Mediterranean diet: a potential player in the link between oral microbiome and oral diseases

Background: The oral microbiome is a complex and dynamic assemblage of microorganisms that colonize different sites of the oral cavity maintaining both oral and systemic health. Therefore, when its composition is altered, oral diseases occur. Among oral inflammatory pathologies, periodontal diseases affect the tissues surrounding the teeth, representing the main cause of tooth loss and one of the most important threats to the oral health. Lifestyle and eating habits influence the composition of the human oral microbiota and the development and progression of oral diseases. In this context, the Mediterranean Diet (MD) model, comprising both healthy dietary choices and lifestyle, is linked to the prevention of several metabolic and chronic-degenerative pathological processes, including oral diseases. Indeed, the MD is a plant-based diet, enriched of anti-inflammatory and antioxidant nutrients, which may induce beneficial effects against dental caries and periodontal diseases. Aim: This review summarizes the role of the oral microbiome in the development of the oral diseases and the potential of MD in modulating the oral microbiome leading to implications for oral health. Conclusions: The data collected highlight the need to promote the MD pattern along with the correct hygiene habits to prevent the development of oral diseases

Vestibular rehabilitation in older adults with and without mild cognitive impairment: Effects of virtual reality using a head-mounted display

Purpose: Due to the gap in the knowledge in the field of vestibular rehabilitation the purpose of this randomized study is to highlight the outcomes of head-mounted display (HMD)implementation in older adults and patients with mild cognitive impairment (MCI), suffering from unilateral vestibular hypofunction (UVH). Materials and methods: Vestibulo-ocular reflex (VOR)gain, postural sway examination and dizziness-related and quality of life scores were collected in 12 UVH elderly and 12 UVH subjects suffering from MCI only undergoing vestibular rehabilitation and in 11 UVH elderly and 12 UVH subjects suffering from MCI undergoing a home-based HMD + vestibular rehabilitation protocol. Results: Although the within-subjects analysis found in all groups a significant (p < 0.05)improvement in posturography parameters and dizziness-related and quality of life scores and no changes in VOR gain, implementation of HMD demonstrated a significant (p < 0.05)increase in post-treatment between-group comparisons in the same tests and VOR gain with respect to those older adults and participants with MCI only undergoing vestibular rehabilitation. Positive correlations were discovered between Mini-Mental Score Exam values and pre-/post-treatment differences in (i)power spectra values in the low-frequency interval (r = 0.72)and in (ii)Dynamic Gait Index scores (r = 0.76). Conclusions: This study demonstrates that the implementation of a home-based virtual reality protocol may be a safe option in order to ameliorate VOR, postural control and the quality of life also in the vestibular impaired patients in whom the presence of cognitive decline could hinder the achievement of the goal of rehabilitation

Degree of functional impairment associated with vestibular hypofunction among older adults with cognitive decline

Objective:Considering the altered multisensory signal compensation during senescence, the aim of the present study was to evaluate the integration rearrangements in unilateral vestibular hypofunction (UVH) during age-related cognitive decline.Study Design:Cross-sectional study.Setting:Longitudinal cohort study unit and of University tertiary referral center.Patients:Older UVH individuals 55 years with Mild Cognitive Impairment (MCI) or Alzheimer Disease (AD) and matched UVH control group with age-appropriate cognitive function.Intervention:Vestibulo-ocular reflex, postural sway examination (respectively performed by means of video head impulse test and static posturography), and dizziness-related and quality of life scores were collected in all three groups of UVH patients cognitively evaluated by means of Mini Mental State Examination and Alzheimer's Disease Assessment Scale (ADAS-cog).Main Outcome Measures:Vestibulo-ocular reflex gain, length, surface, and spectral values of body oscillation were measured. Dizziness Handicap Inventory, Activities-specific Balance Confidence scale, and Dynamic Gait Index scores were collected.Results:A significant (p<0.05) increase in surface and length values during both eyes closed and eyes open conditions was found when comparing scores for AD to both MCI and control group patients, respectively. These patients demonstrated significantly (p<0.05) lower spectral values of body oscillation on posturography platform in both eyes closed and eyes open condition within the low-frequency interval than MCI and AD patients.Conclusion:This is the first study reporting an association between cognitive decline and posturography parameters with possible preventive clinical implications in evaluating the risk for falls in high-risk patients, such as older adults with common neuro-otological disorders

Vaccinations and chronic diseases: Knowledge, attitudes, and self-reported adherence among patients in Italy

The aims of this cross-sectional survey were to evaluate the knowledge, attitudes, and self-reported adherence to recommended vaccinations among a random sample of patients with chronic conditions presenting for a medical visit in out-patient clinics in Italy. Patients who were healthcare workers (HCWs), those with diabetes, those who had received information by Internet, physicians, and friends/relatives, and those who needed more information were more likely to know that the influenza vaccine is recommended for patients with chronic diseases. More than half (58.2%) and 8.9% self-reported to have received at least one recommended vaccination and more than one, respectively. Patients who believed that vaccine-preventable diseases (VPDs) were dangerous for them, those who had received information by physicians, and those who needed information were more likely to have received at least one recommended vaccination. This behavior was less likely in married patients, those who were worried about the side effects of the vaccines, and those who suffered from renal failure. The results highlight the need to implement effective vaccination programs in order to decrease the complication of VPDs in at-risk population

Role of the Insula and Vestibular System in Patients with Chronic Subjective Dizziness: An fMRI Study Using Sound-Evoked Vestibular Stimulation

Chronic subjective dizziness (CSD) is a common vestibular disorder characterized by persistent non-vertiginous dizziness, unsteadiness, and heightened sensitivity to motion stimuli that may last for months to years after events that cause acute vestibular symptoms or disrupt balance. CSD is not associated with abnormalities of basic vestibular or oculomotor reflexes. Rather, it is thought to arise from persistent use of high-threat postural control strategies and greater reliance on visual cues for spatial orientation (i.e., visual dependence), long after triggering events resolve. Anxiety-related personality traits confer vulnerability to CSD. Anomalous interactions between the central vestibular system and neural structures related to anxiety may sustain it. Vestibular- and anxiety-related processes overlap in the brain, particularly in the insula and hippocampus. Alterations in activity and connectivity in these brain regions in response to vestibular stimuli may be the neural basis of CSD. We examined this hypothesis by comparing brain activity from 18 patients with CSD and 18 healthy controls measured by functional magnetic resonance imaging during loud short tone bursts, which are auditory stimuli that evoke robust vestibular responses. Relative to controls, patients with CSD showed reduced activations to sound-evoked vestibular stimulation in the parieto-insular vestibular cortex (PIVC) including the posterior insula, and in the anterior insula, inferior frontal gyrus, hippocampus, and anterior cingulate cortex. Patients with CSD also showed altered connectivity between the anterior insula and PIVC, anterior insula and middle occipital cortex, hippocampus and PIVC, and anterior cingulate cortex and PIVC. We conclude that reduced activation in PIVC, hippocampus, anterior insula, inferior frontal gyrus, and anterior cingulate cortex, as well as connectivity changes among these regions, may be linked to long-term vestibular symptoms in patients with CSD. Furthermore, altered connectivity between the anterior insula and middle occipital cortex may underlie the greater reliance on visual cues for spatial orientation in CSD patients relative to controls

Situational crime prevention and Public Safety Canada’s crime-prevention programme

This study examines the work undertaken by Canada’s National Crime Prevention Centre (NCPC) under the auspices of the Public Safety Canada. NCPC operates with a social development approach to preventing crime, focussing largely on small pilot projects that work with at-risk youth. We suggest that this is a rather narrow definition of crime prevention and that it may not necessarily be an optimal strategy for all crime preventions in Canada. In particular, many international crime and safety organizations suggest the need for integrated approaches in crime prevention. In addition, there is an array of evidence-based situational crime prevention (SCP) strategies from which Canada might benefit. SCP has a history of success in designing out a wide range of crimes from credit card fraud to car theft and burglary. It is proposed that, at minimum, a more inclusive crime-prevention programme that incorporates SCP would produce a significant net benefit to the safety of Canadians