Pediatric dentistry and the child with asthma

A child with asthma who needs dental treatment, can be a source of concern to the pediatric dentist. Recent studies have provided a better understanding of the pathophysiology of asthma as well as the role of emotions in the expression of asthma. The goal in managing the patient with asthma is to prevent an acute asthmatic episode during the dental procedure. Suggestions are made to meet this goal. Asthma does not require alteration of routine dental practices and, most importantly, the well-managed child with asthma does not need special treatment when it comes to possible behavior problems in the dental office.     

Gastroenterological drugs and denture stomatitis

The aim of this study was to investigate the medical and dental variables related to the presence of denture stomatitis. The study population was comprised of 106 elderly people (82 women, 24 men; mean age, 81.3 years) using a maxillary complete denture and living in a geriatric nursing home in Oulu, Finland. The following variables were used in the analysis: medical diagnoses, which could have a possible biological association with stomatitis; daily use of drugs; ability to cope with everyday life; oral hygiene; and the condition of the denture. The prevalence of stomatitis was 52% among residents wearing complete dentures. Patients receiving gastroenterological drugs had less stomatitis (p = 0.01, chi-square). The results suggest a preliminary finding that older adults using gastroenterological drugs had less stomatitis .     

An Alternative Technique for an Accurate Implant-Retained Prosthesis Impression

A technique is described to help ensure the accurate reproduction of rigid implant components and the edentulous soft tissue. Splinted implant impression copings are luted together with resin to a specially designed custom tray.     

Gingival hyperplasia: a side effect of nifedipine and diltiazem

Currently, calcium channel blockers are being used increasingly for the treatment of hypertension in the elderly. Several case reports in the dental literature suggest that patients treated with the calcium channel blockers manifest gingival hyperplasia similar to that seen in patients taking phenytoin (Dilantin, Parke-Davis). A small study of 89 patients undertaken at the Westside Veterans Administration Medical Center, Chicago seems to indicate that nifedipine and diltiazem do indeed cause gingival hyperplasia. A total of 83% of the patients studied receiving nifedipine showed evidence of hyperplastic tissue and 74% of those on diltiazem were found to have hyperplastic tissue     

Alcohol consumption, cigarette sales and mortality in the United Kingdom: an analysis of the period 1970-1985

This paper examines official published statistics for various causes of death in the United Kingdom between 1970 and 1985. The variables selected were mainly those that had been linked to alcohol or cigarette use. In particular, changes in mortality due to acute myocardial infarction, cancer of trachea, bronchus and lung, cirrhosis of the liver and 'alcoholism' were found to be associated with each other. Changes in all of these were highly associated with changes in both alcohol consumption and cigarette sales. For most of the causes of death examined, correlations were higher for changes in the current year than they were for lagged data. Thus even chronic disorders related to prolonged heavy alcohol or tobacco use appear to be influenced rapidly by shifts in general levels of drinking and smoking.     

Adult body height and childhood socioeconomic group in the Swedish population.

Cross-sectional data from interviews of a sample of the Swedish population aged 16 to 74 years in 1980-81 were used to obtain information on the relation between father's socioeconomic status during the childhood of the participants and the adult body height of the latter. A difference in height between members of higher and lower socioeconomic groups was found. The difference diminished over falling age but was still noticeable among men born in the early and mid 1950s. The mean difference in height between sons of senior salaried employees and sons of unskilled workers was 2.9 cm. The difference was less for women.     

Characterization of central H2 receptors mediating cardiovascular activity by means of three histamine H2 receptor antagonists: MK-208, BMY-25368, and cimetidine in the rat

Stimulation of central histamine H₁ and or H₂ receptors with histaminergic drugs results in a dose-related pressor response and bradycardia in conscious, freely-moving rats. Two recently developed peripheral histamine H₂ antagonists, MK-208 and BMY-26368, as well as cimetidine, were evaluated with respect to their ability to block the cardiovascular actions of central histamine H₂ receptors. These drugs do not readily cross the blood brain barrier, therefore, they were administered intracerebroventricularly (i.c.v.). The ability of these agents to attenuate the cardiovascular effects of the H₂ agonist impromidine was studied in conscious, freely-moving rats. Blood pressure and heart rate were monitored directly via indwelling carotid catheters, and drugs were administered i.c.v. through permanently implanted cannulae. All of the H₂ antagonists tested induced a transient hypertensive response that lasted approximately 15 min. MK-208 (30 μg) partially blocked the central cardiovascular actions of impromidine. Unlike other histaminergic agents, MK-208 produced a tachycardia and a profound hyperactivity which slowly developed into seizures. BMY-25368 and cimetidine failed to antagonize the cardiovascular actions of impromidine. These results demonstrate that cimetidine and BMY-25368, established peripheral H₂ antagonists, did not block central H₂ receptors, suggesting that central and peripheral H₂ receptors may be pharmacologically distinct.     

Clinical pharmacokinetics: a simplified approach, Part 2

Part 1 of this two-part series in clinical pharmacokinetics (J Natl Med Assoc 1985; 77:475-482) introduced the clinician to the basic principles required for rational therapeutic drug management at the bedside. Practical problems were included that demonstrated how these principles could be put to clinical use.