Comparison of three representative subjective evaluations of chewing function

In 2018, oral hypofunction was registered officially as a disease in Japan. It is important to detect oral hypofunction symptoms early in patients, before frank oral dysfunction symptoms occur. Subjective evaluations of chewing function, which help to identify foods that cannot be chewed, might be useful in diagnosing oral hypofunction. Previous evaluations used to identify patients with oral hypofunction used varying standards, making it impossible to compare and integrate them without first developing a unified screening method. This study aimed to compare and integrate known evaluation methods that are useful for diagnosing oral hypofunction. A total of 76 elderly participants （aged ＞65 years） were enrolled after providing consent to participate in this study. The established subjective evaluation methods of chewing function investigated for this study included the Yamamoto denture performance judgment table, the Sato table for evaluation of chewing function in complete denture wearers, and the Hirai evaluation method for the masticatory function in complete denture wearers. As the Yamamoto method lacks scoring, the total number of circles was used as the score. A time study was performed on the time taken for the description, entry, and analysis of these tables. There was a strong correlation between the Sato and Hirai methods （r＝0.71） and between the Sato and Yamamoto （r＝0.68） and Hirai and Yamamoto （r＝0.60） methods. During the time study, the description time was the shortest with the Yamamoto method, and the entry and analysis times were the shortest with the Sato method. The total time was significantly shorter with the Sato method than with the Yamamoto method. Three evaluation methods showed correlation, but the examination times varied. In future studies, we plan to clarify the selection criteria, including the relevance of objective evaluation and usability

Acute megakaryoblastic leukemia, unlike acute erythroid leukemia, predicts an unfavorable outcome after allogeneic HSCT

Acute erythroid leukemia (FAB-M6) and acute megakaryoblastic leukemia (FAB-M7) exhibit closely related properties in cells regarding morphology and the gene expression profile. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered the mainstay of the treatment for both subtypes of leukemia due to their refractoriness to chemotherapy and high rates of relapse, it remains unclear whether allo-HSCT is curative in such cases due to their scarcity. We retrospectively examined the impact of allo-HSCT in 382 patients with M6 and 108 patients with M7 using nationwide HSCT data and found the overall survival (OS) and relapse rates of the M6 patients to be significantly better than those of the M7 patients after adjusting for confounding factors and statistically comparable with those of the patients with M0/M1/M2/M4/M5 disease. Consequently, the factors of age, gender, performance status, karyotype, disease status at HSCT and development of graft-vs.-host disease predicted the OS for the M6 patients, while the performance status and disease status at HSCT were predictive of the OS for the M7 patients. These findings substantiate the importance of distinguishing between M6 and M7 in the HSCT setting and suggest that unknown mechanisms influence the HSCT outcomes of these closely related subtypes of leukemia. © 2016 Elsevier Ltd.Embargo Period 12 month

Associations between Oral Hypofunction Tests, Age, and Sex

Oral function declines in older individuals due to disease and age-related changes, making them vulnerable to oral and physical frailty. Therefore, it is important to manage the decline in oral function in older outpatients. Oral hypofunction is diagnosed by seven tests related to oral function, oral hygiene, oral moisture, occlusal force, oral diadochokinesis, tongue pressure, masticatory function, and swallowing function. However, sex or age were not factored into the current reference values of these tests. We included subjects attending the dental hospital clinic for maintenance, and recorded and analyzed oral hypofunction and the factors associated with its diagnosis. Of the 134 outpatients (53 males and 81 females, mean age 75.2 ± 11.2 years), 63% were diagnosed with oral hypofunction. Oral hypofunction prevalence increased significantly with age, and significant variations were observed in all tests. Furthermore, oral hygiene and swallowing function were not associated with oral hypofunction diagnosis. All examined factors decreased with increasing age, even after adjusting sex, except for oral hygiene and moisture. Occlusal force and masticatory function were higher in men after adjusting age. This study suggested that older outpatients were likely to be diagnosed with oral hypofunction, and that the test reference value and their selection for oral hypofunction should be reconsidered