[Show abstract][Hide abstract] ABSTRACT: Poor oral health of hospitalized patients is associated with an increased risk of hospital-acquired infections and reduced life quality.
To systematically review the evidence on oral health changes during hospitalization.
Cochrane library, Medline, OldMedline, Embase and CINAHL without language restrictions.
Observational longitudinal studies. DATA APPRAISAL AND SYNTHESIS METHODS: Two independent reviewers screened studies for inclusion, assessed the risk of bias and extracted data. Risk of bias was assessed using the Newcastle-Ottawa assessment scale. A narrative synthesis was conducted.
Five before and after studies were included. The data suggest a deterioration in oral health following hospitalization with an increase in dental plaque accumulation and gingival inflammation and a deterioration in mucosal health.
While before and after studies are at a general risk of bias, other specific study characteristics were judged to have a low risk of bias. However, methodological issues such as unvalidated outcome measures and the lack of assessor training limit the strength of the evidence.
Hospitalization is associated with a deterioration in oral health, particularly in intubated patients.
Journal Of Clinical Periodontology 04/2011; 38(7):628-36. · 3.61 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The prevalence of human herpesvirus 8 (HHV-8) in populations at different risks of developing Kaposi's sarcoma (KS) was assessed using a protocol involving immunomagnetic fractionation of CD45+ blood cells prior to detection of the HHV-8 genome by nested PCR. Preliminary studies using blood of eight gay men infected by human immunodeficiency virus-1 (HIV-1) revealed that, for the detection of HHV-8 DNA derived from open reading frame (ORF) 26 of the HHV-8 genome, this protocol provided substantially higher rates (100%) compared to one involving red blood cell (RBC) lysis (0%) and to another requiring double density gradient centrifugation (DDGC) of leukocytes (13%). When the CD45+ fractionation protocol was applied to samples from 103 other HIV-1-infected patients (the vast majority of whom were gay men) and 100 blood donors, the ORF 26 DNA detection rates obtained were 37% and 8%, respectively. When DNA from the variable region 1 of ORF K1 was additionally amplified from samples of the blood donors, a detection rate of 9% was achieved. This rate was highly concordant with the ORF 26 DNA detection rate. Furthermore, the ORF K1 sequences were predominantly unique, assignable to genotypes A1, A4, and C3. When assays for anti-HHV-8 and anti-herpes simplex viruses (HSV) 1 and 2 were applied, significant concordances between HHV-8 DNA detection rates and those relating to anti-HHV-8 and to anti-HSV 1 and 2 were more frequently observed for HIV-1-infected patients than for blood donors. The higher-than-expected HHV-8 genoprevalence rate in blood donors requires further confirmation in view of its implications for post-transfusion HHV-8 transmission.
Journal of Medical Virology 02/2007; 79(1):52-9. · 2.22 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Individuals with special needs, namely those whose dental care is complicated by a physical, mental or social disability, often have a higher level of unmet dental need and poorer oral hygiene than the general population, and offer unique challenges to the dental practitioner. This paper outlines the dental management of the three most common groups of individuals with special needs.
[Show abstract][Hide abstract] ABSTRACT: Selected periodontopathic bacteria were sought in 20 HIV-infected English patients and eight noninfected control subjects with similar periodontal status, using highly specific DNA probes. Actinobacillus actinomycetemcomitans (A. a), Porphyromonas gingivalis, Campylobacter rectus, Prevotella intermedia, and Fusobacterium nucleatum were more frequently detected and were found at higher levels in HIV-infected individuals than in controls. Significantly increased levels of Treponema denticola but, in contrast, lower levels of Eikenella corrodens were found in nonbleeding sites of HIV-infected patients compared with controls. The results of the present investigation on English patients suggest a periodontopathogenic role for A. a, P. gingivalis and C. rectus, and possibly P. intermedia and are in general accord with most previously reported data from the United States. Longitudinal studies are now required to determine more precisely the association between periodontopathic microflora, immune competence and periodontal health and disease in HIV-infected persons.
AIDS PATIENT CARE and STDs 07/1999; 13(6):369-74. · 3.58 Impact Factor