group exhibited significantly higher rates of moderate to severe disability at discharge (odds ratio = 9.18, 95% confidence interval [CI]: 1.74–48.30, P = 0.009), lower FOIS scores at discharge (β = -0.96, 95% CI: -1.71 to -0.20, P = 0.014), and longer hospital stays (β = 10.70, 95% CI: 0.80–20.61, P = 0.034) than the other group. Conclusion: In older patients with acute ischemic stroke, poor oral health status at admission was associated with worse short-term functional outcomes, including increased disability, dysphagia, and longer hospital stay. Clinical relevance: Assessing and addressing the oral health status of this population can potentially improve short-term functional outcomes and enhance comprehensive stroke care. [ABSTRACT FROM AUTHOR]

Iron is an essential micronutrient for living organisms, but its solubility is extremely low under alkaline conditions. Plants often suffer from iron deficiency chlorosis in calcareous soils, which consist of approximately 30% of the world's cultivated area, severely limiting plant productivity. Iron deficiency anemia is also a widespread problem in humans, especially in Asian and African people who take up iron mainly from staple foods containing low iron concentrations. Transgenic manipulation of genes involved in plant iron uptake, translocation, and storage has made improvements in enhancing iron deficiency tolerance or iron accumulation in edible parts, but these two properties have been characterized separately. We previously produced transgenic rice lines, with concomitant improvement of iron deficiency tolerance and grain iron accumulation by knocking-down OsHRZ ubiquitin ligases, which negatively regulate iron deficiency response and iron accumulation in rice. In the present report, we aimed to further improve the iron deficiency tolerance and grain iron accumulation of OsHRZ knockdown rice by the simultaneous introduction of the engineered ferric-chelate reductase gene Refre1/372 under the control of the OsIRT1 promoter for further enhancement of iron uptake. We obtained several transgenic rice lines with repressed OsHRZ expression and induced Refre1/372 expression. These lines showed a variable degree of iron deficiency tolerance in calcareous soils, with increased iron accumulation in brown seeds under both iron-deficient and iron-sufficient soil cultures. Selected OsHRZ knockdown plus Refre1/372 lines showed similar or better growth compared with that of singly introduced OsHRZ knockdown or Refre1/372 lines in calcareous soils under both non-submerged and submerged conditions. After submerged calcareous soil cultivation, these OsHRZ knockdown plus Refre1/372 lines accumulated 2.5–4.3 times and 17–23 times more iron concentrations than that of non-transformants in brown rice and straw, respectively, which was comparable or superior to a single OsHRZ knockdown line. Our results indicate that the combined introduction of OsHRZ knockdown and OsIRT1 promoter-Refre1/372 is highly effective in further improving the iron deficiency tolerance without compromising the iron accumulation of the OsHRZ knockdown effects. [ABSTRACT FROM AUTHOR]

Purpose: A high score determined by SARC-F, a simple screening questionnaire for sarcopenia, has been reportedly associated with worse medical outcomes. However, information regarding whether high SARC-F scores are associated with a poor prognosis in patients with advanced cancer remains limited. We clarified whether a SARC-F score ≥ 4 predicts poor prognosis in patients with cancer receiving palliative care.Methods: We conducted a retrospective cohort study of patients with cancer who received palliative care at a university hospital between May 2019 and April 2020. Patient characteristics including age, sex, height, weight, cancer type, serum albumin level, C-reactive protein level, presence of edema, Eastern Cooperative Oncology Group-Performance Status (ECOG-PS), SARC-F score, history of anticancer therapy, and clinical outcomes were collected from electronic medical records.Results: Of 304 patients, 188 had a SARC-F score < 4, and 116 patients had a SARC-F score ≥ 4. The overall survival of patients with a SARC-F score ≥ 4 was 40 days (95% CI 29-47), which was significantly worse than 121 days (95% CI 95-156) for patients with a SARC-F score < 4 (p < 0.001). SARC-F score ≥ 4 (hazard ratio: HR 1.56), edema (HR 1.94), head and neck cancer (HR 0.51), C-reactive protein (HR 1.05), ECOG-PS ≥ 3 (HR 1.47), and radiotherapy (HR 0.52) were associated with overall survival. The ability to climb stairs was a SARC-F sub-item significantly associated with mortality (HR 1.59).Conclusion: The SARC-F questionnaire is a useful predictor of prognosis for patients with cancer receiving palliative care because a SARC-F ≥ 4 score predicts worse overall survival. [ABSTRACT FROM AUTHOR]

Transcutaneous electrical sensory stimulation (TESS) devices are approved for use in Japan, but their safety when used through the neck skin for dysphagia rehabilitation has not been reported. This study aimed to verify the safety of TESS use through the neck skin. Twenty patients (mean age 86.5 ± 5.1 years) with aspiration pneumonia undergoing dysphagia rehabilitation were included in this retrospective observational and matched control study. We compared vital signs in 10 subjects who underwent swallowing rehabilitation with the TESS device, and matched control patients over 7 days. The results were the following: tachycardia, 0.60 ± 1.07 vs. 0.70 ± 0.67 days; high blood pressure, 0.40 ± 0.70 vs. 0.50 ± 1.08 days; low blood pressure, 0.40 ± 0.70 vs. 0.10 ± 0.32 days; low oxygen saturation, 0.60 ± 1.58 vs. 0.50 ± 1.08 days, p = 0.870; oxygen administration, 0.80 ± 2.20 vs. 1.20 ± 2.15 days; tachypnea, 0.50 ± 0.71 vs. 0.50 ± 0.53 days; elevated body temperature, 2.00 ± 1.41 vs. 1.60 ± 1.96 days. There were no significant differences in clinical stability between the TESS and control groups of patients with aspiration pneumonia. TESS through the neck appears safe as an intervention in dysphagia rehabilitation. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether geniohyoid and/or masseter muscle mass can predict the severity of dysphagia after salvage surgery for head and neck cancer. We conducted a retrospective cohort study of 45 male patients with head and neck cancer (median age, 68 years) who underwent salvage surgery. The preoperative geniohyoid and masseter muscle masses were evaluated using computed tomography and the severity of dysphagia was evaluated by Penetration Aspiration Scale (PAS), Functional Oral Intake Scale (FOIS) and Oropharyngeal swallow efficiency (OPSE). The median PAS, FOIS and OPSE scores after surgery were 7 (interquartile range [IQR] 1–8), 6 (IQR 2–7) and 95.8 (IQR 67.1–116.2), respectively. The mean geniohyoid muscle masses were 3.13 ± 0.78 cm2 and the mean masseter muscle masses were 4.37 ± 0.99 cm2, respectively. The multivariate analysis showed that the geniohyoid muscle mass was significantly associated with the PAS, FOIS and OPSE scores. Conversely, the masseter muscle mass was not significantly associated with the PAS score but was significantly associated with the FOIS and OPSE scores. Geniohyoid muscle mass may predict the severity of dysphagia after salvage surgery. [ABSTRACT FROM AUTHOR]

Carbonated beverages initiate the swallowing reflex earlier than water and have a shorter pharyngeal transit time. However, the effects of carbonation in thickened beverages of the same flavor on swallowing dynamics have not been reported. Therefore, we investigated the effects of thickened carbonated beverages on swallowing in patients with dysphagia by comparing the swallowing dynamics between thickened carbonated and thickened non-carbonated beverages. We enrolled 38 patients with dysphagia and divided them into two groups. Thickened carbonated and thickened non-carbonated beverages were used. Videoendoscopic swallowing evaluations were performed. Aspiration, penetration, pharyngeal residue, and initiation position of the swallowing reflex were evaluated. The reduction in the amount of residue in both the vallecula (p = 0.007) and pyriform sinus (p = 0.004) was greater after ingestion of thickened carbonated cola than thickened non-carbonated cola. The onset of the swallowing reflex was significantly earlier after ingestion of thickened carbonated cola than thickened non-carbonated cola (p = 0.007). There were no significant differences in the extent of penetration. Thickened carbonated beverages positively affected swallowing compared with thickened non-carbonated beverages. Thus, the use of thickened carbonated beverages may be helpful for patients with dysphagia. [ABSTRACT FROM AUTHOR]

Background: Recently, diagnostic criteria for malnutrition have been proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN). This study aimed to investigate the utility of the ESPEN malnutrition criteria as a predictor for major complications following hepatectomy and pancreatectomy. Methods: Data were reviewed from 176 consecutive patients who underwent hepatectomy (n = 103) or pancreatectomy (n = 73) between November 2017 and December 2019. Patients were divided into two groups according to the ESPEN malnutrition criteria using a prospectively collected database. The clinical data and the surgical outcomes of patients in the malnourished and normal groups were retrospectively analyzed. Results: Thirty-five (20%) patients were diagnosed with malnourishment according to ESPEN criteria. The malnourished group had a significantly low preoperative albumin concentration (p = 0.001). After hepatectomy, major complications (Clavien grade ≥ 3a) occurred significantly more frequently in the malnourished group than in the normal group (p = 0.013). Multivariate analysis indicated that operative duration ≥ 300 min (hazard ratio: 22.47, 95% CI: 2.17 to 232.73, p = 0.009) and malnourishment (hazard ratio: 14.56, 95% CI: 2.58 to 82.17, p = 0.002) were independently associated with major complications after hepatectomy. On the other hand, malnutrition was not associated with major complications after pancreatectomy. Conclusions: The ESPEN malnutrition criteria are a valuable predictor for major complications following hepatectomy. [ABSTRACT FROM AUTHOR]

The Calcineurin/NFAT (nuclear factor of activated T cells) pathway plays an essential role in the tumorigenic and metastatic properties in breast cancer. The molecular mechanism of the antiproliferative effect of calcineurin inhibition, however, is poorly understood. We found that calcineurin inhibition delayed cell cycle progression at G1/S, and promoted cyclin D1 degradation by inhibiting dephosphorylation at T286. Importantly, overexpression of cyclin D1 partially rescued delayed G1/S progression, thereby revealing cyclin D1 as a key factor downstream of calcineurin inhibition. Cyclin D1 upregulation is observed in human invasive breast cancers, and our findings indicate that dysregulation of T286 phosphorylation could play a role in this phenomenon. We therefore propose that targeting site specific phosphorylation of cyclin D1 could be a potential strategy for clinical intervention of invasive breast cancer. [ABSTRACT FROM AUTHOR]

(c) Bar graph comparing the amount of pharyngeal residue for thickened carbonated cola and thickened non-carbonated cola. (a) Comparison of penetration/aspiration with thickened carbonated cola and thickened non-carbonated cola. (b) Boxplot comparing the amount of pharyngeal residue between thickened carbonated cola and thickened non-carbonated cola (*p < 0.05). [Extracted from the article]

A letter to the editor is presented in response to the article "Skeletal muscle mass and quality as risk factors for postoperative outcome after open colon resection for cancer" by author B.C. Boer and others that was published in the in the 2016 issue of periodical.