Oral health status of hospitalized amyotrophic lateral sclerosis patients: a single-centre observational study

Objective: To assess the intraoral conditions and oral function of patients with amyotrophic lateral sclerosis (ALS).

Material and methods: This single-centre, cross-sectional observational study included 50 ALS patients, who were treated with tracheostomy positive-pressure ventilation (TPPV) while hospitalized. The disease duration, TPPV duration, current number of teeth, number of occlusal units, number of decayed/missing/filled teeth, community periodontal index, bleeding on probing, dental calculus, maximum mouth opening, salivation rate, tongue anomalies (atrophy or hypertrophy) and tongue coating were determined for each patient. Differences in intraoral conditions according to disease duration or TPPV duration were statistically analysed.

Results: The maximum mouth opening was low in the included patients, with a mean distance of 13.7?±?7.4?mm. Furthermore, the maximum mouth opening showed a significant negative correlation with both disease duration and TPPV duration. No statistically significant differences were found between any other intraoral parameters and disease duration or TPPV duration.

Conclusions: Severe dental disease is uncommon among hospitalized ALS patients who receive oral care by nurses; however, mouth opening is very restricted in these patients. Early intervention for restricted mouth opening, directed by a dentist or dental hygienist, is essential in this population.     

The laterality of stop and go processes of the motor response in left-handed and right-handed individuals

The objective of the present study was to investigate whether the stop and go processes of the motor response are asymmetrical and whether the asymmetries are dependent on handedness and the response selection process that is engaged. Both right-handed and left-handed participants abducted either the left or right index finger in response to an imperative cue in the choice reaction time (choice RT) or the simple RT task. A stop cue was presented after the imperative cue with a probability of .25. When the stop cue was presented, the participants withheld the prepared response. On the choice RT task, left-handed participants had significantly shorter RT and stop signal reaction time (SSRT) with the left versus the right hand, whereas right-handers showed no difference between hands on either measure. In the simple RT task, the RT and SSRT were not significantly different between the groups or the response sides. These results indicate that both the stop and go processes of the prepared left-hand response are completed earlier than those of the right-hand response in left-handed individuals when the stimulus-response process involves a response selection process.     

Correction to: The characteristics of gastrointestinal symptoms in patients with severe COVID-19: a systematic review and meta-analysis

Journal of Gastroenterology - A correction to this paper has been published: https://doi.org/10.1007/s00535-021-01786-z     

A case of adult-onset Still’s disease complicated by thrombotic thrombocytopenic purpura with retinal microangiopathy and rapidly fatal cerebral edema

We present a patient who had adult-onset Still’s disease (AOSD) complicated by thrombotic thrombocytopenic purpura (TTP) that resulted in retinal microangiopathy and rapidly fatal cerebral edema. The patient was a 37-year-old male who developed fever, eruption, arthritis and hepatic dysfunction, that, based on close examination, was diagnosed as AOSD. Despite treatment with corticosteroids, the patient developed acute visual field defect, neurological deterioration including convulsions and impaired consciousness, as well as acute renal failure that ultimately resulted in death. Pathological examination of autopsy specimens revealed multiple fibrin thrombi disseminated in small vessels of the brain and kidney, which was consistent with TTP, along with marked cerebral edema. Although TTP has rarely been reported in association with AOSD, awareness of the possible coexistence of these two diseases is important for diagnosis and treatment.