Objective: Diet interventions may reduce the risk of urinary stone formation and its recurrence, but there is no conclusive consensus in the literature regarding the effectiveness of dietary interventions and recommendations about specific diets for patients with urinary calculi. The aim of this study was to review the studies reporting the effects of different dietary interventions for the modification of urinary risk factors in patients with urinary stone disease. Materials and Methods: A systematic search of the Pubmed database literature up to July 1, 2014 for studies on dietary treatment of urinary risk factors for urinary stone formation was conducted according to a methodology developed a priori. Studies were screened by titles and abstracts for eligibility. Data were extracted using a standardized form and the quality of evidence was assessed. Results: Evidence from the selected studies were used to form evidencebased guideline statements. In the absence of sufficient evidence, additional statements were developed as expert opinions. Conclusions: General measures: Each patient with nephrolithiasis should undertake appropriate evaluation according to the knowledge of the calculus composition. Regardless of the underlying cause of the stone disease, a mainstay of conservative management is the forced increase in fluid intake to achieve a daily urine output of 2 liters. Hypercalciuria: Dietary calcium restriction is not recommended for stone formers with nephrolithiasis. Diets with a calcium content ≥ 1 g/day (and low protein-low sodium) could be protective against the risk of stone formation in hypercalciuric stone forming adults. Moderate dietary salt restriction is useful in limiting urinary calcium excretion and thus may be helpful for primary and secondary prevention of nephrolithiasis. A low-normal protein intake decrease calciuria and could be useful in stone prevention and preservation of bone mass. Omega-3 fatty acids and bran of different origin decreases calciuria, but their impact on the urinary stone risk profile is uncertain. Sports beverage do not affect the urinary stone risk profile. Hyperoxaluria: A diet low in oxalate and/or a calcium intake normal to high (800-1200 mg/day for adults) reduce the urinary excretion of oxalate, conversely a diet rich in oxalates and/or a diet low in calcium increase urinary oxalate. A restriction in protein intake may reduce the urinary excretion of oxalate although a vegetarian diet may lead to an increase in urinary oxalate. Adding bran to a diet low in oxalate cancels its effect of reducing urinary oxalate. Conversely, the addition of supplements of fruit and vegetables to a mixed diet does not involve an increased excretion of oxalate in the urine. The intake of pyridoxine reduces the excretion of oxalate. Hyperuricosuria: In patients with renal calcium stones SummaryNo conflict of interest declared. DOI: 10.4081/aiua.2015.2.105the decrease of the urinary excretion of uric acid after restriction of dietary protein and purine is suggested although not cle...
A 3‐month clinical trial was conducted to compare the effects of two concentrations of a chlorhexidine mouthrinse on gingivitis and plaque accumulation. Six hundred (600) adults were divided into three treatment groups matched for age, sex, and initial gingivitis severity. Following a thorough examination and prophylaxis at baseline, subjects were given a mouthrinse containing either 0.12% or 0.20% chlorhexidine gluconate or a placebo mouthrinse. Subjects were evaluated after 6 weeks and 3 months of mouthrinse use. After 3 months, both chlorhexidine groups showed significantly less gingivitis and plaque than the placebo group. The group using the 0.12% chlorhexidine gluconate mouthrinse demonstrated 27–27 % less gingivitis occurrence and 28–28% less gingivitis severity than the placebo group. The 0.12% chlorhexidine gluconate group also had 48–48% less gingival bleeding and 36% less plaque than the placebo group. There were no significant advantages for the 0.20% mouthrinse over the 0.12% mouthrinse. It is therefore concluded that a 0.12% chlorhexidine gluconate mouthrinse offers the same clinical benefits as a 0.20% chlorhexidine gluconate mouthrinse.
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