Adequacy of and Satisfaction with Delivery and Use of Home-Delivered Meals

For home-delivered meals to have a beneficial impact on older persons, it is important that both delivery of services and use by older persons are adequate. From November 2004 to February 2005, we conducted a random-sample telephone survey of 1505 New York City home-delivered meals recipients, asking them about adequacy of and satisfaction with delivery of services and use of meal services. Fourteen percent of recipients relied solely on program food. Two-thirds prepared other foods themselves. Consumption of fruit, vegetables, and milk was low; 14–20% of recipients consumed each of these less than 1 time per day. Most recipients saw (and about half talked with) the meal deliverer most of the time. Most could contact the meal provider agency, but had not done so. A second stratified sample of 500 meal recipients was surveyed in June 2006 regarding satisfaction with food packaging and labels, food acquisition, meal delivery, and meal variety. About three-fourths of recipients reported satisfaction most of the time with the meals in terms of taste, variety, ease of preparation, healthfulness, and fit to religious or cultural needs. The most satisfied recipients were those who were receiving hot meals, food-secure, without hearing problems, frailer, in better emotional health, with informal social support, and more religious.     

Clinical evaluation of patients with temporomandibular joint implants

PURPOSE: An undetermined number of patients with temporomandibular joint (TMJ) symptoms have been treated with intra-articular disc implants composed of Teflon ethylene/propylene or Teflon polytetrafluoroethylene and aluminum oxide (Proplast-Teflon; Vitek, Houston, TX). These implants have shown the potential to fragment in situ resulting in nonbiodegradable particles that stimulate a giant cell reaction and lead to degeneration of local structures, pain, and limitation of mandibular opening. We examined the possible relationship between TMJ implants and persistent pain, responses to sensory stimuli, quality of life, and systemic immune dysfunction. PATIENTS AND METHODS: This case series (32 patients) were referred from university-based orofacial pain centers and private practices from across the United States. Laboratory and clinical assessments evaluated orofacial pain symptoms, neurologic function, clinical signs and symptoms of rheumatologic disease, physical function, systemic measures of immune function, and behavioral measures. RESULTS: We found that TMJ implant patients appeared to have altered sensitivity to sensory stimuli, a higher number of tender points with a diagnosis of fibromyalgia, increased self-report of chemical sensitivity, higher psychologic distress and significantly lower functional ability. Systemic illness or autoimmune disease was not evident in this series of TMJ implant patients. CONCLUSIONS: Significant problems were noted on clinical assessment of TMJ implant patients. This is a US government work. There are no restrictions on its use.     

Fungal load and candidiasis in Sjögren's syndrome

OBJECTIVE: We sought to investigate the prevalence of Candida carriage and the relationships between salivary flow rates and oral Candida load in patients with Sj?gren's syndrome (SS). METHODS: The oral Candida load of patients with SS was evaluated by culturing oral rinse (swish and spit) samples. Culture, Gram stain, and wet-mount test results were reported. RESULTS: One hundred three patients (96 women) met European criteria for SS (91 with primary SS and 12 with secondary SS). The mean age (95% confidence interval) was 55 years (range, 51-57 years). Oral rinse cultures were positive in 77% of subjects. The total stimulated salivary flow rate was inversely correlated with oral Candida load (r = -0.47; P 相似文献   

Hepatitis C virus infection and lichen planus: a short review

OBJECTIVE: To review the current literature regarding the association of lichen planus (LP) and liver disease, with particular attention to the association of the oral variant of the disease with hepatitis C virus (HCV) infection.
MATERIALS AND METHODS: Available literature of the possible association of LP with systemic disorders, in particular chronic hepatic disease, has been reviewed. RESULTS: LP is sometimes associated with infectious or autoimmune disease and/or neoplasia, however an aetio-logical association between LP and these disorders seems unlikely. A more consistent association exists between LP and chronic hepatic disease. The precise cause of this association is not known. However, in the last 6 years a notable association between HCV infection and LP has been observed, particularly in patients in Spain, Italy and Japan. The pathogenesis of this possible HCV-associated LP is not known, but it may involve a cell mediated response to an altered epithelial antigen.
CONCLUSION: There is now evidence to suggest a significant association between HCV infection and LP in some groups of patients.     

Angioedema and swellings of the orofacial region

OBJECTIVE: Patients may have various forms of angioedema and require dental treatment which can cause or contribute to the onset of an episode of angioedema. This paper seeks to highlight the causes and the management of this serious condition.
DESIGN: An outline of the different types of angioedema is given here, along with three case reports which illustrate treatment and management.
SUBJECTS AND METHODS: Three patients who presented to an Oral Medicine clinic with angioedema are presented to illustrate various types of angioedema and the different contributing factors that precipitated episodes of the condition.
MAIN OUTCOME MEASURES: The three patients were all investigated for biochemical and allergic factors which may have caused their disease.
RESULTS: Both drugs and dental materials were shown to be involved in the pathogenesis of angioedema in this short series of patients.
CONCLUSIONS: Dental treatment or the use of some materials may promote or contribute to the disorder. Referral to hospital for specialist care is indicated for certain groups of patients who require invasive dental treatment. The multi-disciplinary team approach in the investigation and management of patients with angioedema is emphasised.