OBJECTIVES

A growing body of evidence points to a positive association between periodontitis and
various systemic diseases, including cardiovascular diseases (CVD), hypertension, and rheumatoid arthritis. However,
there is limited data on the prevalence and odds of having systemic conditions among Filipino periodontal patients.
Thus, this study aimed to determine the association of periodontal disease with systemic conditions among Filipino
patients at a university dental clinic.

METHODS

The periodontal and medical charts of all patients who underwent periodontal consult at a university
dental clinic within two academic years were reviewed. Periodontal diagnoses which had originally been assigned
using the 1999 classification of periodontal diseases were reclassified based on the 2018 European Federation
of Periodontology-American Academy of Periodontology classification. Listed medical conditions in the patients’
charts were self-reported. The prevalence of various systemic conditions in 715 periodontitis cases was compared
to that of 834 control patients without periodontitis. Fisher’s exact test was performed to evaluate the difference
in the prevalence of comorbidities between groups, while adjusted odds ratios (AOR) were computed using logistic
regression analysis, accounting for age, sex, educational attainment, and smoking status.

RESULTS

The prevalence of having at least one systemic condition was significantly higher among periodontitis patients
(44.5%) compared to non-periodontitis patients (36.3%). Compared to controls, a significantly higher number of
periodontitis cases had two systemic comorbidities (P=0.001). The prevalence of hypertension (18.6% versus 5.04%),
CVD including hypertension (20.42% versus 6.95%), arthritis (9.37% versus 3.0%), and diabetes mellitus (5.73% versus
0.84%) were all significantly higher in patients with periodontitis compared to non-periodontitis controls.
The odds of having CVD (AOR=1.81), hypertension (AOR=2.14) and diabetes (AOR=3.05) were higher in periodontitis cases. Meanwhile, the prevalence of asthma (9.23% versus 5.31%), respiratory diseases including asthma (12.95% versus 8.25%), and allergies (18.82% versus 13.71%) were significantly higher in non- periodontitis patients compared to periodontitis cases.

CONCLUSION

Periodontitis patients were more likely to present with CVD, hypertension, and diabetes mellitus. On the other hand, no association was found between periodontitis and respiratory diseases, as well as between periodontitis and asthma.

Human ; Male ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; Regression (psychology) ; Respiratory Tract Diseases ; Regression Analysis ; Periodontal Diseases ; Cardiovascular Diseases

This article reports 2 cases of urinary retention in Alzheimer's disease with agitation treated by acupuncture. Based on patients' clinical symptoms, the etiology and pathogenesis were determined, and acupuncture was applied to Baihui (GV20), Sishencong (EX-HN1), Shenting (GV24), and bilateral Ciliao (BL32), Zhongliao (BL33), Fengchi (GB20), Taiyang (EX-HN5), etc. to regulate the mind and promote water metabolism. The positive and negative electrodes of the SDZ-Ⅴ type electroacupuncture device were attached to ipsilateral Ciliao (BL32), Zhongliao (BL33) respectively, with continuous wave, at the frequency of 15 Hz, and the current of 3 to 10 mA, depending on patients' tolerance. The needles were retained for 20 min. The treatment was delivered once every other day, 3 interventions a week and 12 interventions as 1 course. Both patients reported the micturition desire after 1 intervention with acupuncture and the catheter was removed on the same day. The urination was ameliorated without dysuresia after 1-2 courses of treatment, and the agitated behavior was alleviated. It can be the reference for the clinical treatment of urinary retention in patients with Alzheimer's disease with agitation.
Humans ; Alzheimer Disease/psychology* ; Acupuncture Therapy ; Urinary Retention/etiology* ; Male ; Female ; Aged ; Acupuncture Points ; Psychomotor Agitation/complications*

BACKGROUND: While emotional distress, encompassing anxiety and depression, has been associated with negative clinical outcomes, its impact across various clinical departments and general hospitals has been less explored. Previous studies with limited sample sizes have examined the effectiveness of specific treatments (e.g., antidepressants) rather than a systemic management strategy for outcome improvement in non-psychiatric inpatients. To enhance the understanding of the importance of addressing mental health care needs among non-psychiatric patients in general hospitals, this study retrospectively investigated the impacts of emotional distress and the effects of early detection and management of depression and anxiety on hospital length of stay (LOS) and rate of long LOS (LLOS, i.e., LOS >30 days) in a large sample of non-psychiatric inpatients. METHODS: This retrospective cohort study included 487,871 inpatients from 20 non-psychiatric departments of a general hospital. They were divided, according to whether they underwent a novel strategy to manage emotional distress which deployed the Huaxi Emotional Distress Index (HEI) for brief screening with grading psychological services (BS-GPS), into BS-GPS ( n = 178,883) and non-BS-GPS ( n = 308,988) cohorts. The LOS and rate of LLOS between the BS-GPS and non-BS-GPS cohorts and between subcohorts with and without clinically significant anxiety and/or depression (CSAD, i.e., HEI score ≥11 on admission to the hospital) in the BS-GPS cohort were compared using univariable analyses, multilevel analyses, and/or propensity score-matched analyses, respectively. RESULTS: The detection rate of CSAD in the BS-GPS cohort varied from 2.64% (95% confidence interval [CI]: 2.49%-2.81%) to 20.50% (95% CI: 19.43%-21.62%) across the 20 departments, with a average rate of 5.36%. Significant differences were observed in both the LOS and LLOS rates between the subcohorts with CSAD (12.7 days, 535/9590) and without CSAD (9.5 days, 3800/169,293) and between the BS-GPS (9.6 days, 4335/178,883) and non-BS-GPS (10.8 days, 11,483/308,988) cohorts. These differences remained significant after controlling for confounders using propensity score-matched comparisons. A multilevel analysis indicated that BS-GPS was negatively associated with both LOS and LLOS after controlling for sociodemographics and the departments of patient discharge and remained negatively associated with LLOS after controlling additionally for the year of patient discharge. CONCLUSION Emotional distress significantly prolonged the LOS and increased the LLOS of non-psychiatric inpatients across most departments and general hospitals. These impacts were moderated by the implementation of BS-GPS. Thus, BS-GPS has the potential as an effective, resource-saving strategy for enhancing mental health care and optimizing medical resources in general hospitals.
Humans ; Retrospective Studies ; Male ; Length of Stay/statistics & numerical data* ; Female ; Middle Aged ; Adult ; Psychological Distress ; Inpatients/psychology* ; Aged ; Anxiety/diagnosis* ; Depression/diagnosis*

Chaihu and Longgu Muli Decoction has demonstrated significant efficacy in the treatment of tachyarrhythmia accompanied by anxiety and depression. However, there is a lack of standardized guidelines for its clinical application. In this study, the Chaihu and Longgu Muli Decoction was investigated through extensive research on ancient and modern literature, as well as a collection of clinical medical records. The basic information, medication details, and diagnostic information from medical records, personal experience literature, and clinical cases in the treatment of tachyarrhythmia accompanied by anxiety were extracted and analyzed to preliminarily identify the prescription characteristics and syndrome patterns. Subsequently, the Delphi method was employed to construct an item pool based on the data obtained in the first step. An expert questionnaire was prepared to collect scores and revision opinions from experts regarding these items. After statistical analysis and group discussions, a second round of questionnaires was formed by screening out certain items. This process was repeated until a final item set for the treatment of tachyarrhythmia accompanied by anxiety with Chaihu and Longgu Muli Decoction was determined. These findings provided guidance for clinical prescription practices. By extracting 71 syndromes and signs, as well as 33 tongue and pulse characteristics, the main syndrome features included palpitations, chest tightness, irritability, etc., which were basically consistent with the ancient syndromes. Through frequency analysis and group discussions, 71 items were screened out. After screening, modification, and primary and secondary division, 11 main diagnostic items and 10 secondary diagnostic items were determined. On this basis, the research team believes that Chaihu and Longgu Muli Decoction is mainly indicated for the following syndromes in the treatment of tachyarrhythmia accompanied by anxiety(palpitations, poor sleep, bitter taste, dry mouth, irritability/easily angered/anxiety/fearfulness/easily startled, red tongue with greasy yellow coating, rapid pulse, high work/life pressure, tachyarrhythmia on electrocardiogram/Holter monitor, and positive results on anxiety scale). Secondary syndromes include chest tightness, shortness of breath, feeling heavy and weak in the body, sweating, poor appetite, constipation, greasy white tongue coating, wiry pulse, slippery pulse, or knotted and intermittent pulse.
Drugs, Chinese Herbal/therapeutic use* ; Humans ; Delphi Technique ; Anxiety/complications* ; Tachycardia/psychology* ; Female ; Male ; Middle Aged ; Adult ; Aged

PURPOSE: Attention-deficit/hyperactivity disorder (ADHD) increases the risk of road traffic injuries through various mechanisms including higher risky driving behaviors. Therefore, drivers with ADHD are shown to be more prone to road traffic injuries. This study was conducted in a community-based sample of drivers to determine how ADHD affects driving behavior components. METHODS: At the cross-sectional phase of a national population-based cohort, a representative sample of 1769 drivers were enrolled. Manchester driving behavior questionnaire and Conners' adult ADHD rating scales were used to assess driving behavior and ADHD symptom scores, respectively. Data were analyzed using Stata version 17. Multiple linear regression was used to investigate the association of driving behavior with ADHD while adjusting for the potential confounding role of age, sex, marital status, educational level, driving history, etc. RESULTS: According to the results, the normalized driving behavior score of drivers with ADHD was 4.64 points higher than drivers without ADHD. Having an academic compared to school education, increased the driving behavior score by 1.73 points. The normalized driving behavior score of drivers under 18 years of age was 6.27 points higher than drivers aged 31-45 years. The score of the aggressive violation subscale of drivers with ADHD was 7.33 points higher than drivers without ADHD compared to an increment of a range of 4.50-4.82 points for other driving subscales. The score of the ordinary violation subscale of female drivers was 2.23 points lower than that of male drivers. No significant relationship was found between sex and other subscales of driving. CONCLUSION Drivers with ADHD who are in adolescence or early adulthood exhibit more dangerous and aggressive driving behaviors than those who are older. Implementing training interventions to increase awareness of drivers with ADHD, their families, and psychologists regarding the effects of ADHD on driving is an essential step in preventing motor vehicle crashes among drivers with ADHD.
Humans ; Attention Deficit Disorder with Hyperactivity/psychology* ; Automobile Driving/psychology* ; Male ; Adult ; Female ; Middle Aged ; Cross-Sectional Studies ; Accidents, Traffic ; Iran ; Adolescent ; Surveys and Questionnaires ; Young Adult ; Cohort Studies ; Risk-Taking

BACKGROUND: Narrative care is emerging as a new discipline to achieve high-quality nursing. It can be seen in clinical studies on improving the management of schizophrenia, depression and chronic diseases, but its application in surgical patients with lung cancer is rarely reported. The aim of this study was to study the effect on improving symptom cluster management and post-traumatic growth of surgical patients through narrative care model, and to explore its clinical advantages in promoting physical and mental rehabilitation of lung cancer patients. METHODS: A total of 82 patients with lung cancer who underwent surgical treatment in the First Affiliated Hospital of Zhejiang University from July 2024 to October 2024 were selected as the study objects by convenience sampling, and randomly divided into the control group and observation group according to random number method, with 41 cases in each group. The control group received routine nursing; On this basis, the observation group was integrated into three consecutive narrative nursing sessions on the day of admission, 3 days after surgery and 1 week after surgery. After collecting the general data of the patients before intervention, the Generalized Anxiety Scale, the Pittsburgh Sleep Quality Index, the Chinese Version of the Lung Cancer Patients Quality of Life Assessment Scale and the Chinese Version of the Post-traumatic Growth Assessment Scale were used. After each narrative intervention, the two groups of patients were assessed again, and the scores of the two groups were compared at the three stages. RESULTS: The scores of anxiety, sleep, quality of life and post-traumatic growth level of the patients on the 3 days and 1 week postoperatively were better in the observation group than in the control group, and the differences were all statistically significant (P<0.05). In addition, the results within the groups showed that the anxiety scores of the observation group and the control group gradually decreased in the preoperative period, 3 days and 1 week postoperatively; the post-traumatic growth scores gradually increased in the preoperative period, 3 days and 1 week postoperatively; however, due to the stress of the surgery and postoperative discomfort, the sleep scores of the patients of the two groups on 3 days postoperatively were higher than those in the preoperative period and 1 week postoperatively, and the sleep scores of the patients of 1 week postoperatively were significantly lower than those in the preoperative period; and the quality of life of the patients on the 3 days postoperatively scores were lower than preoperative period and 1 week postoperatively, and the quality of survival scores in 1 week postoperatively were higher than the preoperative period, and the differences were statistically significant (P<0.05). CONCLUSIONS The application of narrative nursing to lung cancer surgery patients is conducive to alleviating perioperative symptom clusters, helping patients achieve post-traumatic growth, and enhancing their psychosocial adaptability and quality of survival.
Humans ; Lung Neoplasms/psychology* ; Male ; Female ; Middle Aged ; Quality of Life ; Aged ; Adult ; Posttraumatic Growth, Psychological

BACKGROUND: Quick accomplishment and responsiveness are behaviors related to time management by perceived control of time, such as a positive feeling of using one's time well. In recent years, positive psychological states have been associated with a lower risk of cardiovascular disease (CVD). Thus, we investigated the associations of quick accomplishment and responsiveness with CVD mortality in a large cohort study. METHODS: The study participants were 75,049 (30,901 men and 44,148 women) aged 40-79 between 1988 and 1990 and followed until the end of 2009. Hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality from CVD according to quick accomplishment, responsiveness, and their combination were calculated after adjustment for potential confounding factors using the Cox proportional hazard model. RESULTS: Quick accomplishment was associated with a lower risk of CVD mortality in women; a similar but marginally significant association was observed in men; the respective multivariable HR (95%CI) was 0.91 (0.83-0.99) and 0.93 (0.86-1.01). The presence of both quick accomplishment and responsiveness was associated with lower risk in men, which was confined to men aged 60-79; the respective multivariable HR (95%CI) was 0.88 (0.78-0.99) and 0.83 (0.72-0.96). CONCLUSIONS Quick accomplishment was associated with a lower risk of CVD mortality. Quick accomplishment and responsiveness combined were inversely associated with CVD mortality risk among older men.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Cardiovascular Diseases/psychology* ; Cohort Studies ; Japan/epidemiology* ; Proportional Hazards Models ; Risk Factors ; East Asian People/psychology*

BACKGROUND: Although the global COVID-19 mortality rate is decreasing, COVID-19 remains an infectious disease with a high mortality rate, especially in older adults and individuals with comorbidities. In Japan, mask-wearing has been left to individual discretion since March 13, 2023, but remains a key protective measure. This study aimed to identify factors influencing individual mask-wearing behavior in post COVID-19 era, with a focus on risk factors for severe COVID-19. METHODS: Data from 33,000 participants, obtained from the Japan COVID-19 and Society Internet Survey 2023, were used, which was conducted from September 25 to November 17, 2023. Participants were randomly selected from approximately 2.2 million panelists from a nationwide Japanese Internet research company, with sampling adjusted by age, sex, and living area to match the population distribution in Japan. The association between wearing a mask and risk factors for severe COVID-19 (age, sex, smoking, COVID-19 vaccination, history of COVID-19, body mass index (BMI), and comorbid conditions) was evaluated using univariate and multivariate analyses. RESULTS: In total, 28,481 individuals were included, of whom 18,371 (64.5%) answered that they wore masks. After adjusting for confounders, older age (adjusted relative risk [RR], 1.50; 95% confidence interval [CI], 1.45-1.55 for "75-83" years), no history of COVID-19 (adjusted RR, 1.06; 95% CI, 1.04-1.08), low BMI (adjusted RR, 1.04; 95% CI, 1.02-1.07), and increased number of comorbid conditions (adjusted RR, 1.11; 95% CI, 1.05-1.18 for three or more) were significant positive factors for wearing a mask. In contrast, men (adjusted RR, 0.89; 95% CI, 0.87-0.90), no COVID-19 vaccination (adjusted RR, 0.78; 95% CI, 0.76-0.81), and current smoking history (adjusted RR, 0.96; 95% CI, 0.93-0.99) were significant negative factors. CONCLUSION We demonstrated that mask-wearing behavior differed based on individual risk factors for severe COVID-19, with some risk factors negatively influencing mask use in Japan. It may be necessary to recommend mask-wearing for these individuals, especially during situations such as COVID-19 epidemic season or the onset of epidemics, considering individual mask-wearing behavior.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; COVID-19/psychology* ; Japan/epidemiology* ; Masks/statistics & numerical data* ; Risk Factors ; Surveys and Questionnaires ; East Asian People

BACKGROUND: The demand for aged-care services in Japan has surged due to the country's aging population. Furthermore, nationwide survey on the current state of aged-care services revealed that the primary reason for the resignation of women working in these sectors was poor interpersonal relationships. Moreover, given that women working in aged-care services work in shifts around the clock to manage the health and safety of the people in their care, they are at high risk of health-related issues including insomnia symptoms. Thus, we aim to examine the association between levels of satisfaction with interpersonal relationships (LSIR) and insomnia symptoms for women working in aged-care services in Japan, as well as the effect of work-life imbalance on the association between LSIR and insomnia symptoms. METHODS: In this cross-sectional study, the participants were 472 women aged 18-60 years who worked in aged-care services in Japan in 2014-2016. Insomnia symptoms were measured using the Athens Insomnia Scale, and scores of 6 or greater indicated the presence of insomnia. LSIR were assessed through self-administered questionnaires and evaluated at three levels. The association between LSIR and insomnia symptoms was evaluated using a multinominal logistic regression model. Path analysis was used to examine the potential effects of LSIR on insomnia symptoms by incorporating covariates such as work-family conflict, marital status, and depressive symptoms. RESULTS: Compared to high LSIR, the multivariable-adjusted odds ratios (95% confidence interval) of insomnia symptoms were respectively 1.36 (0.81-2.30) and 2.42 (1.11-5.23) for medium and low LSIR. The path analysis showed that low LSIR were significantly associated with having high work-to-family (W-to-F) conflict and being single. CONCLUSIONS Low LSIR were significantly associated with insomnia symptoms among women working in aged-care services in Japan. High W-to-F conflict exacerbated this relationship. Therefore, enhancing interpersonal relationships may be necessary for preventing insomnia. However, due to the cross-sectional nature of our study, causality cannot be inferred. Further longitudinal research is needed to better understand these associations.
Humans ; Japan/epidemiology* ; Sleep Initiation and Maintenance Disorders/psychology* ; Female ; Middle Aged ; Adult ; Cross-Sectional Studies ; Interpersonal Relations ; Young Adult ; Adolescent ; Personal Satisfaction ; Health Services for the Aged/statistics & numerical data*

BACKGROUND: The long-term impact of symptom classification on quality of life (QOL) and economic outcomes among individuals with long coronavirus disease (COVID) remains poorly understood. This study aimed to clarify the situation of long COVID in Japan by analyzing patients using cluster classification. METHODS: This multicenter, retrospective cohort study enrolled 515 patients with COVID-19 and followed up for 36 months via standardized questionnaires. Patients were classified based on: 1) symptom trajectory over time and 2) symptom cluster profiles at 3 months. RESULTS: While the number of symptoms decreased, fatigue and dyspnea frequently persisted, whereas anosmia and dysgeusia declined. Cough and sputum decreased gradually. The proportion of patients with 5-9 symptoms increased. The mean (interquartile range) presenteeism scores were lower in the continuous (60 [50-80]) and relapse groups (65 [48-80]) than in the recovered group (70 [50-80]). The multiple symptoms cluster had the worst SF-36, presenteeism, and absenteeism scores (47.2 [44.7-49.8], 48.8 [27.5-72.5], and 10.9 [0.0-11.0], respectively). CONCLUSIONS Patients with continuous and multiple symptoms experienced persistently lower QOL and greater economic burden up to 36 months after COVID-19 diagnosis. The long-term effects of long COVID are not only physical but also mental and economical. Thus, further research is needed to clarify the economical and physiological impact of long COVID.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; COVID-19/complications* ; Japan/epidemiology* ; Post-Acute COVID-19 Syndrome/psychology* ; Quality of Life ; Retrospective Studies ; Surveys and Questionnaires ; East Asian People