The prevalence and findings of fibre-optic endoscopic evaluation of swallowing in hospitalised patients with dysphagia

Swallowing disorder or dysphagia is quite common in hospitalised patients. Using fibre-optic endoscopic evaluation of swallowing (FEES) is one of the clinical standards for evaluating swallowing disorder to prevent serious consequences such as aspiration pneumonia. This study aimed to determine the prevalence and the associated risk of dysphagia in hospitalised patients by using FEES finding. We retrospectively analysed the FEES records from the patients who were screened and suspected of swallowing problems by a certified nurse of dysphagia nursing (CNDN). The FEES findings were compared between dysphagia and without dysphagia to evaluate the associated risk of dysphagia. Six-hundred and nine FEES records were analysed. We found dysphagia 76% in patients who suspected swallowing problems by CNDN. FEES was assessed after the subjects had been admitted for 22 days on average. There was no difference in age between dysphagia and without dysphagia participants. However, the advanced age (age > 85 years old) increased the odd of dysphagia 1.18, P = .03. The primary disease of the subjects was mainly cerebrovascular disease (24%) and pneumonia (22%). Abnormal FEES findings including soft palate elevation, velopharyngeal contraction, whiteout, volitional cough, glottis closure during breath holding, cough reflex and presence of secretion in pharynx were found in hospitalised patients with dysphagia. The prevalence of dysphagia was high in hospitalised patients. Hence, screening the swallowing problem by nurse and FEES evaluation is essential to detect and prevent the complication in the patient who has dysphagia.     

Thirteen week toxicity study of dietary l‐tryptophan in rats with a recovery period of 5 weeks

Although l ‐tryptophan is nutritionally important and widely used in medical applications, toxicity data for its oral administration are limited. The purpose of this study was to evaluate the potential toxicity of an experimental diet containing added l ‐tryptophan at doses of 0 (basal diet), 1.25%, 2.5% and 5.0% when administered to Sprague–Dawley rats for 13 weeks. There were no toxicological changes in clinical signs, ophthalmology, urinalysis, hematology, necropsy, organ weight and histopathology between control rats and those fed additional l ‐tryptophan. Body weight gain and food consumption significantly decreased throughout the administration period in males in the 2.5% group and in both sexes in the 5.0% group. At the end of the dosing period, decreases in water intake in males in the 5.0% group and in serum glucose in females in the 5.0% group were observed. The changes described above were considered toxicologically significant; however, they were not observed after a 5 week recovery period, suggesting reversibility. Consequently, the no‐observed‐adverse‐effect level of l ‐tryptophan in the present study was 1.25% for males and 2.5% for females (mean intake of l ‐tryptophan: 779 mg kg^–1 body weight day^–1 [males] and 1765 mg kg^–1 body weight day^–1 [females]). As the basal diet used in this study contained 0.27% of proteinaceous l ‐tryptophan, the no‐observed‐adverse‐effect level of overall l ‐tryptophan was 1.52% for males and 2.77% for females (mean intake of overall l ‐tryptophan: 948 mg kg^–1 body weight day^–1 (males) and 1956 mg kg^–1 body weight day^–1 (females)). We conclude that l ‐tryptophan has a low toxicity profile in terms of human use.     

Replacing sedentary time with physical activity: effects on health-related quality of life in older Japanese adults

Background

The isotemporal substitution (IS) approach can be used to assess the effect of replacing one activity with the equal duration of another activity on relevant outcomes. This study examined the associations of objectively assessed sedentary behavior (SB) and physical activity (PA) with health-related quality of life (HRQOL) in older Japanese adults, using the IS approach.

Methods

Participants were 287 older Japanese adults (aged 65–84?years) who wore accelerometers for at least 7 days. We calculated the average daily time spent in SB (≤1.5 METs); light-intensity PA (LPA: >?1.5 to <?3.0 METs); and moderate- to vigorous-intensity PA (MVPA: ≥3.0 METs) per day. HRQOL was assessed using the Medical Outcomes Survey Short Form-8 questionnaire.

Results

The IS models showed replacing SB or LPA with MVPA to be significantly associated with better physical component summary scores. Replacing SB with MVPA was marginally associated with better mental component summary scores.

Conclusion

These findings indicate that replacing SB with the same amount of MVPA may contribute to better physical HRQOL in older adults.

     

Antimicrobial action of natural substances on oral bacteria

The antimicrobial action of natural substances was investigated in vitro against oral bacteria including Streptococcus sp., Actinomyces sp., Actinobacillus sp., Bacteroides sp., Capnocytophaga sp., Eikenella sp., Fusobacterium sp. and Propionibacterium sp. Among the natural substances tested, hinokitiol was the most inhibitory to oral bacteria. Cinnamon bark oil, papua-mace extracts, and clove bud oil in spice extracts were also inhibitory against many oral bacteria. Egg white lysozyme exhibited antimicrobial action against the periodontitis associated bacteria.     

Fluoride intake in Japanese children aged 3-5 years by the duplicate-diet technique

This study was conducted to determine the fluoride intakes in 94 preschool children aged 3, 4 and 5 (n = 30, 30, 34, respectively) residing in Yokkaichi, Mie Prefecture (< 0.16 ppm F water supply). The parents duplicated all the diets that their children ingested on 3 separate days during a 1-year period. The acid-diffusible fluoride in the diet was isolated by the acid-diffusion technique and measured with a fluoride electrode. The mean daily fluoride intakes from diet alone by children aged 3, 4 and 5 were 0.30 mg (n = 29, SD 0.19), 0.28 mg (n = 30, SD 0.19) and 0.30 mg (n = 34, SD 0.19), respectively. The total estimated mean values from diet and dentifrice were 0.35 mg (n = 29, SD 0.22, range 0.13-1.00), 0.33 mg (n = 30, SD 0.19, range 0.13-0.86) and 0.39 mg (n = 34, SD 0.18, range 0.18-1.01), respectively. It was concluded that the mean (+/-SD) total fluoride from diet and dentifrice in 3- to 5-year-old Japanese children was 0.35 +/- 0.19 mg/day (0.021 +/- 0.012 mg/kg body weight).