Of the article: evaluation of the masticatory efficiency of children with stainless steel crowns: a pilot cross-sectional split-mouth study.

BACKGROUND: Stainless steel crowns (SSCs) are commonly employed to restore the posterior teeth of children and over the years, they are available with improved anatomical shapes. This study was conducted to evaluate and assess the effect of the placement of SSCs on the masticatory efficiency of children. METHODS: This pilot cross-sectional split-mouth study assessed masticatory efficiency in children aged 6-11 years. Fifteen participants, each with stainless-steel crowns placed unilaterally at least one month prior, were included. This study utilized two flavours of trident chewing gum (red and green) to measure masticatory efficiency. The child was asked to chew half a strip of red and green chewing gum placed one on top of the other using either the noncrown or crown side 15 times. Another set of chewing gum was given to the child to chew 20 times on the same side. The chewing exercise was repeated using teeth on the other side. Chewed gum samples were collected, photographed, and analysed via ImageJ software to determine the red and green areas. Masticatory efficiency was subsequently calculated with the help of a formula in which the red areas and green areas were calculated via ImageJ software. The data were analysed with paired t tests via SPSS (version 20.0). RESULTS: When the mean values of the crown side were compared with those of the noncrown side following 15 chewing cycles, the chewing efficiency on the noncrown side was greater, with a difference of 0.303, whereas the chewing efficiency following 20 chewing cycles was greater on the crown side, with a difference of 0.814. However, both differences were statistically nonsignificant, with t values of -0.07 and 0.26, respectively, and p values of 0.94 and 0.8, respectively. CONCLUSION: The presence of SSCs on the molars of children did not affect masticatory efficiency.

Comparison of the effect of chewing gum with routine method on ileus after burns: a randomized clinical trial.

BACKGROUND: Chewing gum is a healthy, cheap, and familiar solution for patients with premature irritation of the stomach and intestines. This study compared the effect of chewing gum and the routine method on ileus after burns. METHODS: This study is a randomized clinical trial conducted in Valiasr Hospital in Arak, Markazi Province, in the center of Iran, from December 2021 to February 2023. After the diagnosis of intestinal ileus in 83 patients hospitalized in the burn department by a general surgeon, with the available sampling method, these patients were evaluated based on the inclusion and exclusion criteria of the study. As a result, 66 patients were selected and divided into groups A (33 patients in the intervention group: routine care + gum chewing) and B (33 patients in the control group: routine care) by random allocation method. For the intervention group, from entering the ward until the beginning of oral feeding, gum (without sugar) was chewed four times a day for 15 min, while control groups received the routine diet of the department. Both groups' condition of the bowel sounds, time of passing gas, and stool were recorded. The statistical analyses were performed using SPSS version 16. The chi-squared, Fisher's exact, Independent t-test, and Mann-Whitney U tests were utilized. RESULTS: The results showed that the median bowel sound return time, time of the first gas discharge, earliest defecation time, and time to start the diet were significantly shorter in the intervention group than in the control group (P < 0.001). CONCLUSION: This study showed the effect of chewing gum without sugar in shortening the symptoms of intestinal ileus after burns. However, it was not effective in reducing the hospitalization period of patients. According to these results, it is recommended to add chewing gum to the routine care of people hospitalized due to burns. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20180715040478N1, 2021-07-27.

Effects of Caffeinated Chewing Gum on Ice Hockey Performance after Jet Lag Intervention: Double-Blind Crossover Trial.

The purpose of this study was to examine the impact of caffeinated chewing gum on the physical performance of elite ice hockey players after a jet lag intervention. Fourteen national-level (age: 25.2 ± 5.4; height: 176.5 ± 5.3; weight: 78.1 ± 13.4) ice hockey players were tested late at night after a full day awake schedule with jet lag. A randomised, double-blind experimental design was employed in which participants either chewed caffeinated gum (CAF) containing 3 mg/kg caffeine or a caffeine-free placebo gum (PLA) for 10 min prior to undertaking a series of on-ice and off-ice tests. The off-ice tests included grip force, the counter-movement jump (CMJ), and the squat jump (SJ). The on-ice tests included a 35 m sprint, the S-Shape agility test, and the Yo-Yo intermittent recovery test (Yo-Yo IR1 test). The CMJ height (CAF: 47.2 ± 4.4; PL: 45.9 ± 3.5; p = 0.035; Cohen's d = 0.32) and SJ height (CAF: 46.7 ± 4.1; PL: 44.9 ± 3.8; p = 0.047; Cohen's d = 0.44) were found to be significantly higher in the CAF than in the PL trial. However, there were no significant differences (p > 0.05) in grip force, as well as in the 35 m sprint, the S-Shape agility test, and the Yo-Yo IR1 test. The present study found that, following a jet lag intervention, although the consumption of caffeinated gum resulted in an increase in vertical jump height, it had no impact on performance in the ice tests. The results of this study may help coaches and athletes consider the need for caffeine supplementation when experiencing jet lag.

Comparative efficacy of pharmaceutical (Ibuprofen) and non-pharmaceutical (photobiomodulation, and chewing gum) interventions for pain reduction after elastomeric separator placement in orthodontic patients: a randomized clinical trial.

This study compared the efficacy of pharmaceutical (ibuprofen) and non-pharmaceutical (photobiomodulation and chewing gum) interventions for pain reduction after elastomeric separator placement in orthodontic patients. This 3-arm, parallel-group randomized clinical trial was conducted on 90 orthodontic patients. The level of anxiety and pain threshold of patients were measured at baseline using the Pain Catastrophizing Scale (PCS) and an algometer, respectively. The patients were randomly assigned to three groups (n = 30; equal number of males and females). In the laser group, 940 nm diode laser (Epic X, Biolase, USA, 12.35 J/cm2 energy density and 300 mW power in continuous-wave mode., The cross-sectional area of the laser handpiece tip was 1.7 cm2.) was irradiated to the buccal and lingual surfaces for 35 s each, prior to placement of separators. In the gum group, the patients were asked to chew a piece of sugar-free gum immediately after the placement of separators and repeat every 8 h for 5 min for one week in case of pain. In the ibuprofen group, patients received 400 mg ibuprofen (Hakim Pharmaceuticals, Tehran, Iran) after the placement of separators and were asked to take one tablet every 8 h for one week in case of pain. The pain score was recorded using the Modified McGill Pain Questionnaire (MPQ). The normality of data distribution was analyzed by the Kolmogorov-Smirnov test. ANOVA was applied to compare age, and the Chi-square and Monte Carlo Chi-square tests were used to compare gender and patient responses to the questions among the groups. Repeated measures ANOVA was used to compare the pain score at different time points and among the three groups. All statistical analyses were conducted using SPSS version 19 (SPSS Inc., Chicago, IL, USA) at 0.05 level of significance. Data analysis in this study had an intention to treat approach. Although the pain score was slightly lower in ibuprofen and gum groups, the difference among the three groups was not statistically significant (P > 0.05). 'Repeated measures ANOVA showed no significant effect of method of pain reduction on pain score (F = 1.520, P = 0.225). Time had a significant effect on pain score (F = 20.310, P < 0.001). The interaction effect of time and pain reduction method on pain score was not significant (F = 0.737, P = 0.651). patients experienced a lower level of pain in the ibuprofen and chewing gum groups, the difference in pain score was not significant among the three groups (P = 0.225). patients experienced a higher level of pain at 12 and 24 hours after the placement of separators in all groups. Considering the comparably equal analgesic efficacy of this modalities, non-pharmaceutical interventions can be used for pain reduction of elastomeric separator. The study protocol was registered in the Iranian Registry of Clinical Trials (IRCT20210927052611N1). Date of registration 2022/03/14.

Examining the effects of caffeine during an auditory attention task.

Participants completed two sessions of an auditory attention task and intermittently responded to thought probes asking about their level of mind-wandering. After the first session one group received 200 mg of caffeinated chewing gum (n = 61) and another group received regular (placebo) chewing gum (n = 66). The gum was chewed for 20-minutes and then disposed of before beginning the second session. Participants who received caffeine showed a performance benefit as well as reported being more on task and fewer instances of spontaneous mind-wandering compared to those in the placebo group. Participants who received caffeine also reported greater positive affect and arousal, as well as less feelings of boredom, sleepiness, and mental effort required to stay on task compared to those who received placebo. These results suggest that caffeine may benefit attentional engagement as well as performance during a sustained attention task.

Assessment of masticatory performance in pediatric patients receiving preformed crowns by Hall technique: a controlled clinical trial.

PURPOSE: The purpose of the study was to assess and compare the masticatory performance in children receiving preformed metal crown by Hall technique and conventional technique. METHODS: Children having teeth indicated for restorative/endodontic therapy and belonging to the age group of six to ten years were invited to participate in the study. Eighteen children received preformed metal crowns (PMCs) by Hall technique. Meanwhile, nineteen children received preformed metal crowns by the conventional technique. Their masticatory performance (MP) was assessed at T0 (pre-intervention), T1 (day 1 post-intervention), T2 (1 week), T3 (2 weeks), T4 (1 month) and T5 (3 months) using Hue-check Gum® (University of Bern, Switzerland). The chewing gum samples were scanned within 24 h of their collection and processed in the ViewGum Software©. The software calculated the hue value (VOH) which indicated the masticatory performance of the individual. A questionnaire was given to the parents at T4 and T5 to assess any discomfort or pain associated with PMCs placed in both groups. RESULTS: The evaluation of masticatory performance using the two-color chewing method revealed reduction in MP on day 1 post-intervention (p < 0.001) for both groups. However, the MP values recorded at T5 were comparable to the baseline values at T0 (p = 0.009). No significant discomfort or pain was reported in both groups. CONCLUSION: The findings of the current clinical study indicate that placement of PMCs by both conventional and Hall technique in children deteriorates their MP which equilibrates within 1 month. CLINICAL TRIAL REGISTRY OF INDIA NUMBER: CTRI/2021/02/031532 [Registered on: 25/02/2021]-Trial Registered Prospectively.

Unleashing the Potential of ß -cyclodextrin Inclusion Complexes in Bitter Taste Abatement: Development, Optimization and Evaluation of Taste Masked Anti-emetic Chewing Gum of Promethazine Hydrochloride.

Motion sickness also known as kinetosis is a condition in which there exists a disagreement between visually perceived movement and the vestibular system's sense of movement. Nausea, vomiting, dizziness, fatigue, and headache are the most common symptoms of motion sickness. This study mainly focuses on the taste masking of Promethazine Hydrochloride (PMZ) by inclusion complexation method, its formulation development in the chewing gum form by using directly compressible gum base HIG® and its quality and performance testing. Different molar ratios (1:1, 1:2, 1:3 and 1:4) of PMZ-cyclodextrin complexes were prepared by using ß-Cyclodextrin (ß-CD) as a taste masking agent. These complexes were evaluated for FTIR, DSC, % Entrapment Efficiency, % drug yield, and taste evaluation by E-Tongue. The optimized ratio was further evaluated by sophisticated analytical techniques such as Scanning Electron Microscopy (SEM) and X-Ray Diffraction (XRD). A central composite design (CCD) (3 ^2) was utilized to examine the effects of independent variables (amount of gum-X1 and amount of plasticizer-X2) on dependent variables (%CDRY1 and hardness Y2). The prepared gums were evaluated for drug content, organoleptic properties, in-vitro dissolution testing by fabricated disintegration apparatus, texture analysis, etc. The optimization statistics showed that on decreasing the amount of gum, in- vitro drug release increases and hardness decreases. The optimized batch MCG-2 of Promethazine MCG showed 92.34 ± 0.92% of drug release, whereas for marketed formulation (Phenergan®-25 mg) drug release value was 86.19 ± 1.88%. Results provided evidence that PMZ MCGs could be a better alternative to conventional tablet formulations with improved drug release, palatability and texture.

Impact of Preoperative Gum Chewing on Postoperative Anti-Emetic Use in Robot-Assisted Laparoscopic Surgery for Benign Ovarian Masses: A Prospective, Single-Blinded Randomized Controlled Trial.

Background and Objectives: Postoperative nausea and vomiting (PONV) is a common issue for females undergoing gynecological surgeries, including those assisted by robotic systems. Despite available prophylactic measures, the incidence of PONV remains high, negatively impacting recovery and increasing healthcare costs. This study evaluates whether preoperative gum chewing reduces the need for anti-emetic drugs in females undergoing robot-assisted laparoscopic surgery for benign ovarian mass. Materials and Methods: This prospective, single-blinded, randomized controlled trial enrolled 92 adult females scheduled for robot-assisted laparoscopic surgery to treat benign ovarian mass. Following exclusions, the remaining participants were randomly assigned to either a gum-chewing group or a no-gum-chewing group. The gum-chewing group chewed sugar-free gum for 15 min in the holding area before surgery. The primary outcome measured was the need for anti-emetics to control PONV during the first hour in the post-anesthesia care unit (PACU). Secondary outcomes included the number of anti-emetic requests. No preemptive anti-emetics were administered during surgery. Results: Out of the initial 92 patients, 88 were included in the final analysis, with 44 in each group. The incidence of PONV requiring anti-emetics in the PACU was significantly lower in the gum-chewing group (79.5%) compared to the no-gum-chewing group (95.5%). Additionally, the number of anti-emetic requests was higher in the no-gum-chewing group. No postoperative complications such as tooth or jaw pain/injury or gastric content regurgitation were reported. Conclusions: Preoperative gum chewing for 15 min immediately before surgery significantly reduced the incidence of PONV in females undergoing robot-assisted laparoscopic surgery for benign ovarian mass. This simple, non-pharmacological intervention improved patient comfort and reduced the need for anti-emetic medications without any adverse effects. Further studies are needed to confirm these findings and to develop guidelines for incorporating preoperative gum chewing into clinical practice.

Topical prebiotic nitrate: optimizing the 'hang-time', source and dose for specific oral or systemic effects.

In our opinion, the 'hang-time' of nitrate-containing products discussed in the letter by Green and Green is an interesting variable that should be considered when nitrate-based treatment or prevention strategies are designed. However, due to direct nitrate recycling after nitrate intake, products with a long 'hang-time' (e.g., chewing gum) may not always have an advantage compared to products with a short 'hang-time' (e.g., vegetable juices). We argue that extending the 'hang-time' is especially relevant and potentially beneficial for different applications, such as using a low nitrate dose to stimulate the oral effects, reaching oral tissues that may otherwise not be exposed to dietary nitrate (e.g., periodontal pockets), and providing a longer nitrate exposure in individuals with an impaired salivary flow. Apart from the 'hang-time', other important variables are the nitrate dose and source (e.g., different salts and vegetable extracts), as well as the desired effect (e.g., an oral effect versus systemic effects). Finally, we believe that the alterations in salivary microbiota observed before and after chewing three nitrate-rich gums over a period of ~5 h, as reported by Green and Green, could be considered beneficial. However, the oral microbiota composition is affected by the circadian rhythm and the effect of gum mastication should be evaluated. These results should thus be confirmed by a placebo-controlled study, where these confounding factors can be accounted for.

Caffeine Gum Improves Reaction Time but Reduces Composure Versus Placebo During the Extra-Time Period of Simulated Soccer Match-Play in Male Semiprofessional Players.

This study aimed to determine whether caffeine gum influenced perceptual-cognitive and physical performance during the extra-time period of simulated soccer match-play. Semiprofessional male soccer players (n = 12, age: 22 ± 3 years, stature: 1.78 ± 0.06 m, mass: 75 ± 9 kg) performed 120-min soccer-specific exercise on two occasions. In a triple-blind, randomized, crossover design, players chewed caffeinated (200 mg; caffeine) or control (0 mg; placebo) gum for 5 min following 90 min of soccer-specific exercise. Perceptual-cognitive skills (i.e., passing accuracy, reaction time, composure, and adaptability) were assessed using a soccer-specific virtual reality simulator, collected pre- and posttrial. Neuromuscular performance (reactive-strength index, vertical jump height, absolute and relative peak power output, and negative vertical displacement) and sprint performance (15 and 30 m) were measured at pretrial, half-time, 90 min, and posttrial. Caffeine gum attenuated declines in reaction time (pre: 90.8 ± 0.8 AU to post: 90.7 ± 0.8 AU) by a further 4.2% than placebo (pre: 92.1 ± 0.8 AU to post: 88.2 ± 0.8 AU; p < .01). Caffeine gum reduced composure by 4.7% (pre: 69.1 ± 0.8 AU to post: 65.9 ± 0.8 AU) versus placebo (pre: 68.8 ± 0.8 AU to post: 68.3 ± 0.8 AU; p < .01). Caffeine gum did not influence any other variables (p > .05). Where caffeine gum is consumed by players prior to extra-time, reaction time increases but composure may be compromised, and neuromuscular and sprint performance remain unchanged. Future work should assess caffeine gum mixes with substances like L-theanine that promote a relaxed state under stressful conditions.

Influence of two paraffin wax chewing gums with different con-sistencies on the stimulated salivary flow rate.

This study investigated and compared the consistency and compressive strength of two commercially available paraffin wax chewing gums (Aurosan (AU) and GC Europe (GC)), as well as their impact on stimulated salivary flow rate. Instrumental texture analysis was uti-lized to assess the consistency and compressive strength of AU and GC during a 7-min chewing period. Subsequently, stimulated salivary flow rate (sSFR) was evaluated in healthy subjects using AU and GC over a 7-minute period. The compressive strengths from the pre-liminary test were compared over time with the sialometry data. Eighty-one test subjects, comprising 33 men and 48 women, participated. Over the 7-min measurement period, dif-ferences were observed in the total amount of saliva accumulated per minute. Direct com-parison of AU and GC revealed that regardless of age and gender, the amount of saliva formed after 1 min was 0.63 times less with AU than with GC (95% CI: 0.56 - 0.70; P < 0.001). The accumulated saliva volume with AU was also significantly lower than that with GC in the first 4 min (P = 0.016). However, from minute 5 onwards, the two products no longer showed statistical differences in the total amount of saliva. Comparison of the com-pressive strength of AU and GC showed that the values after 1 and 2 min were significantly higher for AU than for GC (P < 0.05); for all other time points, the compressive strength was higher for GC. In the mixed-effects model after log-transformation of compressive strength and saliva volume, GC exhibited decreasing saliva volumes with increasing compressive strength (P <0.001). Conversely, the opposite was observed for AU (P = 0.019). The study suggests that the consistency or compressive strength of paraffin wax chewing gums from different manufacturers could impact sSFR.

An outline of the management and prevention of postoperative ileus: A review.

Postoperative ileus (POI) is a prevalent surgical complication, which results in prolonged hospitalization, patient distress, and substantial economic burden. The literature aims to present a brief outline of interventions for preventing and treating POI post-surgery. Data from 2014 to 2023 were gathered from reputable sources like PubMed, PubMed Central, Google Scholar, Research Gate, and Science Direct. Inclusion criteria focused on studies exploring innovative treatments and prevention strategies for POI, using keywords such as novel POI treatments, non-pharmacological prevention, POI incidence rates, POI management, and risk factors. The findings revealed that integration of preventive measures such as coffee consumption, chewing gum, probiotics, and use of dikenchuto within enhanced recovery programs has significantly reduced both the frequency and duration of POI, without any adverse effects, with minimally invasive surgical approaches showing promise as an additional preventive strategy. While treatment options such as alvimopan, NSAIDs, and acupuncture have demonstrated efficacy, the use of lidocaine has raised concerns due to associated adverse effects. The ongoing exploration of novel therapeutic strategies such as targeting the mast cells, vagal nerve stimulation and tight junction protein, and prokinetic-mediated instigation of the cholinergic anti-inflammatory trail not only holds promise for enhanced treatment but also deepens the understanding of intricate cellular and molecular pathways underlying POI. POI presents a complex challenge in various surgical specialties, necessitating a multifaceted management approach. The integration of preventive and treatment measures within enhanced recovery programs has significantly reduced POI frequency and duration.

Very old age impacts masticatory performance: a study among sexagenarians to centenarians.

OBJECTIVE: This cross-sectional pilot study evaluated the impact of age on masticatory performance among individuals aged 65 to 106 years, as part of the Heidelberg Dental Centenarian Study (HD-100Z) conducted in South-Western Germany. MATERIALS AND METHODS: A total of 31 centenarians were recruited, alongside 31 individuals each from the age groups 75-99 and 65-74, matched based on sex, prosthetic status, and number of teeth. Masticatory performance was assessed using a two-colored chewing gum test and digital image processing. Multiple linear regression analysis was performed to assess the effect of age, sex, number of teeth, type of prosthesis on the masticatory performance. RESULTS: Masticatory performance, as measured by the standard deviation of hue in the chewing gum test, decreased significantly in centenarians compared to individuals aged 75-99 years (-0.112, p = 0.037) and those aged 65-74 years (-0.274, p < 0.001). The effects of sex, number of teeth, and type of prosthesis on masticatory performance were not significant associations (p ≥ 0.135). CONCLUSION: The findings suggest that age may have a significant influence on masticatory performance in the studied age groups, challenging previous notions that aging itself has little impact on masticatory ability. The inclusion of centenarians in the study highlights the need for further investigation into masticatory function in age groups reaching up to 100 years or more. CLINICAL RELEVANCE: This study contributes to the understanding of how ageing affects oral function, which may guide dental treatment approaches for older individuals, and set the stage for more in-depth investigations in this field in the future.

Do chewing gums and sweets containing xylitol prevent caries in children?

DATA SOURCES: Three electronic databases (Pubmed, Embase and the Cochrane Library) were searched in December 2022, and again for additional literature on 3-5th January 2023. Reference lists of relevant systematic reviews were hand searched for other eligible studies for inclusion. STUDY SELECTION: Randomised controlled clinical trials and controlled clinical trials conducted on children (aged ≤ 18 years), conducted between 1974-2022 and available in English, were eligible for inclusion. Studies were excluded if caries was not an outcome, the control group was not sufficient, they were lab-based studies or studies where xylitol delivery was not a sweet or chewing gum and where the xylitol product contained a component such as fluoride which may influence the outcomes. DATA EXTRACTION AND SYNTHESIS: Four calibrated reviewers independently screened titles and abstracts, and disagreements were resolved via group discussion. Preventative effect was determined by comparing the mean caries increment in the control and intervention groups, producing a preventative fraction. A total of 617 titles were initially screened for relevance. After duplicate removal, 268 abstracts were screened and 16 full text articles reviewed, with one more study then excluded. 10 studies investigated xylitol-containing chewing gum, and six looked at xylitol candy (one did both). Eight included studies were randomised controlled trials. Data extraction was undertaken by two reviewers. RESULTS: 3466 participants were included in the 10 studies that investigated xylitol chewing gum, and all 10 studies reported a statistically significant preventive effect compared to a no chewing gum or placebo control. In 9 studies, the preventive fraction was clinically significant. The six studies investigating xylitol candies contained a total of 1023 participants, and only one study demonstrated a significant preventative effect. CONCLUSIONS: There is some evidence that incorporating xylitol chewing gum daily has a caries-reducing effect in those with a moderate-to-high baseline caries level. This effect was not present for xylitol sweets.

Caffeinated Chewing Gum Improves Basketball Shooting Accuracy and Physical Performance Indicators of Trained Basketball Players: A Double-Blind Crossover Trial.

(1) Background: This study investigated the effects of caffeinated chewing gum on the basketball-specific performance of trained basketball players. A double-blind, randomized crossover design was employed. (2) Methods: Fifteen participants (age: 20.9 ± 1.0 years; height: 180.9 ± 5.4 cm; mass: 77.2 ± 7.5 kg; training age: 8.2 ± 0.3 years) were recruited and divided into a caffeine trial (CAF) and placebo trial (PL). The participants in the CAF trial chewed gum containing 3 mg/kg of caffeine for 10 min, while those in the PL trial chewed a placebo gum without caffeine. Following a 15 min rest, all the participants completed basketball-specific performance tests. (3) Results: The free throw accuracy for the CAF trial was significantly higher than that for the PL trial (CAF: 79.0 ± 4.31%; PL: 73.0 ± 9.16%; p = 0.012; Cohen's d = 0.94). Additionally, the CAF trial demonstrated significantly better performance in the 20 m segmented dash (CAF: 2.94 ± 1.12 s; PL: 3.13 ± 0.10 s; p < 0.001; Cohen's d =1.8) and squats (p < 0.05), and exhibited lower fatigue indexes (CAF: 3.6 ± 1.6%; PL: 5.2 ± 1.6%; p = 0.009; Cohen's d =1.0). (4) Conclusions: These findings suggest that chewing gum containing 3 mg/kg of caffeine offers moderate-to-large improvements in key performance aspects relevant to professionally trained basketball players.

Non-pharmacological interventions to reduce thirst in patients with heart failure or hemodialysis: A systematic review and meta-analysis.

BACKGROUND: Thirst is a frequent and burdening symptom in many patients, especially in patients with chronic heart failure (CHF) and/or receiving hemodialysis (HD). As drug therapies are not feasible, non-pharmacological strategies are needed to reduce thirst and thirst-related burden. OBJECTIVES: To identify non-pharmacological interventions aiming to reduce thirst in patients with CHF and/ or HD, to describe intervention components, and to evaluate the effectiveness of these interventions. METHODS: In February 2024, we completed a systematic search in MEDLINE via PubMed, Livivo, CINAHL, Cochrane Library and Web of Science. Two reviewers independently screened titles, abstracts, and full texts, performed critical appraisal and data extraction. We checked risk of bias with the checklists of the Joanna Briggs Institute and the Cochrane Risk of Bias tool and calculated meta-analyses for sufficiently homogeneous studies using fixed-effects models. RESULTS: We included 15 intervention studies applying non-pharmacological interventions including chewing gum (n = 8), low-sodium diet (n = 2), acupressure (n = 1), frozen strawberries (n = 1), fluid timetables (n = 1), ice cubes and mouthwash (n = 1), and a psychological intervention (n = 1). Sample sizes varied between 11 and 88 participants. Eleven intervention studies showed a reduction of thirst as intervention effect. Meta-analyses for chewing gum showed no significant effect on thirst using a visual analogue scale (IV: -2,32 [-10.37,5.73]; p = 0.57) or the dialysis thirst inventory (IV: -0.26 [- 1.83, 1.30]; p = 0.74). Quality of studies was moderate to low. CONCLUSION: Results indicate that various non-pharmacological interventions could be helpful to reduce thirst in patients with CHF or HD, but important uncertainty remains.

Formulation Consideration of Medicated Chewing Gum: A Review.

In recent times, technological and scientific advances have been made in studying and developing orally delivered medication. Such studies demonstrate the importance of the oral route among patients. The accuracy of drug delivery is very important to achieve a successful therapeutic effect in the case of various pharmaceutical products. A novel drug delivery system adds new benefits or advantages to a drug. This review covers all the aspects of medicated chewing gum (MCG) as a new drug delivery method, including the benefits and drawbacks, manufacturing methods, type of MCG, composition of chewing gum, evaluation parameters, factors that affected the release of API, its pharmaceutical significance, various marketed chewing gum and chewing gum packaging. Chewing gum as a drug delivery system has the potential to cure or prevent various indications, such as analgesic, CNS stimulation, smoking cessation, motion sickness, and treatment and prevention of dental caries or gingivitis. Pharmaceutical distribution to the oral mucosa can be made more convenient and enticing with the help of MCG. Compared to conventional techniques, this delivery system has a longer-lasting effect, which makes it a viable option for treating digestive problems, headaches, migraines, coughing, anxiety, and allergies.

Understanding the two-stage degradation process of peach gum polysaccharide within ultrasonic field.

This study investigated the dynamic degradation process of peach gum polysaccharide (PGPS) within ultrasonic field. The results show that the molecular weight, intrinsic viscosity, and polydispersity of PGPS were rapidly reduced within the initial 30 min and then gradually decreased. The solubility of PGPS was drastically improved from 3.0% to 40.0-42.0% (w/w) after 120 min. The conformation of PGPS changed from an extended chain to a flexible random coil within initial time of ultrasound, and gradually tended to be compact spheres. The apparent viscosity of PGPS significantly decreased after 30 min, and PGPS solution exhibited a near-Newtonian fluid behavior. It is possible that these above changes are a result of random cleavage of the decrosslinking and the backbone of PGPS, resulting in the preservation of its primary structure. The results will provide a fundamental basis for orientation design and process control of ultrasonic degradation of PGPS.

Randomized controlled clinical trial on the efficacy of a novel antimicrobial chewing gum in reducing plaque and gingivitis in adolescent orthodontic patients.

OBJECTIVES: Chewing gums containing antiseptics or other antimicrobial substances may be effective in reducing plaque and gingivitis. Therefore, the aim of this randomized placebo-controlled clinical trial was to investigate the efficacy of a novel antimicrobial chewing gum containing essential oils (cinnamon, lemon, peppermint) and extracts on reduction of dental plaque and gingivitis as well as on oral health-related quality of life (OHRQoL) in adolescent orthodontic patients. MATERIALS: 52 patients (11-22 years of age) were randomly assigned to use a test chewing gum (COVIDGUM, Clevergum) or a commercially available control chewing gum over a period of 10 days. Approximal plaque index (API), papillary bleeding index (PBI) and an OHRQoL questionnaire for children (COHIP-G19) were assessed at baseline (BL), after 10 days (10d) and 30 days (30d). In addition, oral health and oral hygiene related questions of the COHIP-G19 questionnaire were evaluated separately in subscales at each timepoint. Data were analyzed using non-parametrical statistical procedures (α = 0.05). RESULTS: API and PBI decreased significantly over time from BL to 10d and from BL to 30d in both groups, without significant differences between the groups. In both groups, the COHIP-G19 score, oral health subscale and oral hygiene subscale decreased significantly over time. Regarding the oral hygiene subscale, the test group showed significantly better scores at 30d (p = 0.011). CONCLUSION: Both chewing gums performed similarly effective in terms of reducing plaque accumulation and gingival inflammation and improving OHRQoL. CLINICAL RELEVANCE: Chewing gums without antimicrobial ingredients may be sufficient to decrease plaque accumulation and gingival inflammation.