Youth Preferences for Weight-Related Conversations

ABSTRACT

Little guidance is available to clinicians on how to talk about weight with their patients. The aim of this study is to explore youth preferences for weight-related conversations. Participants came from the National MyVoice Text Message Cohort. Between 7/2017 and 01/2018, 952 MyVoice participants provided open-ended responses via text message to three questions about weight-related conversations (“Has your doctor ever talked to you about weight?”, “What did he or she say?”, and “What should a doctor NOT say when talking about weight?”). The presence of themes was coded using standard qualitative methods. Of the 952 respondents, 568 (60%) reported that their doctor had talked with them about weight. Of these, 85% indicated that their doctor had notified them of their weight, BMI, or weight status and/or the need to change their body weight and 16% had doctors who provided advice about weight control. Eight themes emerged from the analysis of responses to the question “What should a doctor NOT say when talking about weight?”. The two most common themes were: (1): Avoid stigmatizing terms/language (32%); and (2) Do not shame patient for their weight (25%). Findings suggest that weight-related conversations do not reflect the preferences of the youth they are designed to benefit. Youth recommended that clinicians focus on health and sustainable behavioral solutions, avoid stigmatizing language and comparing them to others, and be aware of the potential harm associated with making assumptions that conflate weight with health behaviors, morality, or appearance.     

Dental plaque biofilm in oral health and disease

Dental plaque is an archetypical biofilm composed of a complex microbial community. It is the aetiological agent for major dental diseases such as dental caries and periodontal disease. The clinical picture of these dental diseases is a net result of the cross-talk between the pathogenic dental plaque biofilm and the host tissue response. In the healthy state, both plaque biofilm and adjacent tissues maintain a delicate balance, establishing a harmonious relationship between the two. However, changes occur during the disease process that transform this 'healthy' dental plaque into a 'pathogenic' biofilm. Recent advances in molecular microbiology have improved the understanding of dental plaque biofilm and produced numerous clinical benefits. Therefore, it is imperative that clinicians keep abreast with these new developments in the field of dentistry. Better understanding of the molecular mechanisms behind dental diseases will facilitate the development of novel therapeutic strategies to establish a 'healthy dental plaque biofilm' by modulating both host and microbial factors. In this review, the present authors aim to summarise the current knowledge on dental plaque as a microbial biofilm and its properties in oral health and disease.     

Identification of cultivable microorganisms from primary endodontic infections with exposed and unexposed pulp space

This study was aimed at comparing the cultivable microorganisms in canals with periapical radiolucencies with exposed and unexposed pulp space. Microbiological samples were taken and analyzed from 45 canals with exposed pulp space, and 43 canals with unexposed pulp space. The canal contents were analyzed by aerobic/anaerobic culture, and conventional identification techniques. There were 211 isolates of bacteria belonging to 28 genera and 55 species recovered from exposed canals. In the unexposed group, 185 isolates of bacteria were recovered, of which 54 species of 28 genera were identified. Among the four most common genera, Prevotella was significantly more common in the exposed group (51/211 in the exposed group versus 30/185 in the unexposed group) (p = 0.049), while there were no differences in prevalence of Actinomyces, Peptostreptococcus, and Campylobacter between two groups of canals. In addition, Fusobacterium nucleatum and Propionibacterium acne were significantly more common in the unexposed canals (p = 0.047 and p = 0.0051, respectively). Similarity in bacterial species in these two groups suggests that pulp space exposure may not be a significant factor in determining the type of bacteria present in infected canals.     

Predominant cultivable supragingival plaque in Chinese "rapid" and "slow" plaque formers

Abstract The aim of this study was to compare the predominant cultivable bacterial flora in supragingival plaque samples of Chinese “rapid” and “slow” plaque formers, using the experimental gingivitis model. 11 Chinese subjects (5 “rapid” and 6 “slow” plaque formers) were selected from 49 healthy young adults. The selection was based on the plaque index on the buccal surfaces of all the canines, premolars and 1st molars after 3-days without plaque control. The 11 subjects began a 14-day no oral hygiene period after prophylaxis. Plaque samples were collected on day 1. day 3, day 7 and day 14 from the buccal surface of upper right canine. 2nd premolar. 1st premolar and 1st molar, respectively. The samples were then dispensed into a tryptic soy broth, and cultured anaerobically to obtain pure isolates which were then identified by conventional means. Results showed similar trends in plaque development in the two groups; gram-positive bacteria were the predominant cultivable species (“rapid”: 71–37%; “slow”: 53–63%) and gram-negative species increased in proportion to the plaque age (“rapid”: 9–47%. “slow”: 13–28%). “Rapid” plaque formers showed a statistically significant higher percentage of gram-negative rods (38%) than the “slow” group (17%) in the 14-day samples. The difference in the proportions of other groups of bacteria between the “rapid” and “slow” plaque formers were also found to be statistically significant using the MANOVA test (p=0.0162). Most of the cultivable gram-negative rods belonged to Fusobacterium and Capnocytophaga species. Besides the quantitative difference observed clinically, there seems to be a qualitative difference in the cultivable flora between subjects with different rates of plaque formation.     

Prunus mume extract exhibits antimicrobial activity against pathogenic oral bacteria

International Journal of Paediatric Dentistry 2011; 21: 299–305 Objectives. Prunus mume is a common fruit in Asia, which has been used in traditional Chinese medicine. In this study, we focused on the antimicrobial properties of Prunus mume extract against oral pathogens related to dental caries and periodontal diseases. Study design. A total of 15 oral pathogens including Streptococcus mutans, S. sobrinus, S. mitis, S. sanguinis, Lactobacillus acidophilus, P. gingivalis, Aggregatibacter actinomycetemcomitans, and Candida species were included in the study. Initially, agar diffusion assay was performed to screen the antimicrobial activities of Prunus mume extract. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were then determined for sensitive species. Effect of Prunus mume extract on human oral keratinocytes (HOK) viability was also tested. Result. In the agar diffusion assay, drug suspension of 2 g/mL was able to inhibit all the bacterial species tested, but not the fungal species. MIC and MBC range of Prunus mume extract against the oral bacteria was 0.15625–0.0003 g/mL and P. gingivalis being the most susceptible species. Prune extract did not cause any detrimental effect on HOK. Conclusion. Prunus mume extract may be a potential candidate for developing an oral antimicrobial agent to control or prevent dental diseases associated with oral pathogenic bacteria.     

Expression of human beta-defensins-1 and -2 peptides in unresolved chronic periodontitis

BACKGROUND: Human beta-defensins (hBDs) are antimicrobial peptides which contribute to host innate immunity by disrupting the membrane integrity of a broad spectrum of microorganisms. OBJECTIVES: This study aimed to determine the expression profiles of hBD-1 and -2 peptides in gingiva and to assess the possible relations of these antimicrobial peptides with periodontal health and disease. METHODS: Seven periodontally healthy subjects and 22 patients with unresolved chronic periodontitis were recruited and the gingival biopsies collected consisted of healthy tissues from the healthy subjects (HT-C); periodontal pocket tissues (PoT) and inflamed connective tissues (ICT) from the base of pocket, i.e. granulation tissues, as well as clinically healthy tissues (HT-P) from the adjacent clinically healthy sites from the patients. The expression of hBD-1 and -2 peptides was detected by immunohistochemistry and quantitatively analyzed with a computerized image processing system. RESULTS: Both hBD-1 and -2 peptides were detected in all periodontally healthy subjects, while hBD-1 was detected in all patients and hBD-2 was found in most of the patients. Their expression was mainly confined to the granular and spinous layers of gingival epithelium, in which hBD-1 was detected in both intercellular spaces and cytoplasm, whereas hBD-2 was mainly observed in the cytoplasm. HT-C expressed significantly higher levels of hBD-2 than HT-P (p < 0.05). Within the patients, both defensins were up-regulated significantly in PoT as compared with the adjacent HT-P (p < 0.05). CONCLUSIONS: The present study showed that hBD-1 and -2 were frequently expressed in the granular and spinous layers of gingival epithelia and their expression may be associated with periodontal health and disease.     

Pharmacokinetics of High-Dose Propylene Glycol–Free Melphalan in Multiple Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation

High-dose melphalan followed by autologous stem cell transplant (ASCT) is standard of care for eligible patients with multiple myeloma (MM). Evomela (propylene glycol–free melphalan HCl [PG-Free Mel]; Spectrum Pharmaceuticals, Irvine, CA) was approved by the US Food and Drug Administration as conditioning therapy for ASCT in MM in 2 daily 100-mg/m² doses for a total dose of 200?mg/m². In this phase II, open-label study PG-Free Mel (Evomela) conditioning was given at single dose of 200?mg/m² on day ?2 pre-ASCT to establish pharmacokinetic (PK) parameters and safety. Twenty-four patients (median age, 64 years) were enrolled between August 2016 and February 2017. Myeloablation followed by successful neutrophil engraftment occurred at a median of 10 days in all patients. Peak melphalan concentration was observed at 10 minutes after infusion, whereas there was considerable variation in the maximum plasma concentration (C_max) and area under concentration time curve (AUC). Median C_max was 7380?ng/mL (interquartile range [IQR], 6522 to 8027). Similarly, median AUC was 533,552?ng/mL?min (IQR, 450,850 to 662,936). PG-Free Mel had an acceptable safety profile regardless of the exposure, with no mortality and an overall response rate of 96% and a very good partial response rate of 75%. In conclusion, although PG-Free Mel at a single dose of 200?mg/m² was safe, considerable PK variability was observed with the highest quartile having an ~3-fold higher AUC than the first quartile, suggesting that strategies for higher targeted exposure could be explored in future trials to optimize clinical benefit.     

Effect of Glycemic Control on Self‐Perceived Oral Health,Periodontal Parameters,and Alveolar Bone Loss Among Patients With Prediabetes

Background: The effect of glycemic control on severity of periodontal inflammatory parameters in patients with prediabetes is unknown. The aim of the present study is to assess the effects of glycemic control on self‐perceived oral health, periodontal parameters, and marginal bone loss (MBL) in patients with prediabetes. Methods: A total of 303 individuals were included. Hemoglobin A1c (HbA1c) and fasting blood glucose levels (FBGLs) were recorded. Participants were divided into three groups: 1) group A: 75 patients with prediabetes (FBGLs = 100 to 125 mg/dL [HbA1c ≥5%]); 2) group B: 78 individuals previously considered prediabetic but having FBGLs <100 mg/dL (HbA1c <5%) resulting from dietary control; and 3) control group: 150 medically healthy individuals. Self‐perceived oral health, socioeconomic status, and education status were determined using a questionnaire. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), and clinical attachment loss (AL) were recorded. Premolar and molar MBLs were measured on panoramic radiographs. Results: Periodontal parameters (PI, BOP, PD, and AL) (P <0.01) and MBL (P <0.01) were worse among individuals in group A than those in group B. Self‐perceived gingival bleeding (P <0.001), pain on chewing (P <0.001), dry mouth (P <0.001), and oral burning sensations (P <0.05) were worse among patients in group A than those in group B. There was no difference in periodontal parameters, MBL, and self‐perceived oral symptoms among patients with prediabetes in group B and healthy controls. Conclusions: Self‐perceived oral health, severity of periodontal parameters, and MBL are worse in patients with prediabetes than controls. Glycemic control significantly reduces the severity of these parameters as well as the state of prediabetes in affected individuals.     

Discovery and Development of LX7101, a Dual LIM-Kinase and ROCK Inhibitor for the Treatment of Glaucoma

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