This systematic review was to assess the presence of Trichomonas tenax in patients with periodontitis and to elucidate its potential role in the onset and development of this disease.
Systematic ...review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and by consulting the five databases: Medline, Science Direct, Web of Science, Dentistry and Oral Science Sources and Cochrane Central Register of Controlled Trials. Following Koch's postulates revisited by Socransky as PICO framework, this collection data was only including full text of clinical trials concerning patients with periodontitis, case-reports and in vitro research published between 1960 and March 2019.
On the 376 studies identified, only 25 fulfilled our eligible criteria. Most of these studies were in vitro research articles designed to evaluate potential virulence factors, and others were clinical trials (case-control studies, randomized controlled trial) and case-reports. The analysis of these papers has shown that i) Trichomonas tenax is more frequently detected in dental biofilm from sites with periodontitis than in healthy sites; ii) this live flagellate seems capable of producing diverse enzymes that could participate in periodontal breakdown and has the capacity to adhere to epithelial cells, its lysed form could induce the synthesis of IL-8 from macrophage cell lines; iii) the impact of non-surgical treatment of periodontitis have not been thoroughly evaluated on the presence of T. tenax.
This systematic review has reported the presence of T. tenax more frequently in diseased than healthy sites and the capacity of this flagellate to synthesis enzymes which could participate to the degradation of periodontal tissues. Nevertheless, these data do not meet all the postulates and are not enough to provide firm conclusions about the role of T. tenax in the etiopathogenesis of periodontitis.
Advanced glycation end-products play a role in diabetic vascular complications. Their optical properties allow to estimate their accumulation in tissues by measuring the skin autofluorescence (SAF). ...We searched for an association between SAF and major adverse cardiovascular events (MACE) incidence in subjects with Type 1 Diabetes (T1D) during a 7 year follow-up.
During year 2009, 232 subjects with T1D were included. SAF measurement, clinical age, sex, body mass index (BMI), comorbidities and biological data (HbA1C, blood lipids, renal parameters) were recorded. MACE (myocardial infarction, stroke, lower extremity amputation or a revascularization procedure) were registered at visits in the center or by phone call to general practitioners until 2016.
The participants were mainly men (59.5%), 51.5 ± 16.7 years old, with BMI 25.0 ± 4.1 kg/m
, diabetes duration 21.5 ± 13.6 years, HbA1C 7.6 ± 1.1%. LDL cholesterol was 1.04 ± 0.29 g/L, estimated Glomerular Filtration Rates (CKD-EPI): 86.3 ± 26.6 ml/min/1.73 m
. Among these subjects, 25.1% were smokers, 45.3% had arterial hypertension, 15.9% had elevated AER (≥ 30 mg/24 h), and 9.9% subjects had a history of previous MACE. From 2009 to 2016, 22 patients had at least one new MACE: 6 myocardial infarctions, 1 lower limb amputation, 15 revascularization procedures. Their SAF was 2.63 ± 0.73 arbitrary units (AU) vs 2.08 ± 0.54 for other patients (p = 0.002). Using Cox-model, after adjustment for age (as the scale time), sex, diabetes duration, BMI, hypertension, smoking status, albumin excretion rates, statin treatment and a previous history of MACE, higher baseline levels of SAF were significantly associated with an increased risk of MACE during follow-up (HR = 4.13 1.30-13.07; p = 0.02 for 1 AU of SAF) and Kaplan-Meier curve follow-up showed significantly more frequent MACE in group with SAF upper the median (p = 0.001).
A high SAF predicts MACE in patients with T1D.
L’insuffisance d’activité physique (AP) et la sédentarité sont des facteurs de risques de nombreuses maladies et sont associées à une augmentation de la mortalité. Le rôle du médecin généraliste est ...central dans le repérage de ces deux facteurs de risque pour intervenir précocement dans la modification des comportements. Il existe de nombreux outils de mesure de l’AP validés mais ils sont difficilement utilisables en consultation. Un questionnaire court, en deux questions, le Brief Physical Activity Assessment Tool (BPAAT) ou questionnaire de Marshall, a été validé, en anglais, versus accélérométrie. Notre étude avait pour but de comparer la capacité du test de Marshall (dans sa version française) à classer les patients en suffisamment ou insuffisamment actifs, par rapport aux tests IPAQ et le GPAQ. Les objectifs secondaires étaient, d’évaluer la faisabilité de ce repérage en pratique de soins primaires et de tester trois autres approches : une autoévaluation par le patient de son AP ; une question sur l’inscription dans un club ou une association sportive, une question de repérage rapide de la sédentarité.
Étude épidémiologique transversale comparant une évaluation par le médecin avec le questionnaire de Marshall et les questions des trois autres approches à un questionnaire autorempli contenant les questionnaires IPAQ et GPAQ.
Quatre cents quatre-vingt-seize sujets ont été inclus. Le questionnaire de Marshall avec un seuil à trois permettait de classer correctement les patients en suffisamment actifs ou insuffisamment actifs avec 68,41 % de concordance par rapport à l’IPAQ, et avec 70,10 % de concordance par rapport au GPAQ. Une question d’autoévaluation de l’activité physique pourrait avoir une valeur discriminante proche du test de Marshall. Pour l’évaluation de la sédentarité, une simple question évaluant le niveau de sédentarité ressenti de 0 à 10 est utilisable en pratique. Les médecins étaient capables de repérer les patients insuffisamment actifs et/ou sédentaires dans plus du tiers de leurs consultations.
Insufficient physical activity (PA) and physical inactivity are risk factors for many diseases and are associated with increased mortality. The role of the general practitioner is central in identifying these two risk factors in order to intervene early in behavior modification. There are many validated PA measurement tools but they are difficult to use in consultation. A short questionnaire, in two questions, the Brief Physical Activity Assessment Tool (BPAAT) or Marshall questionnaire, was validated, in English, versus accelerometry. Our study aimed to compare the ability of the Marshall test (in its French version) to classify patients as sufficiently or insufficiently active, compared to the IPAQ and GPAQ tests. The secondary objectives were to assess the feasibility of this screening in primary care practice and to test three other approaches: patient self-assessment of their PA; a question about registering with a club or a sports association, a question of quickly identifying a sedentary lifestyle.
Cross-sectional epidemiological study comparing physician assessment with Marshall's questionnaire and questions from the other three approaches to a self-completed questionnaire containing the IPAQ and GPAQ questionnaires.
Fur hundred and ninety six subjects were included. The Marshall questionnaire with a threshold of three made it possible to correctly classify patients as sufficiently active or insufficiently active with 68.41% agreement with respect to the IPAQ, and with 70.10% agreement with respect to the GPAQ. A self-assessment question on physical activity could have a discriminating value close to the Marshall test. For the evaluation of sedentariness, a simple question evaluating the level of sedentariness felt from 0 to 10 is usable in practice. Doctors were able to identify insufficiently active and/or sedentary patients in more than a third of their consultations.
Abstract
Background
For more than 20 years, and despite the development of new social networks, health forums have remained a privileged place for people to discuss health issues. This study ...investigates the motivations of participants to post a message on a French online health forum (called 'Doctissimo') (Forum Santé - Doctissimo, 2022).
Method
Between January 1, 2017 and December 31, 2019, all the first messages recorded on the health forum doctissimo (
www.forum.doctissimo.fr
) were selected in their initial format by a crawler. The transcripts were imported into the qualitative analysis software Nvivo. Two researchers coded the data until a theoretical saturation was obtained.
Results
We identified four categories of motivation: 1) 'Questioning' allows the exchange of mainly medical information, or sharing of feedback on experiences with the disease: 1722 codes, 44.8%, 2) Worry, need for reassurance: 1066 codes, 27.7% about symptoms or anticipatory anxiety, 3) 'Expressing oneself' mainly allows a catharsis and thus an emotional release, especially negative, but also to share a personal experience: 764 codes 19.9%, 4) Community spirit is a central element to create an emotional support group for psychological support, exchange ideas, meet people in similar situations: 291 codes, 7.6%. The relationship with a health professional when mentioned is generally marked by doubts 39.5%, confusion, or lack of information and the need for additional elements 64.6% or reassurance 60%. The relationship and the obstacles to a medical consultation are described in relation to the use of the forum: immediate availability, anonymity, absence of taboo and community spirit.
Conclusion
The use of information sources offered by the Internet is a way to ask questions, to be reassured, to express oneself or to be confirmed by the community in the hypothesis emitted by a health professional. Patients are looking for an immediate answer, they come to the community for reassurance, they feel free and legitimate.
Summary Background & aims Eating habits may influence the life span and the quality of ageing process by modulating inflammation. The RISTOMED project was developed to provide a personalized and ...balanced diet, enriched with or without nutraceutical compounds, to decrease and prevent inflammageing, oxidative stress and gut microbiota alteration in healthy elderly people. This paper focused on the effect on inflammation and metabolism markers after 56 days of RISTOMED diet alone or supplementation with three nutraceutical compounds. Methods A cohort of 125 healthy elderly subjects was recruited and randomized into 4 arms (Arm A, RISTOMED diet; Arm B, RISTOMED diet plus VSL#3 probiotic blend; Arm C, RISTOMED diet plus AISA d -Limonene; Arm D, RISTOMED diet plus Argan oil). Inflammatory and metabolism parameters as well as the ratio between Clostridium cluster IV and B ifidobacteria (CL/B) were collected before and after 56 days of dietary intervention, and their evolution compared among the arms. Moreover, participants were subdivided according to their baseline inflammatory parameters (erythrocytes sedimentation rate (ESR), C-Reactive Protein, fibrinogen, Tumor Necrosis Factor-alfa (TNF-α), and Interleukin 6) in two clusters with low or medium–high level of inflammation. The evolution of the measured parameters was then examined separately in each cluster. Results Overall, RISTOMED diet alone or with each nutraceutical supplementation significantly decreased ESR. RISTOMED diet supplemented with d-Limonene resulted in a decrease in fibrinogen, glucose, insulin levels and HOMA-IR. The most beneficial effects were observed in subjects with a medium–high inflammatory status who received RISTOMED diet with AISA d -Limonene supplementation. Moreover, RISTOMED diet associated with VSL#3 probiotic blend induced a decrease in the CL/B ratio. Conclusions Overall, this study emphasizes the beneficial anti-inflammageing effect of RISTOMED diet supplemented with nutraceuticals to control the inflammatory status of elderly individuals.
Patient education constitutes a relevant strategy to improve pain management. In the field of therapeutic patient education (TPE), we aimed 1) to assess pain impact in cancer patients, 2) to identify ...patients' educative needs in pain management, and 3) to refine research criteria for its future evaluation.
Pain intensity, relief and interference were assessed in 75 cancer patients with unbalanced background pain. Self-assessment questionnaire evaluated i) patients' pain management and ii) their knowledge and needs in TPE.
Most patients experienced pain for more than 6 months and 41.6% reported adequate pain relief. Understanding pain and pain management were major patients' preferences (>58%). Most patients declared they knew their pain treatments, but fewer than half of them were able to name them. However, education concerning pain treatment was considered as essential in <30% of patients. Almost all patients (97.1%) stated pain education as beneficial, with a preference for individualized sessions (41.2%). In addition, the assessment criteria for its future evaluation were refined.
Targeted population mainly concerned patients with persistent pain. Only half of patients reported pain relief despite antalgics. Patient education was declared as beneficial for almost all participants.
Tailoring a pain TPE on patients' needs has the potential to help them to optimally manage their pain daily.
Summary
Desulfovibrio are sulfate‐reducing anaerobic gram‐negative rods that have been proposed as potential periodontopathogens. We investigated the capacity of Desulfovibrio to invade epithelial ...cells and induce cytokine secretion from these cells. Desulfovibrio strains were co‐cultured with KB cells and counts of intracellular bacteria evaluated up to 3 days after infection. Desulfovibrio desulfuricans and Desulfovibrio fairfieldensis were able to survive within epithelial cells. Intracytoplasmic location of both bacterial species was confirmed by confocal laser scanning microscopy and transmission electron microscopy. Invasion was sensitive to nocodazole, an inhibitor of microtubule polymerization, but not to cytochalasin D, a microfilament inhibitor, suggesting that microtubule rearrangements were involved in the internalization of Desulfovibrio strains by KB cells. Infection by Desulfovibrio resulted in increased production of IL‐6 and IL‐8 by KB cells. The ability of D. desulfuricans and D. fairfieldensis to survive within oral epithelial cells and to modulate the epithelial immune response may contribute to the initiation and progression of periodontal diseases.
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