Oral adverse effects:drug-induced tongue disorders

OBJECTIVES: Due to a worldwide increase in drug consumption, oral healthcare professionals are frequently confronted with patients using one or more drugs. A large number of drugs can be accompanied with adverse drug reactions in the orofacial region, amongst others of the tongue. This paper aims to give an overview of drugs that are known to be accompanied with tongue disorders. MATERIALS AND METHODS: The national drug information database for Dutch pharmacists, composed of scientific drug information, guidelines and summaries of product characteristics, was analysed for drug‐induced tongue disorders. “MedDRA classification” and “Anatomical Therapeutic Chemical codes” were used to categorize the disorders. RESULTS: The database comprises of 1645 drugs of which 121 (7.4%) are documented to be accompanied with tongue disorders as an adverse effect. Drug‐induced tongue disorders are predominantly observed in the following drug categories: “nervous systems,” “anti‐infectives for systemic use” and “alimentary tract and metabolism”. The most common drug‐induced tongue disorders are glossitis, tongue oedema, tongue discoloration and burning tongue. CONCLUSION: Healthcare professionals are frequently confronted with drugs that can cause tongue disorders. The overview of drugs reported in this article supports clinicians in their awareness, diagnosis and treatment of drug‐induced tongue disorders

Electroconvulsive therapy-induced volumetric brain changes converge on a common causal circuit in depression

Neurostimulation is a mainstream treatment option for major depression. Neuromodulation techniques apply repetitive magnetic or electrical stimulation to some neural target but significantly differ in their invasiveness, spatial selectivity, mechanism of action, and efficacy. Despite these differences, recent analyses of transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS)-treated individuals converged on a common neural network that might have a causal role in treatment response. We set out to investigate if the neuronal underpinnings of electroconvulsive therapy (ECT) are similarly associated with this causal depression network (CDN). Our aim here is to provide a comprehensive analysis in three cohorts of patients segregated by electrode placement (N = 246 with right unilateral, 79 with bitemporal, and 61 with mixed) who underwent ECT. We conducted a data-driven, unsupervised multivariate neuroimaging analysis Principal Component Analysis (PCA) of the cortical and subcortical volume changes and electric field (EF) distribution to explore changes within the CDN associated with antidepressant outcomes. Despite the different treatment modalities (ECT vs TMS and DBS) and methodological approaches (structural vs functional networks), we found a highly similar pattern of change within the CDN in the three cohorts of patients (spatial similarity across 85 regions: r = 0.65, 0.58, 0.40, df = 83). Most importantly, the expression of this pattern correlated with clinical outcomes (t = -2.35, p = 0.019). This evidence further supports that treatment interventions converge on a CDN in depression. Optimizing modulation of this network could serve to improve the outcome of neurostimulation in depression

Beschouwingen over het gebruik van corticosteroïden in de dentoalveolaire chirurgie

Corticosteroïden worden incidenteel gebruikt bij een dentoalveolaire chirurgische behandeling om eventuele nabezwaren te reduceren. Lichaamseigen corticosteroïden worden geproduceerd in de bijnierschors. Van de synthetische vormen van corticosteroïden is bekend dat ze een anti-inflammatoire werking hebben als ze worden toegediend in hogere doses dan de normale fysiologische hoeveelheid die het lichaam produceert. Eveneens is bekend dat ze een aantal bijwerkingen en contra-indicaties hebben. Toediening van corticosteroïden bij een dentoalveolaire chirurgische behandeling laat een reductie van oedeemvorming en pijn zien. Een groter risico op infectie na toediening is niet bekend en het risico op bijwerkingen is minimaal. Op basis van de literatuur kan niet worden aanbevolen bij een dentoalveolaire chirurgische behandeling standaard corticosteroïden toe te dienen

The basal ganglia: A central hub for the psychomotor effects of electroconvulsive therapy

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The impact of need-based care on formal caregivers' wellbeing in nursing homes : a cluster randomized controlled trial

Abstract: Background Need-based care is a structured and standardized model that supports formal caregivers in nursing homes in delivering person-centered care by responding with tailored non-pharmacological interventions on residents' unmet needs as well as having positive effects on behavioral and psychological symptoms on residents with dementia. However, limited resources as well as the shortage of caregivers in nursing homes make the implementation of need-based care challenging, especially when it comes to finding ways to spend more time with residents. The aim of this study is to evaluate the impact of the implementation of need-based care in nursing homes on formal caregivers' wellbeing. Methods A three-arm cluster randomized controlled trial was set up in 24 Belgian nursing homes: formal caregivers in the \u2018need-based care\u2019 group (intervention; n\u202f=\u202f195) spent time twice a week with residents who had behavioral and psychological symptoms according to the principles of need-based care while formal caregivers in the \u2018time\u2019 group (n\u202f=\u202f257) filled in the way they spent time twice a week; a third group delivered standard care (n\u202f=\u202f299). An implementation strategy was built upon the Implementation Quality Framework and used in the \u2018need-based care group\u2019. A total of 741 formal caregivers completed the digital questionnaire at one or more of the five time points (every nine weeks) between November 2021 and July 2022; they rated their sense of competence in dementia care, level of burnout, and, level of engagement. Moments of time were registered in a printed registration book. Results Only formal caregivers from the \u2018need-based care\u2019 group experienced a higher sense of competence in dementia care at time points three (p\u202f=\u202f0.010) and four (p\u202f=\u202f0.001) compared with baseline with an increase of respectively 1.5 (95\u202f% confidence interval [0.25, 2.84]) and 2.4 (95\u202f% confidence interval [0.77, 4.04]) points. No differences in scores on burnout and engagement were found. Conclusion Despite challenging workforce circumstances in nursing homes, caregivers in the need-based care group as well as in the time group were able to spend time twice a week with residents with behavioral and psychological symptoms. No negative effects were found on formal caregivers' wellbeing after the implementation of need-based care in nursing homes. However, it requires strong leadership and the use of well-considered implementation strategies including reflective practice

Oral adverse effects: drug-induced tongue disorders

© 2020 The Authors. Oral Diseases published by Wiley Periodicals LLC.Objectives: Due to a worldwide increase in drug consumption, oral healthcare professionals are frequently confronted with patients using one or more drugs. A large number of drugs can be accompanied with adverse drug reactions in the orofacial region, amongst others of the tongue. This paper aims to give an overview of drugs that are known to be accompanied with tongue disorders. Materials and methods: The national drug information database for Dutch pharmacists, composed of scientific drug information, guidelines and summaries of product characteristics, was analysed for drug-induced tongue disorders. “MedDRA classification” and “Anatomical Therapeutic Chemical codes” were used to categorize the disorders. Results: The database comprises of 1645 drugs of which 121 (7.4%) are documented to be accompanied with tongue disorders as an adverse effect. Drug-induced tongue disorders are predominantly observed in the following drug categories: “nervous systems,” “anti-infectives for systemic use” and “alimentary tract and metabolism”. The most common drug-induced tongue disorders are glossitis, tongue oedema, tongue discoloration and burning tongue. Conclusion: Healthcare professionals are frequently confronted with drugs that can cause tongue disorders. The overview of drugs reported in this article supports clinicians in their awareness, diagnosis and treatment of drug-induced tongue disorders