BACKGROUND & AIMS: :Oral tolerance, an important feature of the mucosal immune system, appears to protect against immune-mediated disease by blunting production of systemic IgG and IgM antibody directed toward immunogens chronically present at mucosal surfaces. In this study, we explored the role of oral tolerance and mucosal immunoregulation in an experimental model of IgA nephropathy (IgAN), an important form of nephritis in humans. Cyclophosphamide and estradiol were used to inhibit the expression of oral tolerance, which otherwise develops after chronic oral presentation of Ag. BALB/c mice given drinking water containing 0.1% bovine gamma globulin (BGG) continuously for 14 wk were randomly assigned to groups given either 2 mg of cyclophosphamide i.p., 2 mg of estradiol s.c. or both drugs. Groups of control mice received neither BGG nor drugs. In three separate experiments, a low percentage of saline-treated orally immunized mice had microscopic hematuria (0 to 20%), as did nonimmunized controls (0 to 20%). However, 58 to 83% of mice given estradiol and/or cyclophosphamide at appropriate times developed significant hematuria. If drugs were given at suboptimal times, only 25 to 56% of mice developed hematuria. Drug-treated immunized mice also had more serum IgG and IgM anti-BGG antibodies than control and saline groups. Immunofluorescence showed significantly more glomerular deposits of IgG, IgM, and C3 in drug-treated immunized mice compared to saline-treated immunized and normal untreated control mice. Hematuria and glomerular deposits of IgG, IgM, and C3 paralleled serum IgG and IgM antibody. All immunized mice showed significant mesangial IgA and BGG deposits and there were no differences in such deposits between saline- and drug-treated immunized mice. We suggest that blunting of oral tolerance with promotion of systemic IgG and IgM antibody production leads to nephritis in chronically orally immunized mice and that glomerular immune complexes containing IgG and/or IgM promote complement deposition and hematuria in IgAN. Analogous defects in oral (or more generally mucosal) tolerance could play a role in the genesis of symptomatic human IgAN.

背景与目标： ：口腔耐受是粘膜免疫系统的一个重要特征，它似乎通过减弱针对长期存在于粘膜表面的免疫原的全身性IgG和IgM抗体的产生，来保护自身免受免疫介导的疾病的侵害。在这项研究中，我们探讨了口服耐受性和粘膜免疫调节在IgA肾病（IgAN）（一种人类肾炎的重要形式）实验模型中的作用。环磷酰胺和雌二醇被用来抑制口腔耐受性的表达，否则这种耐受性会在长期口服Ag后发展。连续14周连续喝含0.1％牛γ-球蛋白（BGG）的饮用水的BALB / c小鼠被随机分为两组，分别给予2 mg环磷酰胺i.p.，2 mg雌二醇s.c.或同时使用这两种药物。对照组小鼠既不接受BGG也不接受药物。在三个独立的实验中，经盐水处理的经口免疫小鼠中有低百分比的患者出现镜下血尿（0％至20％），而未免疫的对照小鼠则为0％至20％。但是，在适当的时间接受雌二醇和/或环磷酰胺的小鼠中有58％至83％出现了明显的血尿。如果在最适时的时间使用药物，则只有25％到56％的小鼠会出现血尿。药物治疗的免疫小鼠也比对照组和生理盐水组具有更多的血清IgG和IgM抗BGG抗体。免疫荧光显示与盐水处理的免疫小鼠和正常未处理的对照小鼠相比，在药物处理的免疫小鼠中IgG，IgM和C3的肾小球沉积明显更多。血尿和IgG，IgM和C3的肾小球沉积物与血清IgG和IgM抗体平行。所有免疫的小鼠均显示出明显的系膜IgA和BGG沉积物，并且在盐水和药物处理的免疫小鼠之间，此类沉积物没有差异。我们建议通过口服全身免疫的小鼠促进全身性IgG和IgM抗体产生的口服耐受性减退会导致肾炎，而含有IgG和/或IgM的肾小球免疫复合物会促进IgAN中的补体沉积和血尿。口腔（或更常见的粘膜）耐受性的类似缺陷可能在有症状的人类IgAN的发生中起作用。

BACKGROUND & AIMS: :This study aimed to clarify the effectiveness of post-operative oral care, including tooth brushing, denture cleaning and tongue cleaning, after digestive tract surgery. Subjects included 30 elderly patients aged 60-98 years (74.9 +/- 7.8 years) who underwent digestive tract surgery. Subjects were randomly divided into an intervention group and a control group. In the intervention group, the following oral care was provided daily over a 5-min period in the morning starting at baseline (day of surgery) and continued for 5 days: gargling with povidone iodine, tooth brushing, denture cleaning using a special brush and tongue cleaning using a tongue brush. In the control group, the subjects only gargled with povidone iodine. We compared the following variables between the two groups at baseline and 5 days later: the sensation of dry mouth, intra-oral gas concentration, pulmonary sounds, body temperature and bacterial flora. The number of patients with abnormal pulmonary sounds (dry or moist rales) increased from 1 to 2 in the intervention group and from 0 to 4 in the control group (P < 0.05). The average number of bacterial species per subject for the control group was 3.64 +/- 1.34 pre-operatively and 3.50 +/- 1.74 post-operatively, whereas that for the intervention group was 3.08 +/- 0.95 pre-operatively and 2.62 +/- 0.65 post-operatively. In the intervention group, there was a significant decrease in the number of bacterial species (P < 0.05). These findings indicate that post-operative oral care in elderly patients undergoing digestive tract surgery lowers the number of bacterial species found in the oral cavity. This effect, in turn, might improve respiratory function.

背景与目标： ：这项研究旨在阐明消化道手术后口腔清洁的有效性，包括刷牙，义齿清洁和舌头清洁。受试者包括接受消化道手术的30位年龄在60-98岁（74.9 /-7.8岁）的老年患者。将受试者随机分为干预组和对照组。在干预组中，每天从基线（手术日）开始，在每天的5分钟内，每天进行以下口腔护理，并持续5天：用聚维酮碘漱口，刷牙，使用专用刷子清洁义齿和使用舌刷清洁舌头。在对照组中，受试者仅含聚维酮碘。我们在基线和5天后比较了两组之间的以下变量：口干的感觉，口内气体浓度，肺音，体温和细菌菌群。在干预组中，肺音异常（干音或湿音）的患者数量从1增加到2，对照组从0增加到4（P <0.05）。对照组术前平均细菌种类为3.64 /-1.34，术后为3.50 /-1.74，而干预组术前为3.08 /-0.95，术后为2.62 /-0.65。操作上。在干预组中，细菌种类的数量显着减少（P <0.05）。这些发现表明，接受消化道手术的老年患者的术后口腔护理降低了在口腔中发现的细菌种类的数量。反过来，这种效果可能会改善呼吸功能。

BACKGROUND & AIMS: :Passive immunity against gastrointestinal infections has recently been successfully applied as prophylaxis and therapy in patients in a variety of virally and bacterially induced infections. Campylobacter jejuni is frequently associated with acute diarrhoea in humans, and several species of animals have been shown to transmit the disease, although birds have been implicated as the main source of infection. We used bovine and chicken immunoglobulin preparations from the milk and eggs, respectively, of immunized animals for prophylactic and therapeutic treatment of chickens infected with C. jejuni. A marked prophylactic effect (a >99% decrease in the number of bacteria) was noted using either antibody preparation, whereas the therapeutic efficacy, i.e. when antibodies were given after the infection was established, was distinctly lower (80-95%) as judged by faecal bacterial counts. These observations may serve as a starting point for experiments aimed at elimination of the infection in an industrial or farm setting. It may also encourage future attempts to treat, prophylactically or therapeutically, patients with Campylobacter-induced diarrhoea.

背景与目标： ：最近，针对胃肠道感染的被动免疫已成功应用于各种病毒和细菌引起的感染的预防和治疗中。空肠弯曲菌常与人类急性腹泻有关，尽管鸟类被认为是主要的感染源，但已显示出几种动物可传播这种疾病。我们分别使用免疫动物的牛奶和鸡蛋中的牛和鸡免疫球蛋白制剂对空肠弯曲杆菌感染的鸡进行预防和治疗。两种抗体制剂均具有显着的预防作用（细菌数量减少> 99％），而判断的治疗效果（即在感染确定后给予抗体）则明显较低（80-95％）通过粪便细菌计数。这些观察结果可作为旨在消除工业或农场感染的实验的起点。它还可能鼓励将来尝试预防性或治疗性弯曲杆菌引起的腹泻患者。

BACKGROUND & AIMS: :Darier disease is an uncommon genodermatosis reflecting defective desmosomal structure and function. The present report details the oral features of a patient with well-characterized Darier disease and reviews current knowledge of the genetic basis of this genodermatosis that can often affect the craniofacial tissues.

背景与目标： ：Darier病是一种罕见的遗传性皮肤病，反映了桥粒结构和功能的缺陷。本报告详细介绍了特征明确的Darier病患者的口腔特征，并回顾了这种遗传皮肤病的遗传基础的当前知识，这种遗传皮肤病通常会影响颅面组织。

BACKGROUND & AIMS: :Oral cancer is a neoplasm with some known causes. Proliferation genes are significant among its few pathogenetic and prognostic factors. Calcyclin is a cell-cycle-related gene, the function of which is still unclear. Its expression and that of Haras and histone-H3 have been investigated in an assessment of their pathogenetic role in squamous cell carcinoma. RNA extracted from the pathological and normal mucosa of patients with squamous cell carcinoma (SCC) and benign lesions was reverse transcribed and amplified by the polymerase chain reaction (PCR). The expression of all three genes in the pathological mucosa was enhanced in SCC only. This suggests that they may be involved in its pathogenesis and provides another parameter for the differentiation of malignant and benign lesions.

背景与目标： ：口腔癌是一种具有某些已知原因的肿瘤。增生基因在其少数致病和预后因素中很重要。钙环蛋白是与细胞周期相关的基因，其功能尚不清楚。为了评估它们在鳞状细胞癌中的致病作用，已经研究了它的表达以及Haras和组蛋白H3的表达。从鳞状细胞癌（SCC）和良性病变的病理和正常粘膜中提取的RNA通过聚合酶链反应（PCR）进行逆转录和扩增。仅在SCC中，病理黏膜中所有三个基因的表达均得到增强。这表明它们可能参与其发病机理，并为区分恶性和良性病变提供了另一个参数。

BACKGROUND & AIMS: :Spherical pellets containing theophylline, calcium acetate and microcrystalline cellulose were extruded and spheronized, before being coated with six different pectins or alginates by interfacial complexation. The aim of this study was to discover the effect of the coatings on physico-mechanical properties that will be crucial in determining the pellets' utility as sustained release systems. An insoluble, smooth and uniformly thick coat of calcium polysaccharide was formed around the core pellets. A factorial experiment was designed to investigate the effect of pellet size and polysaccharide type and concentration on the entrapment efficiency, mechanical properties and other physical characteristics. Coated pellets were observed by scanning electron microscopy and, depending on the particular polysaccharide used, the dry coats were found to be 30-80 microm thick. The size of pellet, the type and concentration of polysaccharide influenced the yield of theophylline in the coated pellets. Although the mechanical properties of the pellets were improved by applying any of the gel coats, use of an alginate with a high content of guluronic acid or an amidated pectin coating gave the best results. This is probably because both of these have significant potential to form very stable cross-links within the gel coats.

背景与目标： 将含有茶碱，乙酸钙和微晶纤维素的球形小球挤出并滚圆，然后通过界面复合将六种不同的果胶或藻酸盐包被。这项研究的目的是发现包衣对物理机械性能的影响，这对于确定微丸作为缓释系统的用途至关重要。在核心药丸周围形成了不溶的，光滑且均匀厚的钙多糖涂层。设计了析因实验，以研究颗粒大小，多糖类型和浓度对包封效率，机械性能和其他物理特性的影响。通过扫描电子显微镜观察包衣的小丸，并且根据所使用的特定多糖，发现干衣的厚度为30-80微米。药丸的大小，多糖的类型和浓度影响了包衣药丸中茶碱的产量。尽管通过施加任何凝胶包衣可以改善粒料的机械性能，但是使用具有高含量古洛糖醛酸的藻酸盐或酰胺化果胶包衣的效果最佳。这可能是因为这两者都具有在凝胶涂层内形成非常稳定的交联的巨大潜力。

BACKGROUND & AIMS: Etoposide produces reversible inhibition of topoisomerase II, leading to cleavage of DNA, and thereby has an antitumor effect. This mechanism suggests that the longer treatment is continued, the greater the antitumor effect will be. In the present study, both therapeutic and adverse effects of long-term treatment with low-dose oral etoposide were studied in 29 patients aged > or = 65 years with non-Hodgkin's lymphoma (NHL) for whom standard chemotherapy was not effective or refractory. These patients received etoposide at a dose of 50 mg/d for as long as possible. Treatment was continued until white blood cell count decreased to < or = 2,000/microL or the platelet count decreased to < or = 5 x 10(4)/microL. According to the World Health Organization (WHO) criteria of therapeutic effects, 6 (20.7%) of the 29 patients achieved complete remission and 13 patients (44.8%) had partial remission, for a response rate of 65.5%. Adverse effects of > or = grade 3 included leukopenia in 24 patients (82.8%) and anemia in 7 (24.1%). Granulocyte colony-stimulating factor (G-CSF) was given in combination with etoposide to eight patients because of leukopenia (granulocyte count < or = 1,000/microL). In view of the excellent subjective tolerance, low incidence of serious adverse effects, and good activity, single agent oral etoposide given continuously over prolonged periods represents a useful treatment for elderly patients with NHL.

背景与目标： 依托泊苷产生对拓扑异构酶II的可逆抑制，导致DNA裂解，因此具有抗肿瘤作用。该机制表明持续的治疗时间越长，抗肿瘤作用越大。在本研究中，对29岁年龄≥65岁的非霍奇金淋巴瘤（NHL）患者进行了长期低剂量口服依托泊苷的治疗，并对其不良反应进行了研究，这些患者对于标准化疗均无效或难治。这些患者尽可能长时间接受依托泊苷50 mg / d的剂量。继续治疗直至白细胞计数降低至<或= 2,000 / microL或血小板计数降低至<或= 5 x 10（4）/ microL。根据世界卫生组织（WHO）的疗效标准，在29例患者中有6例（20.7％）完全缓解，13例（44.8％）部分缓解，缓解率为65.5％。 ≥3级的不良反应包括24例白细胞减少症（82.8％）和7例贫血（24.1％）。由于白细胞减少症（粒细胞计数<或= 1,000 / microL），与依托泊苷联合给予了粒细胞集落刺激因子（G-CSF）与依托泊苷。鉴于出色的主观耐受性，严重不良反应的发生率低和良好的活动性，长时间连续给予单剂口服依托泊苷代表了对老年NHL患者的一种有效治疗方法。

BACKGROUND & AIMS: Tumour cells at the invasive front of carcinomas have been found to differ substantially from the rest of tumour cells in a variety of human cancers. The present multivariate survival analysis of 94 oral squamous cell carcinomas (OSCCs) revealed that both the argyrophilic nucleolar organizer regions-associated protein (AgNOR) content of invading tumour cells and a multiparametric histopathological tumour front grade were significantly and independently associated with tumour-related death, irrespective of conventional Broders' grade and clinical stage of the tumours. High tumour front scores and AgNOR content at the invasive OSCC front thus seem to reflect increased malignant potential. Proliferative activity, assessed by standardized AgNOR analysis, most probably represents one of the biological features underlying the usefulness of evaluating the invasive tumour front.

背景与目标： 已经发现，在多种人类癌症中，处于癌症侵袭性前沿的肿瘤细胞与其余肿瘤细胞有很大的不同。目前对94例口腔鳞状细胞癌（OSCC）的多因素生存分析表明，侵袭性肿瘤细胞的嗜银性核仁组织者区域相关蛋白（AgNOR）含量和多参数组织病理学肿瘤前沿均与肿瘤相关死亡显着且独立相关，与常规Broders的肿瘤分级和临床分期无关。因此，在侵袭性OSCC前沿，较高的肿瘤前沿评分和AgNOR含量似乎反映出恶性潜能的增加。通过标准化AgNOR分析评估的增殖活性很可能代表了评估侵袭性肿瘤前沿有用性的生物学特征之一。

BACKGROUND & AIMS: OBJECTIVES:To describe the prevalence of oral diseases and their impact on oral-health-related quality of life in people with severe mental illness undertaking community-based psychiatric care. METHODS:A survey was conducted at eight outpatient psychiatric care clinics in Tower Hamlets, London, UK. One hundred and twelve consecutive patients with mental illness were invited to participate in this study. They were clinically examined and asked to complete the oral health impact profile (OHIP) questionnaire. RESULTS:The response rate was 79% (n = 89); 57 (64%) males and 58 persons over 45 years of age (65%) participated in this survey. Overall OHIP score was 25.4 (95% CI 23.3, 27.4), 70 (78%) were smokers and 45 (51%) had been to the dentist in the last two years. Forty-seven (53%) respondents had caries in at least one tooth, 60 (67%) had 21 teeth and more, and 14 (16%) used dentures. Advanced periodontal treatment was indicated in 42 (55%) of patients and 52.8% (n = 47) patients reported current pain. CONCLUSION:Overall, this survey found that oral health has a great impact on patients with severe mental illness being treated in the community setting and their oral health is poorer than the national adult general population. Future research should consider the causes that relate to the poorer oral health in this population and potential health promotion mechanisms in this population to encourage an upstream approach to health.

背景与目标： 目的：描述在进行基于社区的精神病治疗的重度精神疾病患者中口腔疾病的流行及其对口腔健康相关生活质量的影响。
方法：在英国伦敦塔哈姆雷特市的八家门诊精神病诊所进行了一项调查。连续邀请112名精神疾病患者参加这项研究。对他们进行了临床检查，并要求他们填写口腔健康影响资料（OHIP）调查表。
结果：回应率为79％（n = 89）；男性（57％）（64％）和58岁以上的58人（65％）参加了这项调查。 OHIP总体得分为25.4（95％CI 23.3、27.4），吸烟者70（78％）和最近两年去牙医的45（51％）。 47名（53％）的被调查者的至少一颗牙齿上有龋齿； 60（67％）的人有21颗及以上的牙齿，以及14颗（16％）的假牙。 42名（55％）患者表示进行了牙周治疗，目前有疼痛的患者占52.8％（n = 47）。
结论：总体而言，该调查发现，口腔健康对在社区环境中接受治疗的严重精神疾病患者有很大影响，并且其口腔健康状况比全国成年人口人群差。未来的研究应考虑与该人群口腔健康较差的原因以及该人群中潜在的健康促进机制，以鼓励采用上游健康方法。

BACKGROUND & AIMS: :Oral squamous cell carcinoma (OSCC) is a growing global public health problem for which standard therapeutic strategies have failed to contribute significantly to improve the survival rates that have remained around 50% over the past three decades. Therefore, there is a pressing need for new therapeutic strategies. Curcumin is a natural dietary compound with known anti-neoplastic activities, hence its classification as a nutraceutical agent. This review presents the current in vitro and in vivo studies in which curcumin has been examined for its anti-cancer potential in treating OSCC. Its mechanisms of action are also beginning to become unveiled. The available studies have been focusing on the impact of curcumin on epithelial malignant cells, but overlooking the components of the tumor microenvironment. Curcumin has been emerging as a promising therapeutic agent in oral cancer, either alone or in combination with standard therapeutic agents, and will probably become of practical use once its route of administration has overcome its poor bioavailability.

背景与目标： ：口腔鳞状细胞癌（OSCC）是一个日益严重的全球性公共卫生问题，对于该问题，标准的治疗策略未能显着提高其存活率，在过去的三十年中，其存活率一直保持在50％左右。因此，迫切需要新的治疗策略。姜黄素是一种具有已知抗肿瘤活性的天然饮食化合物，因此被归类为营养药物。这篇综述介绍了目前的体外和体内研究，其中姜黄素已被检测出其在治疗OSCC中的抗癌潜力。其作用机制也开始被揭示。现有的研究集中在姜黄素对上皮恶性细胞的影响上，但忽略了肿瘤微环境的组成部分。姜黄素已经单独或与标准治疗剂结合起来成为口腔癌中有希望的治疗剂，一旦其给药途径克服了其不良的生物利用度，姜黄素可能会变得实用。

BACKGROUND & AIMS: This multicenter, open-label, third-party-masked trial compared the efficacy and safety of itraconazole oral solution (200 mg once daily) and clotrimazole troches (10 mg five times daily) in a population of immunocompromised subjects composed primarily of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Patients were treated for 14 days; patients who exhibited a clinical response were followed up for an additional month to document the occurrence of relapse. Efficacy was judged by changes from baseline in symptoms of oropharyngeal candidiasis (erythema, soreness/burning), extent of oral lesions, and the presence/absence of Candida species on fungal culture. A total of 162 patients were randomized, and 149 were evaluated for efficacy. The percentage of patients with negative cultures at the end of treatment was significantly greater in the itraconazole group than in the clotrimazole group (60% vs 32%, respectively). Negative culture plus clinical response was achieved in significantly more itraconazole-treated patients (53%) than clotrimazole-treated patients (30%); results were similar in the subgroup of patients with HIV/AIDS. Both drugs were well tolerated, with the most frequently reported adverse events for both agents involving the gastrointestinal system. In conclusion, systemic therapy with intraconazole oral solution is efficacious and well tolerated in immunocompromised patients, including those with HIV/AIDS, when administered once daily for 14 days for the treatment of oral candidiasis.

背景与目标： 这项多中心，开放标签，第三方掩盖的试验在主要由人类患者组成的免疫功能低下人群中比较了伊曲康唑口服溶液（每天200 mg）和克霉唑锭剂（每天10 mg，五次）的疗效和安全性。免疫缺陷病毒（HIV）/后天免疫缺陷综合症（AIDS）。患者接受了14天的治疗；表现出临床反应的患者需要再随访一个月，以记录复发的发生。通过口咽念珠菌病的症状（红斑，酸痛/灼烧），口腔病变的程度以及真菌培养物中是否存在念珠菌，从基线的变化来判断疗效。总共162例患者被随机分组​​，并评估149例疗效。伊曲康唑组治疗结束时培养阴性的患者百分比显着高于克霉唑组（分别为60％和32％）。伊曲康唑治疗的患者（53％）比克霉唑治疗的患者（30％）获得了阴性培养和临床反应。 HIV / AIDS患者亚组的结果相似。两种药物均具有良好的耐受性，两种药物均涉及胃肠道系统，是最常见的不良事件。综上所述，使用康康唑口服液进行全身治疗对于免疫功能低下的患者（包括艾滋病毒/艾滋病患者）有效，并且耐受性良好，每天口服一次，持续14天，可治疗口腔念珠菌病。

BACKGROUND & AIMS: :Non-compliance with oral self-care recommendations, despite education and motivation, is a major problem in preventive dentistry. Forming concrete if-then action plans has been successful in changing self-care behavior in other areas of preventive medicine. This is the first trial to test the effects of a brief planning intervention on interdental hygiene behavior. Two hundred thirty-nine participants received a packet of floss, information, and a flossing guide. They were randomly assigned to a control or an intervention group. The intervention took 1.16 minutes and consisted of forming a concrete plan of where, when, and how to floss. Baseline measures and two-week and two-month follow-ups included self-report, residual floss, and theory of planned behavior variables. The intervention significantly affected flossing in that group at two-week and two-month follow-ups, as compared with the control group. This study provides evidence for the effects of a concise intervention on oral self-care behavior.

背景与目标： ：尽管有教育和动机，但仍未遵守口腔自我保健的建议，是预防牙科的主要问题。制定具体的“如果-则-则”行动计划已成功地改变了其他预防医学领域的自我保健行为。这是第一个测试简短的计划干预对牙齿间卫生行为影响的试验。 239名参与者收到了一包牙线，信息和牙线指南。他们被随机分配到对照组或干预组。干预过程花了1.16分钟，包括制定何时何地，何时以及如何使用牙线的具体计划。基线测量以及两周和两个月的随访包括自我报告，残留牙线和计划的行为变量理论。与对照组相比，干预在两周和两个月的随访中显着影响了该组的牙线剔除。这项研究为简洁干预对口腔自我护理行为的影响提供了证据。

BACKGROUND & AIMS: Kayexalate (Roxane Labs, Columbus, OH) in sorbitol is commonly administered by the oral and rectal route for the treatment of hyperkalemia in patients with renal failure. It is believed to have minimal toxicity because it functions as a cation exchanger and is not absorbed. We herein report on a patient who developed identical serpiginous ulcers in the stomach and the terminal ileum after the use of Kayexalate. We believe that this drug could have significant gastrointestinal toxicity in specific patient groups and suggest tentative guidelines, both for the identification of such patients and for the safer use of Kayexalate in these circumstances.

背景与目标： 山梨糖醇中的Kayexalate（Roxane Labs，俄亥俄州哥伦布）通常通过口服和直肠途径给药，用于治疗肾衰竭患者的高钾血症。据信它具有最小的毒性，因为它起阳离子交换剂的作用并且不被吸收。我们在此报道了使用开塞利酸盐后在胃和末端回肠中发展出相同的锯齿状溃疡的患者。我们认为，这种药物在特定的患者群体中可能具有明显的胃肠道毒性，并建议采用临时性指导原则，以用于识别此类患者以及在这种情况下更安全地使用Kayexalate。

BACKGROUND & AIMS: BACKGROUND:Oral immunotherapy, if proven safe and effective, could be an alternative to subcutaneous immunotherapy. OBJECTIVE:This pilot study investigated the clinic and immunologic effects of ragweed immunotherapy using a new microencapsulated, pH-sensitive, oral delivery system. METHODS:A double-blind, placebo-controlled trial was conducted in 23 patients with allergic rhinitis to short ragweed. Following a baseline nasal challenge with ragweed allergen, oral immunotherapy with encapsulated short ragweed extract or placebo was administered once daily, 6 days/week. Dosed began at 3 micrograms Amb a 1 per day and were increased by 3 micrograms every three days as tolerated, to a maximum daily maintenance dose of 24 micrograms. A nasal challenge was repeated 6 weeks, later, followed by the continuation of maintenance therapy through the natural ragweed season. Daily allergy symptoms and relief medication usage was recorded. A final nasal challenge was performed at the end of the natural season. Short ragweed-specific serum IgE, IgG, and IgG4 antibody levels were measured every 2 weeks during the study. RESULTS:Maximum tolerated doses ranged from 6 to 24 micrograms Amb a 1 per day (74% reached 24 micrograms). Adverse events were not serious or different between the active and placebo groups. The active group showed increased in short ragweed-specific serum IgG and IgG4 antibody levels. Symptom scores during the natural season were numerically but not statistically lower in the active treatment group. This group also experienced a greater reduction from baseline in nasal reactivity as assessed by nasal challenge. CONCLUSIONS:These pilot data suggest that the encapsulated, pH-sensitive oral immunotherapy delivery system was safe, induced a brisk serologic response, and attenuated the symptomatic response to both experimental and environmental ragweed exposure.

背景与目标： 背景：口服免疫疗法如果被证明是安全有效的，则可以替代皮下免疫疗法。
目的：这项初步研究调查了豚草免疫疗法使用新型微囊化，pH敏感，口服给药系统的临床和免疫学作用。
方法：对23名短豚草过敏性鼻炎患者进行了一项双盲，安慰剂对照试验。用豚草变应原进行鼻腔基线攻击后，每天一次，6天/周一次用胶囊化的短豚草提取物或安慰剂进行口服免疫治疗。剂量从每天3微克Amb a 1开始，并在耐受的情况下每三天增加3微克，最大每日维持剂量为24微克。六周后重复一次鼻刺激，然后在天然豚草季节继续进行维持治疗。记录每日过敏症状和缓解药物使用情况。在自然季节结束时进行最后的鼻挑战。在研究期间，每2周测量一次豚草特异性血清IgE，IgG和IgG4抗体水平。
结果：最大耐受​​剂量为每天6至24微克Amb a 1（74％达到24微克）。积极组和安慰剂组之间的不良事件并不严重或没有差异。活性组显示短豚草特异性血清IgG和IgG4抗体水平升高。在活跃的治疗组中，自然季节的症状评分在数值上没有统计学上的降低。通过鼻激发评估，该组的鼻反应性也比基线有更大的降低。
结论：这些试验数据表明，这种封装的，对pH敏感的口服免疫疗法递送系统是安全的，可诱导轻度的血清反应，并减弱对豚草和实验豚草暴露的症状反应。

BACKGROUND & AIMS: :This study aimed to investigate the prevalence of oral health impact on daily performance in Brazilian adults. 276 civil servants 35 to 44 years of age from the Public Works and Waste Disposal Department of Porto Alegre, in southern Brazil, were interviewed and clinically examined. Oral Impacts on Daily Performance (OIDP) was used to evaluate the impact of oral health status on daily performance. 73.6% of all subjects had at least one daily performance affected by an oral impact in the previous six months. The most commonly affected performance was eating (48.6%), while the most common symptoms were discomfort (40.6%) and dissatisfaction with one's appearance (31.5%). Missing teeth (21.7%) and toothache (20.7%) were recognized as the main causes of oral impacts on daily performance. OIDP was useful for measuring (physically, psychologically, and socially) the oral impacts on daily performance.

背景与目标： ：这项研究旨在调查巴西成年人口腔健康对日常工作表现的影响。来自巴西南部阿雷格里港公共工程和废物处理部门的276名35至44岁的公务员接受了采访并进行了临床检查。口腔对日常工作的影响（OIDP）用于评估口腔健康状况对日常工作的影响。在过去的六个月中，有73.6％的受试者每天至少有一次受口头影响的表现。影响最普遍的表现是进食（48.6％），而最常见的症状是不适（40.6％）和对外表的不满意（31.5％）。牙齿缺失（21.7％）和牙痛（20.7％）被认为是口腔影响日常工作的主要原因。 OIDP可用于（从身体，心理和社交方面）评估口腔对日常工作的影响。