Résumé
This study investigates the relationship between smoking and periodontal disease through quantitative analysis of intra-buccal oral pathogenic bacteria detected in smokers and aims to yield objective baseline data for applications in anti-smoking and dental health education programs. From April to May 2016, participants in an oral health management program within an intensive dental hygiene training course at Choonhae College of Health Sciences received an explanation of the study purposes and methods, after which male smokers aged 18~30 years agreed to participate voluntarily. Real-time polymerase chain reaction (PCR) analysis of oral pathogenic bacteria was performed after collecting gingival sulcus fluid samples from 67 smokers. The intra-buccal oral pathogenic bacteria distributions were analyzed based on the subjects' general characteristics, smoking behaviors, and oral care behaviors. The distribution results show that pathogens in the anterior teeth are affected (in this order) by age, toothbrush size, and smoking status; older people had fewer pathogens, those who used larger toothbrushes had more pathogens, and smokers had more pathogens, compared to non-smokers ((adj)R²=19.1). In the posterior teeth, pathogens were influenced (in this order) by smoking status, smoking duration, and the number of tooth brushings per day; smokers had more pathogens than non-smokers, and those who brushed their teeth more often had fewer pathogens ((adj)R²=25.1). The overall pathogen distribution was affected only by smoking status: smokers generally had more pathogens, compared to non-smokers. Therefore, it is necessary to provide information about the risk of periodontal disease due to smoking during anti-smoking or dental health education sessions; particularly, the use of smaller toothbrushes for anterior teeth and the need for smokers in their early twenties to quit smoking for dental health should be highly emphasized.
Sujets)
Humains , Mâle , Bactéries , Éducation en santé dentaire , Santé buccodentaire , Hygiène buccodentaire , Maladies parodontales , Réaction de polymérisation en chaine en temps réel , Fumée , Fumer , DentRésumé
OBJECTIVE: The purpose of this study was to compare the discontinuation rate of widely prescribed atypical antipsychotics when administered to newly admitted, acutely ill patients with schizophrenia or bipolar mania. METHODS: Medical records of patients admitted to psychiatric ward of two university hospitals between January 2007 and December 2008 were retrospectively reviewed. Subjects were eligible for inclusion if they prescribed olanzapine, risperidone or aripiprazole for their psychotic or manic symptom control. Patient groups (olanzapine/risperidone/aripiprazole) were compared for rate of antipsychotics discontinuation and duration of treatment continuation. RESULTS: There was no statistically significant difference in the rates of discontinuation during hospitalized period between olanzapine, risperidone and aripiprazole. Rates of discontinuation were 14.5% for olanzapine, 18.6% for aripiprazole and 24.0% for risperidone. Predictor of treatment discontinuation was short titration period and long illness duration. CONCLUSION: This study demonstrated that risperidone, olanzapine and aripiprazole were comparable with no difference found on the discontinuation rate in treating acutely ill psychiatric patients. However, the small number of patients who participated in this study made it difficult to establish significance.
Sujets)
Humains , Neuroleptiques , Benzodiazépines , Trouble bipolaire , Hôpitaux universitaires , Dossiers médicaux , Pipérazines , Quinolinone , Études rétrospectives , Rispéridone , Schizophrénie , AripiprazoleRésumé
OBJECTIVE: Drug compliance is closely related to progress and prognosis of psychiatric disease. We investigated drug compliance in psychiatric outpatients and factors that influence their compliance. METHODS: Patients who visited a university hospital were asked about drug information and drug compliance using questionnaires. Medical records of the patients were reviewed. Demographic variables, clinical characteristics and drug compliance related variables were compared between non-compliance group and compliance group. Logistic regression analysis was performed to clarify predictors of poor compliance. RESULTS: One hundred eighty one patients participate in this study. 150 patients (82.9%) were compliance group, 31 patients (17.1%) were included in non-compliance group. Patient-related, illness-related and treatment-related factors, DAI total score and knowledge of side effect did not show any difference in both groups. However, illness severity was relatively higher in non-compliance group (p = 0.070) and patient's satisfaction about explanation of side effect was lower in noncompliance group (p = 0.061). Moreover, patients who negatively answered for question about negative recognition to psychiatric medication in DAI questionnaire were more common in non-compliance group (p = 0.075). In logistic regression, answering negatively to question about negative recognition to psychiatric medication in DAI questionnaire was related to non-compliance, but did not reached statistical significance (p = 0.086). CONCLUSION: This study suggests that improving negative recognition about psychiatric medication through drug education and good doctor patient relationship could enhance drug compliance.
Sujets)
Humains , Compliance , Modèles logistiques , Dossiers médicaux , Patients en consultation externe , Pronostic , Enquêtes et questionnairesRésumé
OBJECTS: Depressive symptoms are common in the elderly medical inpatients. But depressive disorders are considerably underdiagnosed and undertreated. Especially in major depressive disorder, patients show cognitive impairments and do not respond adequately to medical treatment. The goals of this study were to examine what are the patterns of depressive symptoms of major depressive disorders which differentiate from minor depressive disorders in the elderly medical inpatients. METHODS: A 4-month prospective study of 312 patients (65 years and older) was conducted in a general hospital. Depression was screened with Hamilton Depression Rating Scale and cognitive function was screened with Mini-Mental State Examination-K. The subjects were diagnosed according to DSM-IV for depression. And according to DSM-IV diagnosis, HDRS and MMSE-K subscales were analysed. RESULTS: In the 228 patients who were investigated, 16 (7%) patients were major depressive disorder, 53 (23%) were minor depressive disorder. Females were more depressed than males but there was no statistical significance. While the patients of major depressive disorder complained of depression and anxiety, the control subjects complained of loss of body weight, somatic symptoms and somatic anxiety, and the minor depressive disorders shows mixed symptoms of the two. The complaining frequency of the somatic symptoms and somatic anxiety were similar among the three groups. Significant differences were found among the three groups in terms of HDRS total scores. Among the three groups in terms of HDRS subscale scores all subscale scores except for the genital symptoms and body weight were significantly high in depressive disorders. Initial insomnia (p<0.01), middle insomnia (p<0.05), GI symptoms (p<0.01) and somatic symptomgeneral (p<0.05) were significantly different between the control subjects and the depressive disorder group. The subscales of terminal insomnia, agitation and loss of insight were significantly different between the minor depressives and major depressives (p<0.01), but no difference between the control subjects and the minor depressives. MMSE total scores were significantly correlated in major depressive disorders among the 3 groups. Comparing subscales of the three groups, significant correlation were found in time orientation, attention and calculation (p<0.05) and language (p<0.01). CONCLUSION: Major depressive disorder patients in elderly medical inpatients chiefly complained of depression and anxiety, but they also complained somatic symptoms. If elderly medical inpatients complain of agitation, terminal insomnia, cognitive impairment associated with depressive symptoms, consultants will pay attention for the major depressive disorders. This study suggests that further systematic study is necessary for the recognition of major depressive disorder in the elderly medical inpatients.
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Anxiété , Poids , Consultants , Dépression , Trouble dépressif , Trouble dépressif majeur , Diagnostic , Diagnostic and stastistical manual of mental disorders (USA) , Dihydroergotamine , Hôpitaux généraux , Patients hospitalisés , Études prospectives , Troubles de l'endormissement et du maintien du sommeilRésumé
OBJECTS:The authors attempted to estimate the prevalence of cognitive impairments (dementia and delirium) among elderly patients, the main causes of delirium, and the extent of physicians' recognition of cognitive impairment in a general hospital medical ward. METHODS: A 4-month prospective study of 312 patients(65 years and older) was conducted with cognitive function screened with Mini-Mental State Examination-K and the Confusion Assessment Method. The subjects were diagnosed according to DSM-IV criteria for dementia and delirium. The physicians' assessment of cognitive capacity was done through the chart review for recording cognitive deficits. RESULTS: In thirty-three(13.87%) of the 238 patients, cognitive impairment was present. It was further diagnosis as dementia in 19(13.9%) patients or delirium in 14(8.0%) patients. The mean length of hospital stay in all age groups was 13.1 +/- 10.6 days with no differences among the 3 groups(dementia, delirium, and control) The main causes for delirium were infection, metabolic disorder, cerebrovascular accident and alcohol withdrawl. The recovery of delirium was observed of 10 of 14 patients before discharge. Regarding the physicians' recognition of cognitive impairment, delirious symptoms were recorded in 9 of 14 patients and dementic symptoms were recorded in only one patient. CONCLUSION: This study suggests that further systematic assessment is necessary to improve physicians recognition of cognitive impairments in the elderly medical inpatients.
Sujets)
Sujet âgé , Humains , Délire avec confusion , Démence , Diagnostic , Diagnostic and stastistical manual of mental disorders (USA) , Hôpitaux généraux , Patients hospitalisés , Durée du séjour , Prévalence , Études prospectives , Accident vasculaire cérébralRésumé
The reliability and validity of the Cognitive Impairment Diagnosing Instrument (CIDI) were studied in 67 nursing home elderly subjects and 251 elderly psychiatric patients. Its possible highest score is 77 and covers 10 subscales: short-term memory, long-term memory, concentration/calculation, abstract thinking, judgement, memory registration, higher cortical functions, orientation in time, orientation in place and object naming. Test-retest correlations were between 0.827 and 0.990 for the subscale scores and 0.984 for the total score. Inter-tester kappas for each item ranged from 0.200 to 1.000 with a mean of 0.698. Concordance rates were between 50.0 and 100.0% with a mean of 87.2%. Cronbach's alphas for the items of the individual subscales ranged from 0.702 to 0.915. Inter-subscale and subscale-total correlations ranged from 0.503 to 0.820 with a mean of 0.684 and from 0.721 to 0.883, respectively. Cronbach's alpha of the subscales was 0.934. Sensitivity and specificity were 93.3% and 93.8% at the cut-off point of 57.0/57.5 for dementia. Subscale and total scores were significantly different between the demented and non-demented. The total CIDI score was significantly correlated with scores of the Blessed Dementia Rating Scale and the Korean version of the Mini-Mental State Examination.