PURPOSE:This study was performed to determine the physical and psychological effects of an urban forest-walking program for office workers. For many workers, sedentary lifestyles can lead to low levels of physical activity causing various health problems despite an increased interest in health promotion.

METHODS:Fifty four office workers participated in this study. They were assigned to two groups (experimental group and control group) in random order and the experimental group performed 5 weeks of walking exercise based on Information-Motivation-Behavioral skills Model. The data were collected from October to November 2014. SPSS 21.0 was used for the statistical analysis.

RESULTS:The results showed that the urban forest walking program had positive effects on the physical activity level (U=65.00, p<.001), health promotion behavior (t=-2.20, p=.033), and quality of life (t=-2.42, p=.020). However, there were no statistical differences in depression, waist size, body mass index, blood pressure, or bone density between the groups.

CONCLUSION:The current findings of the study suggest the forest-walking program may have positive effects on improving physical activity, health promotion behavior, and quality of life. The program can be used as an effective and efficient strategy for physical and psychological health promotion for office workers.

PURPOSE:Compression garments have been commonly used in a medical setting as a method to promote blood flow. Increases in blood flow during exercise may aid in the delivery of oxygen to the exercising muscles and, subsequently, enhance performance. The aim of the current study was to investigate the effect of wearing lower body compression garments during a cycling test.

METHODS:Twelve highly trained cyclists (mean± SD age 30 ± 6 y, mass 75.6 ± 5.8 kg, VO2peak 66.6 ± 3.4 mL · kg-1 · min-1) performed two 30-min cycling bouts on a cycle ergometer in a randomized, crossover design. During exercise, either full-length lower body compression garments (COMP) or above-knee cycling shorts (CON) were worn. Cycling bouts involved 15 min at a fixed workload (70% of VO2max power) followed by a 15-min time trial. Heart rate (HR) and blood lactate (BL) were measured during the fixed-intensity component of the cycling bout to determine the physiological effect of the garments. Calf girth (CG), thigh girth (TG) and perceived soreness (PS) were measured preexercise and postexercise.

RESULTS:COMP produced a trivial effect on mean power output (ES = .14) compared with CON (mean± 95% CI 1.3 ±1.0). COMP was also associated with a lower HR during the fixed-workload section of the test (-2.6% ± 2.3%, ES = -.38). There were no differences between groups for BL, CG, TG, and PS.

CONCLUSION:Wearing compression garments during cycling may result in trivial performance improvements of ~1% and may enhance oxygen delivery to the exercising muscles.

The current study investigated the effects of wearing whole-body compression garments (WBCGs) on prolonged high-intensity intermittent exercise (PHIIE) performance. Eight male team-sport athletes ([X +/- SD] 20.6 +/- 1.2 years; 72.9 +/- 5.9 kg; 57.5 +/- 3.7 ml.kg.min) completed a prescribed 45-minute PHIIE protocol on a nonmotorized treadmill in randomly assigned WBCG and control (typical soccer apparel) conditions. Subjects were given verbal and visual cues for movement categories, and they followed set target speeds, except when instructed of a variable run or sprint where the aim was to run as fast as possible. Total distance, velocity-specific distance, and high-intensity self-paced running speeds were taken as performance indicators. Heart rate, VO(2), tissue oxygenation index (TOI), and tissue hemoglobin index (nTHi) were continuously monitored across the protocol. Blood-lactate concentration ([BLa(-)]) was measured every 15 minutes. Magnitude-based inferences suggested that wearing WBCGs provided moderate strength likely improvements in total distance covered (5.42 +/- 0.63 vs. 5.88 +/- 0.64 km; 88:10:2%; and eta = 0.6) and low-intensity activity distance (4.21 +/- 0.51 vs. 4.56 +/- 0.57 km; 83:14:3%; and eta = 0.6) compared with the control. A similar likely increase was also observed in the average TOI of the WBCG condition (53.5 +/- 8.3% vs. 55.8 +/- 7.2%; 87:11:2%; and eta = 0.6). The current data demonstrated that wearing WBCGs likely increased physical performance, possibly because of improvements in muscle oxygenation and associated metabolic benefits. Therefore, wearing WBCGs during PHIIE may benefit the physical performance of team-sport athletes by likely metabolic changes within the muscle between high-intensity efforts.

Oxidative stress is an important factor which contribute to the pathogenesis of lesions in multiple sclerosis (MS). Whole body cryotherapy (WBCT) is often used in treatment neurological and orthopedic diseases.

THE AIM, MATERIAL AND METHODS: The aim of this study was to determinate the level of total antioxidative status (TAS) in plasma and activity of superoxide dismutase (SOD) and catalase (CAT) in erythrocytes of MS patients (n = 28) before and after 10 exposures of WBCT (-120 degrees C/3 minutes/day). 16 MS patients during 10 exposures of WBCT additionally were supplemented by 10 mg of melatonin.

RESULTS: Increasing of TAS level in plasma as well as supplemented with melatonin and non-supplemented MS patients was observed after 10 exposures of WBCT Melatonin statistically significant increased activity of SOD and CAT in erythrocytes of MS patients treated with WBCT.

CONCLUSIONS: Results of our study indicate significant increase of TAS level in plasma of MS patients of WBCT treatment. This indicate that WBCT might be a therapy which suppress oxidative stress in MS patients.

We evaluated the efficacy and safety of acupuncture for prevention of radiation pneumonitis in patients with lung cancer.Twenty-five patients were prospectively enrolled in this study and randomized to either intervention group or control group. The patients assigned to the intervention group received 15 minutes of acupuncture treatment twice a week. The patients assigned to the control group received RT alone without acupuncture treatment. The primary endpoint was incidence of radiation pneumonitis. The secondary endpoints were FEV1 (forced expiratory volume in 1 second), DLCO (diffusing capacity for carbon monoxide), 6-minute walk distance, and modified Borg scale.The intervention group showed lower incidences of grade 3 and grade≥2 radiation pneumonitis than the control group (10% vs 30% for grade 3 and 50% vs 60% for grade ≥2). In the control group, mean DLCO value was decreased from 62.1% at baseline to 49.1% after RT (= .004). The DLCO was also decreased after RT in the intervention group, but the decrement was not statistically significant (56.7% at baseline and 50.9% after RT,= .204). The FEV1 and 6-minute walk distance were decreased after RT in the control group. However, FEV1 and 6-minute walk distance were increased after RT in the intervention group.This study found that patients who received acupuncture treatment showed a lower incidence of radiation pneumonitis and a protective effect against aggravation of pulmonary function after RT in patients with lung cancer. To confirm the results of this study, well-designed randomized studies with large sample sizes will be required.

BACKGROUND:Cryotherapy using Wartner compound that contains a mixture of dimethyl ether (75%) and propane (25%) has been recently reported as an effective treatment for warts. The present study aimed to evaluate the safety and efficacy of Wartner in male patients with genital warts.

METHODS:A Phase II parallel-randomized clinical trial was performed on 16 Iranian men affected by genital warts who were referred to a dermatology clinic at Tehran University of Medical Sciences. Two genital warts of each patient were selected and randomly assigned to receive either Wartner (intervention) or liquid nitrogen (control).

RESULTS:Two weeks after the treatment, the sizes of the lesions in control and intervention groups decreased by 17.87 ± 2.14 mmand 15.81 ± 1.80 mm, respectively (p = .299). Fourteen days after a single session of treatment, 81% of lesions in the control group and 50% in the Wartner group were completely eradicated, however, the difference was not statistically significant (p = .063).

CONCLUSIONS:The Wartner compound is as effective as the conventional cryotherapy method for treating genital warts. It is particularly valuable when there are contraindications or no access to common treatment options.

OBJECTIVES: Knee osteoarthritis (OA) is a common chronic degenerative disorder. There are various treatment modalities. This study was planned to investigate the efficacy of balneotherapy, mud-pack therapy in patients with knee OA.

METHODS: A total of 80 patients with knee OA were included. Their ages ranged between 39-78. The patients were separated in to three groups. Group I (n=25) received balneotherapy, group II (n=29) received mud-pack therapy and group III (n=26) was hot-pack therapy group. The therapies were applied for 20 min duration, once a day, five times per week and a total of 10 session. Patients were assessed according to pain, functional capacity and quality of life parameters. Pain was assessed by using Visual Analogue Scale (VAS) and Western Ontario McMaster Osteoarthritis Index (WOMAC) pain scale (0-4 likert scale). Functional capacity was assessed by using WOMAC functional capacity and WOMAC global index. Quality of life was evaluated by Nottingham Health Profile (NHP) self-administered questionnaire. Also physician's global assessment and the maximum distance that patient can walk without pain, were evaluated. The assessment parameters were evaluated before and after three months.

RESULTS: There were statistically significant improvement in VAS and WOMAC pain scores in group I (p<0.001), group II and III (p<0.05). The WOMAC functional and global index also decreased in group I (p<0.05), group II (p<0.001) and hot-pack group (p<0.05). Quality of life results were significantly improved in balneotherapy and mud-pack therapy groups (p<0.05). No difference was observed in hot-pack therapy group (p>0.05). The maximum distance was improved both in group I and II (p<0.05) but not in group III. Also physician's global assessment was found to be improved in all groups (p<0.05).

CONCLUSIONS: Balneotherapy and mud-pack therapy were effective in treating patients with knee OA.

To evaluate the efficacy and safety of ketogenic diet (KD) in patients with Dravet syndrome (DS).60 DS patients receiving treatment of KD for more than 12 weeks from 2009 to 2018 were analyzed retrospectively. Modified Johns Hopkins protocol was used to initiate KD. Seizure frequency, electroencephalogram (EEG), cognition, language, and motor function of the patients were assessed. Side effects were monitored and adjusted accordingly. SPSS 23.0 software was used for all statistical analysis.In total, 60 DS patients (34 boys, 26 girls) received treatment of KD for more than 12 weeks, and among them 41 (68.3%) patients remained on the diet for more than 24 weeks, 22 (36.7%) patients for more than 48 weeks. Seizures in 35 patients (58.3%) were reduced by over 50% at 12 weeks, and the KD effect was observed within 2 weeks in most of them. At 24 weeks, 61.1% (25/41) of the patients had a>50% seizure reduction. At 48 weeks, 77.3% (17/22) had an over 50% reduction in their seizure frequency. With the treatment of KD in the 60 DS patients, 10 patients had ever been seizure free for 12 months to 24 months (The median duration was 20 months). In 10 KD-effective patients, the background rhythm of their EEG showed obvious improvement, and interictal epileptic discharges decreased significantly. Cognitive function of 22 patients was improved. Language progressed in 14 patients. Motor function was improved in 13 patients. The efficacy of KD in DS patients did not correlate with the seizure onset age, the starting age of KD treatment, themutation and the numbers of antiepileptic drugs combined with KD treatment. The main adverse reactions of KD in the treatment process were gastrointestinal symptoms and metabolic disorders.KD treatment in DS patients has many advantages, including working rapidly, being effective in more than half of the DS patients and tolerable adverse reactions. Pharmoco-resistant DS patients are suggested to receive KD treatment.

Migraine headaches, a common chronic medical problem, require prophylactic treatment when they are frequent and severe. This is the first study to investigate the efficacy of Kiko, a Japanese practice of Qigong that uses repetitive coordinated breathing and movement as a prophylactic treatment of migraine headaches. This pilot study, a single arm, non-randomized 4-month trial, investigated whether 3 months of Kiko training would reduce the severity and/or frequency of migraine and/or MIDAS scores. The baseline migraine data were collected from participants in the first month and then participants were taught Kiko exercises in 3 monthly sessions. Participants practiced at home and had the opportunity to utilize a Kiko DVD. The participants were instructed by Washin-Ryu style martial arts Master, Hidy Ochiai. Subjects completed monthly diaries that recorded the frequency and severity of their migraines, as well as the frequency and duration of their home Kiko practice. Six of the original 13 subjects completed the trial. All the individuals who completed the study had measurable improvement in their migraines. All participants reported a positive experience in learning the technique, and there were no reported adverse effects. Although the results of this study need to be confirmed in a larger clinical trial with adequate controls for placebo effects, these preliminary results are consistent with other trials that have documented the potential benefits of mind-body practices in controlling symptoms and improving the quality of life of patients suffering from chronic medical illness.

PURPOSE:To investigate the effects of supplementation with tart cherry juice (TCJ) on markers of recovery after intermittent exercise under habitual dietary conditions.

METHODS:Using a randomized, single-blind, placebo (PLA)-controlled, independent-groups design, 20 team-sport players (8 male and 12 female; age 26 [4] y, height 175.4 [9.6] cm, body mass 70.2 [12.6] kg) were divided equally into 2 groups and consumed either TCJ or PLA twice per day for 8 consecutive days while following their normal dietary habits. Participants completed an adapted version of the Loughborough Intermittent Shuttle Test (LIST) on day 6 of supplementation. Countermovement jump, 20-m sprint, maximal voluntary isometric contraction, and delayed onset muscle soreness were assessed at baseline and 1, 24, and 48 hours post-LIST. Blood markers of muscle damage (creatine kinase) and inflammation (C-reactive protein) were taken presupplementation, immediately pre-LIST, and 1, 24, and 48 hours post-LIST. Data were analyzed using a repeated-measures analysis of variance.

RESULTS:Countermovement jump, 20-m sprint, and maximal voluntary isometric contraction showed significantly faster recovery with TCJ (P<.05) at 24 and 48 hours post-LIST. A significant interaction effect (P<.05) was observed for muscle soreness; however, Bonferroni post hoc analysis could not identify when the significant differences between TCJ and PLA occurred. There were no significant differences throughout recovery between TCJ and PLA for C-reactive protein and creatine kinase (P<.05).

CONCLUSION:The results suggest that TCJ, in addition to habitual diet, can accelerate recovery after intermittent exercise and therefore extend the efficacy of TCJ in accelerating recovery in team sports.

The efficacy and safety of the application of essential oils for the prevention of acute respiratory diseases and alleviation of clinical manifestations of rhinitis was evaluated in a group of children aged 3-4 years. It was shown that inhalation of a mixture of essential oils resulted in a 42.5% decrease of the prevalence of the above pathologies. Specifically, they developed only in each third child from the group of frequently ill children. No side effects of the treatment were documented. 25% of the children suffered only from mild acute respiratory diseases, fever was absent in 5%. The severity and duration of the symptoms of rhinitis decreased in more than 80% of the children. Simultaneously, the requirement of decongestants and local (intranasal) antibiotics was reduced.

The term"ASIA-Autoimmune/inflammatory Syndrome Induced by Adjuvants"describes an umbrella of clinical conditions sharing similar signs or symptoms, including post-vaccination phenomena. No information is available on the epidemiology of the ASIA syndrome, especially following HPV vaccination. We carried out an analysis of the VAERS database to retrieve all cases of suspected ASIA syndrome according to the Shoenfeld and Agmon-Levin's guideline for the diagnosis. After causality assessment and case validation, 2,207 cases were considered probably or possibly related to vaccination. These represent the largest ASIA cohort ever reported and allowed us to estimate epidemiological and clinical characteristic of this syndrome. The commonest clinical manifestation observed were pyrexia (58%), myalgia (27%) and arthralgia or arthritis (19%), and the estimated reporting rate was of 3.6 cases per 100,000 doses of HPV vaccine distributed (95% CI 3.4-3.7). This study presents the first systematic estimation of ASIA incidence and expands the knowledge on this pathology. Further analyses are needed to identify genetic and non-genetic risk factors for ASIA syndrome.

Intestinal microbiota changes may be involved in the development of metabolic syndrome (MetS), which is a multicomponent disorder frequently associated with obesity. The aim of this study was to test the effect of consuming two healthy diets: a Mediterranean diet and a low-fat high-carbohydrate diet, for 2years in the gut microbiota of MetS patients and those in the control group. We analyzed the differences in the bacterial community structure between the groups after 2years of dietary intervention (Mediterranean or low-fat diet) through quantitative polymerase chain reaction using primers, targeting specific bacterial taxa. We observed, at basal time, that the abundance of Bacteroides, Eubacterium and Lactobacillus genera is lower in the control group than in MetS patients, while Bacteroides fragilis group, Parabacteroides distasonis, Bacteroides thetaiotaomicron, Faecalibacterium prausnitzii, Fusobacterium nucleatum, Bifidobacterium longum, Bifidobacterium adolescentis, Ruminococcus flavefaciens subgroup and Eubacterium rectale are depleted in MetS patients (all P values<.05). Additionally, we found that long-term consumption of Mediterranean diet partially restores the population of P. distasonis, B. thetaiotaomicron, F. prausnitzii, B. adolescentis and B. longum in MetS patients (all P values<.05). Our results suggest that the Mediterranean diet could be a useful tool to restore potentially beneficial members of the gut microbiota, although the stability of these changes over time still remains to be assessed.

PURPOSE:This study aimed to evaluate the effectiveness of Baduanjin exercise, which is a traditional Chinese Qigong exercise, in breast cancer survivors to assess its efficacy for physical and psychological rehabilitation.

METHODS:The study was a single-blinded randomized controlled trial. Eighty-six subjects were randomly assigned to the intervention (n = 46) or control (n = 40) groups. The intervention group received Baduanjin exercise 3 days/week at hospital and another 4 days/week at home for 6 months, whereas the control group were requested to maintain their original physical activity. Outcomes included body mass index (BMI), heart rate variability, lung capacity, arm circumference, shoulder range of motion, step test index, anxiety, depression, and quality of life (QOL).

RESULTS:After 6 months of intervention, heart rate variability and shoulder range of motion were significantly improved in the Baduanjin group compared to the control group (P < 0.05). There were also significant improvements in depression, QOL, and four QOL dimension scores (physical well-being, social well-being, functional well-being, and breast cancer subscale) (P < 0.05). However, there were no differences in the BMI, lung capacity, arm circumference, step test index, anxiety, and the emotional well-being QOL dimension scores.

CONCLUSION:Our findings indicate that Baduanjin is an effective intervention for improving physical and psychological health outcomes among breast cancer survivors, which is worth recommending and implementing by oncology nurses for breast cancer survivors during their long rehabilitation journeys.

OBJECTIVE:This pilot study is the first to examine the effects of an occupational therapist-led African drumming group on mental well-being among adult psychiatric inpatients with mood disorders.

METHOD:We used a quasi-experimental, uncontrolled, one-group, pretest-posttest design. We collected data for six different drumming groups (N = 13) using the Stellenbosch Mood Scale, the Primary Health Questionnaire-9, the Generalized Anxiety Disorder-7 scale, and the Enjoyment of Interaction Scale.

RESULTS:Participants significantly improved on all six domains of the Stellenbosch Mood Scale, with a large clinical effect. Participants with higher self-reported anxiety and depression benefited the most. According to the Enjoyment of Interaction Scale results, all the participants enjoyed the drumming"a great deal."

CONCLUSION:Our positive findings suggest that drumming may be an effective intervention for adults with acute mood disorders. We recommend further research that uses a control intervention.

OBJECTIVE: Synergy has been proposed between modalities operating at different levels of action. Acupuncture and craniosacral therapy are two very different modalities for which synergy has been proposed. This study sought to test for such synergy and to determine if complementary therapies would improve pulmonary function and quality of life for people suffering from asthma, as well as reducing anxiety, depression, and medication usage. DESIGN: Subjects were randomly assignment to one of five groups: acupuncture, craniosacral therapy, acupuncture and craniosacral, attention control, and waiting list control. METHODS: Subjects received 12 sessions of equal length with pretreatment and posttreatment assessment of pulmonary function, asthma quality of life, depression, and anxiety. Medication use was also assessed. RESULTS: Synergy was not demonstrated. When treatment was compared with the control group, statistically treatment was significantly better than the control group in improving asthma quality of life, whereas reducing medication use with pulmonary function test results remained the same. However, the combination of acupuncture and craniosacral treatment was not superior to each therapy alone. In fact, although all active patients received 12 treatment sessions, those who received all treatments from one practitioner had statistically significant reductions in anxiety when compared with those receiving the same number of treatments from multiple practitioners. No effects on depression were found. CONCLUSIONS: Acupuncture and/or craniosacral therapy are potentially useful adjuncts to the conventional care of adults with asthma, but the combination of the two does not provide additional benefit over each therapy alone.

The purpose of this study is to contribute to efforts to understand the pathophysiology of migraine and create an alternative perspective for prophylaxis and treatment of migraine attacks. Acupuncture treatment was applied to the 22 volunteer migraine patients. The acupuncture treatment consists of 5 sessions with 2 sessions per week. Blood samples have been collected before performing acupuncture, after the 1st session and after the 5th session of the acupuncture. And for the control group blood samples were collected only once. In our study the mean serum NO levels in healthy people were (3.58± 0.53) while patients with migraine group were (5.55 ± 0.70) respectively. Serum NO levels were 55% higher in migraine group compared to the control group. The NO concentration also decreased after 5th session (30%) (p<0.05). After the 1st sessions NO level decreased 4.86% in the migraine group. After the 5th session NO level decreased 30.63% in the migraine group. After the 5th session NO level decreased 27.08% compared to 1st session in the migraine group. After the 1st session of acupuncture treatment, level of NO in migraine group were 4.86% and it is reduced but statistically not significant. After the 5th acupuncture treatment serum NO levels were reduced to (3.85± 0.62) 30.63% in migraine group and were statistically lower (p<0.05). After the 5th session NO level decreased 27.08% compared to 1st session in the migraine group. In this study, acupuncture treatment is appeared to be effective by lowering the levels of serum NO and acupuncture has cumulative effects. Although there are earlier studies showing the effect of NO in migraine, this has been the 1st study in this field, which shows the effect of acupuncture on NO in migraine patients.

Low-income youth experience social-emotional problems linked to chronic stress that are exacerbated by lack of access to care. Drumming is a non-verbal, universal activity that builds upon a collectivistic aspect of diverse cultures and does not bear the stigma of therapy. A pretest-post-test non-equivalent control group design was used to assess the effects of 12 weeks of school counselor-led drumming on social-emotional behavior in two fifth-grade intervention classrooms versus two standard education control classrooms. The weekly intervention integrated rhythmic and group counseling activities to build skills, such as emotion management, focus and listening. The Teacher's Report Form was used to assess each of 101 participants (n = 54 experimental, n = 47 control, 90% Latino, 53.5% female, mean age 10.5 years, range 10-12 years). There was 100% retention. ANOVA testing showed that intervention classrooms improved significantly compared to the control group in broad-band scales (total problems (P<.01), internalizing problems (P<.02)), narrow-band syndrome scales (withdrawn/depression (P<.02), attention problems (P<.01), inattention subscale (P<.001)), Diagnostic and Statistical Manual of Mental Disorders-oriented scales (anxiety problems (P<.01), attention deficit/hyperactivity problems (P<.01), inattention subscale (P<.001), oppositional defiant problems (P<.03)), and other scales (post-traumatic stress problems (P<.01), sluggish cognitive tempo (P<.001)). Participation in group drumming led to significant improvements in multiple domains of social-emotional behavior. This sustainable intervention can foster positive youth development and increase student-counselor interaction. These findings underscore the potential value of the arts as a therapeutic tool.

BACKGROUND:The aim of this study was to analyse the effect of pomegranate juice (POM) supplementation on the levels of selected pro-inflammatory cytokines, hepcidin and markers of iron metabolism in well-trained rowers.

METHOD:The double-blind placebo-controlled study included 19 members of the Polish Rowing Team. The athletes were randomised into the supplemented group (n = 10), receiving 50 ml of standardised POM daily for two months, or the placebo group (n = 9). The subjects performed a 2000 m test on the rowing ergometer at the start of the project (baseline) and end of follow-up period. Blood samples from the antecubital vein were obtained three timesduring each trial: prior to the exercise, one minute after the test, and following a 24 h recovery.

RESULTS:The study documented the beneficial effect of supplementation with pomegranate fruit juice on TAC (P < 0.002). During the resting period, TAC level in the supplemented group was significantly higher than in the placebo group (x ± SD, 2.49 ± 0.39 vs. 1.88 ± 0.45, P < 0.05). The ergometric test conducted at baseline demonstrated a significant post-exercise increase in the concentrations of soluble transferrin receptors (P < 0.04), iron (P < 0.002) and IL-6 (P < 0.02), and to a significant post-exercise decrease in TAC. A significant increase in IL-6 concentration was also observed 24 h post-exercise. The exercise test conducted at the end of the follow-up period resulted in a significant decrease in TBIC and a significant increase in UIBC (P < 0.001), observed in both groups, both immediately post-exercise and after the resting period.

CONCLUSION:Supplementation with POM contributed to a significant strengthening of plasma antioxidant potential in the group of well-trained rowers, but had no effect on iron metabolism markers.

BACKGROUND: The objective of this study was to assess the oral microbiota and clinical data in subjects without access to traditional oral hygiene methods and who ate a diet available in the Stone Age.

METHODS: Ten subjects living in an environment replicating the Stone Age for 4 weeks were enrolled in this study. Bleeding on probing (BOP), gingival and plaque indices, and probing depth (PD) were assessed at baseline and at 4 weeks. Microbiologic samples were collected at the mesio-buccal subgingival aspects of all teeth and from the dorsum of the tongue and were processed by checkerboard DNA-DNA hybridization methods.

RESULTS: No subject had periodontitis. Mean BOP decreased from 34.8% to 12.6% (P <0.001). Mean gingival index scores changed from 0.38 to 0.43 (not statistically significant) and mean plaque scores increased from 0.68 to 1.47 (P <0.001). PD at sites of subgingival sampling decreased (mean difference: 0.2 mm; P <0.001). At week 4, the total bacterial count was higher (P <0.001) for 24 of 74 species, including Bacteroides ureolyticus, Eikenella corrodens, Lactobacillus acidophilus, Capnocytophaga ochracea, Escherichia coli, Fusobacterium nucleatum naviforme, Haemophilus influenzae, Helicobacter pylori, Porphyromonas endodontalis, Staphylococcus aureus (two strains), Streptococcus agalactiae, Streptococcus anginosis, and Streptococcus mitis. Bacterial counts from tongue samples were higher at baseline (P <0.001) for 20 species, including Tannerella forsythia (previously T. forsythensis), Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans; serotype a), and Streptococcus spp.

CONCLUSIONS: The experimental gingivitis protocol is not applicable if the diet (e.g., Stone Age) does not include refined sugars. Although plaque levels increased, BOP and PD decreased. Subgingival bacterial counts increased for several species not linked to periodontitis, whereas tongue bacterial samples decreased during the study period.