Oral health is influenced by oral microbial flora, which are concentrated in dental plaque. Dental plaque provides a microhabitat for organisms and an opportunity adherence of the to either tooth surface or other microorganisms. In critically ill patients, potential pathogens can be cultured from cavity. These microorganisms mouth translocate colonize lung, resulting ventilator-associated pneumonia. The importance care intensive unit has been noted literature, but little research available...

Background Ventilator-associated pneumonia is associated with increased morbidity and mortality. Objective To examine the effects of mechanical (toothbrushing), pharmacological (topical oral chlorhexidine), combination (toothbrushing plus chlorhexidine) care on development ventilator-associated in critically ill patients receiving ventilation. Methods Critically adults 3 intensive units were enrolled within 24 hours intubation a randomized controlled clinical trial 2 x factorial design....

• Background No data have been collected to describe the products, methods, and frequency of oral care needed reduce dental plaque, colonization, ventilator-associated pneumonia in critically ill patients. Objectives To use interventions reported by nurses several intensive units a large southeastern medical center. Methods Staff members completed written survey describing their practices, were recorded from unit’s flow sheet for previous 24 hours all patients at 5 randomly selected times...

Researchers measure biomarkers as a reflection of patient health status or intervention outcomes. While blood is generally regarded the best body fluid for evaluation systemic processes, substitution saliva samples would be less invasive and more convenient. The concentration specific may differ between saliva. objective this study was to compare multiple (27 cytokines) in plasma samples, passive drool filter paper 50 healthy adults. Demographic data three were obtained from each subject:...

Adherence of microorganisms to damaged heart tissue is a crucial event in the pathogenesis infective endocarditis. In present study, we investigated role FimA protein as potential virulence factor associated with Streptococcus parasanguis 36-kDa surface that recognized adhesin oral cavity where it mediates adherence salivary pellicle. An insertion mutant and deletion S. were employed rat model endocarditis determine relevance pathogenesis. Catheterized rats infected either fimA VT929, VT930,...

Streptococcus mutans produces several enzymes which metabolize sucrose. Three glucosyltransferase genes (gtfB, gtfC, and gtfD) a single fructosyltransferase gene (ftf) encode are important in formation of exopolysaccharides. Mutants S. V403 carrying multiple mutations the gtfB, gtfD, ftf recently have been constructed by allelic exchange our laboratory. Using selected strains from this panel mutants, we examined importance water-insoluble glucan, water-soluble fructan production...

Ventilator-associated pneumonia is a significant cause of morbidity and mortality may be influenced by oral health.To describe the relationship between ventilator-associated health status, changes in status during first 7 days after intubation, microbial colonization oropharynx trachea.A total 66 patients were enrolled within 24 hours intubation followed up for to days. Data on measures Clinical Pulmonary Infection Score (CPIS) collected at baseline, day 4 (n = 37), 21). A regression model...

This study assessed the effectiveness of a learner-centered simulation intervention designed to improve communication skills preprofessional sophomore nursing students. An innovative teaching strategy in which are taught students by using trained actors who served as standardized family members clinical learning laboratory setting was evaluated two-group posttest design. In addition current standard education, group received formal training session presenting framework for and 60-minute...

• Background Ventilator-associated pneumonia is a common complication of mechanical ventilation. Backrest position and time spent supine are critical risk factors for aspiration, increasing the pneumonia. Empirical evidence effect backrest positions on incidence ventilator-associated pneumonia, especially during ventilation over time, limited. Objective To describe relationship between elevation development Methods A nonexperimental, longitudinal, descriptive design was used. The Clinical...

Streptococcus mutans belongs to the viridans group of oral streptococci, which is leading cause endocarditis in humans. The LraI family lipoproteins streptococci and other bacteria have been shown function as virulence factors, adhesins, or ABC-type metal transporters. We previously reported identification S. operon, sloABCR, encodes components a putative uptake system composed SloA, an ATP-binding protein, SloB, integral membrane SloC, solute-binding lipoprotein, well metal-dependent...

Streptococcus sanguinis is one of the pioneers in bacterial colonization teeth and most abundant species oral biofilm called dental plaque. S. also common viridans group streptococcal implicated infective endocarditis. To investigate association endocarditis, we established a assay examined formation with signature-tagged mutagenesis library sanguinis. Four genes that have not previously been associated any other bacterium, purB, purL, thrB, pyrE, were putatively identified as contributing...

To describe the relationships among sedation, stability in physiological status, and comfort during a 24-hour period patients receiving mechanical ventilation.Data from 169 monitored continuously for 24 hours were recorded at least every 12 seconds, including sedation levels, status (heart rate, respiratory oxygen saturation by pulse oximetry), (movement of arms legs as measured actigraphy). Generalized linear mixed-effect models used to estimate distribution time spent various heart rates...

Agitation in critically ill adults is a frequent complication of hospitalization and results multiple adverse outcomes. Potential causes agitation are numerous; however, data on factors predictive limited.To identify predictors by examining demographic clinical characteristics patients.A medical record review was performed. Documentation indicated scores the Richmond Agitation-Sedation Scale or use an keyword. Records 200 patients from 1 surgical intensive care unit were used for study. Risk...

ABSTRACT Proteins belonging to the LraI (for “lipoprotein receptor antigen”) family function as adhesins in several streptococci, a virulence factor for endocarditis at least one of these species, and potentially metal transporters many bacteria. We have identified characterized chromosomal locus containing gene (designated sloC ) from Streptococcus mutans , an agent dental caries humans. Northern blot analysis indicated that is cotranscribed with three other genes. As operons, sloA sloB...

Streptococcus sanguinis is a gram-positive, facultative anaerobe and normal inhabitant of the human oral cavity. It also one most common agents infective endocarditis, serious endovascular infection. To identify virulence factors for signature-tagged mutagenesis (STM) was applied to SK36 strain S. sanguinis, whose genome being sequenced. STM allows large-scale creation, in vivo screening, recovery series mutants with altered virulence. Screening 800 by identified 38 putative avirulent 5...

To determine the feasibility of continuous measurement limb movement via wrist and ankle actigraphy (an activity measure) in critically ill patients to compare measurements with observed activity, subjective scores on sedation-agitation scales, heart rate blood pressure patients.In a prospective, descriptive, correlational study, all 20 adult medical coronary care units university center were for 2 hours documented. Wrist actigraphy, rate, systolic diastolic data collected every minute. The...

We used an isogenic mutant of Streptococcus mutans V403, which differs from the wild-type V403 in genes involved glucan and fructan production, to examine importance these exopolysaccharides as factors affecting infectivity endocarditis. Rats inoculated with developed endocarditis more frequently than animals strain produced neither nor (58% versus 12%, P < 0.01). In phagocytosis assays, both strains were found be associated human granulocytes but a greater number live organisms could...