Saori Funayama

Relationships between the amount of saliva and medications in elderly individuals

OBJECTIVE To investigate medications that are related to volume of saliva in the elderly. BACKGROUND DATA In the elderly, many cases of mouth dryness may represent side effects of medication. MATERIALS AND METHODS The volume of unstimulated saliva was measured for 30 s (cotton roll test), and with stimulation for 3 min (gum test) in 368 subjects 79-80 years old (177 men, 191 women). Medications were investigated using subjects medication notebooks. RESULTS Mean volumes of unstimulated and stimulated saliva were 0.14±0.13 and 4.30±2.54 ml respectively. Significant differences were seen between gender and mean volume of saliva. The volume of unstimulated saliva was 0.16±0.15 ml for men and 0.11±0.10 ml for women. The volume of stimulated saliva was 4.99±2.67 ml for men and 3.67±2.25 ml for women. The percentage of subjects taking medication was 64.7% (238/368). Mean number of medications was 2.08±2.26, with no significant difference with gender (2.01±2.37 for men, 2.16±2.16 for women). In a stepwise multiple regression analysis with volume of saliva as the objective variable and number of drugs by category as explanatory variables, significant explanatory variables in addition to gender and number of medications were blood-coagulating agents, Ca antagonists and peptic ulcer drugs for volume of unstimulated saliva, and diabetes medications and peptic ulcer drugs for volume of stimulated saliva. CONCLUSION These findings suggest that differences exist between gender in volume of saliva for elderly individuals, and that the volume of saliva is affected by the number and type of medications.

Assessment of inhalation flow patterns of soft mist inhaler co-prescribed with dry powder inhaler using inspiratory flow meter for multi inhalation devices

The patients’ inhalation flow pattern is one of the significant determinants for clinical performance of inhalation therapy. However, the development of inhalation flow meters for various inhalation devices has been unable to keep up with the increasing number of newly launched inhalation devices. In the present study, we developed simple attachment orifices for the inhalation flow pattern monitoring system, which are suitable for all commercial inhalers, and investigated the efficacy of the system on the clinical inhalation instruction for patients co-prescribed dry powder inhaler (DPI) and soft mist inhaler (SMI). First, we constructed simple attachment orifices that were adjusted for 13 commercial inhalers, and examined the correlation between orifice and inhalation device. Second, the inhalation flow patterns (peak inspiratory flow rate, PIFR; inhalation duration time, DT) of patients prescribed a combination of DPI and SMI were monitored before and after inhalation instruction. The inhalation resistance of commercial inhalers are listed in the following order; Twincaps® > Handihaler® > Swinghaler® = Clickhaler® > Twisthaler® > Turbuhaler® > Jenuair® > Diskus® = Ellipta® > Diskhaler® > Breezhaler® > Respimat® = pMDI. The pressure drop via orifice was significantly correlated with that via the commercial inhaler. For the confirmation, all participants achieved the DPI criterion of PIFR. On the other hand, 4 participants (6 clinical visits) of 10 experimented participants could not achieve the essential criterion of DT (> 1.5 sec) for SMI, but all participants improved their duration time after inhalation instruction by pharmacists (P<0.05). In the present study, we successfully developed simple attachment orifice suitable for 13 commercial inhalation devices. These data suggested that our simple attachment orifices for the inhalation flow pattern monitoring system can detect patients with inadequate inhalation patterns via SMI.

Evaluation of oral wetness using an improved moisture-checking device for the diagnosis of dry mouth

Abstract Purpose In 2013, we reported the results of a third-generation oral moisture-checking device in a multicentre clinical study involving patients with dry mouth and healthy volunteers. Subsequently, several improvements have been made to the third-generation device, and a fourth-generation device is now commercially available. This study aimed to confirm the usefulness of this improved fourth-generation device in the diagnosis of dry mouth and to assess the physiological wetness of lingual mucosa by using this device. Materials and Method This multicentre study comprised subjects with dry mouth (dry mouth group) and those without dry mouth (healthy group). Results In this study, the degree of moisture was considerably different between the two groups. Receiver operating characteristic analysis revealed an area under the curve value of 0.831. Sensitivity and specificity values were close to 80% in cases where the degree of moisture ≥29.6 was defined as normal, ≤27.9 was defined as dry mouth, and 28.0–29.5 was defined as borderline dry mouth. Conclusions These results suggest that the improved fourth-generation moisture-checking device can be used for the diagnosis of oral dryness.

Factors associated with mucosal dryness in multiple regions and skin: A web-based study in women

We hypothesized that feeling mucosal dryness in one body region and the skin may be associated with dryness in other regions and that there are common background factors for dryness. In an earlier web‐based survey, we reported prevalence figures of dry eyes, nose, mouth, skin, and vagina. In the present study, additional analyses were made to investigate the factors associated with dryness in each region, and simultaneous dryness in multiple regions.

Current Status of Salivary Gland Diseases: Sjögren's Syndrome and Dry Mouth

Abstract As societies age, the number of people complaining of dry mouth is increasing; an estimated 30,000,000 people suffer from dry mouth in Japan. The mouth fulfills many basic human appetites, such as eating, drinking, tasting, and talking, and a core component of these functions is saliva. In this paper we will; (1) Explain what dry mouth is; (2) Introduce Niigata University Medical and Dental Hospitals dry mouth outpatient clinic; (3) Describe a new diagnostic method using ultrasonic waves; and (4) Describe salivary protein analysis in patients suffering from Sjogrens syndrome (SS).