Subantimicrobial dose doxycycline as adjunctive treatment for periodontitis. A review

BACKGROUND: Subantimicrobial dose doxycycline (SDD--20 mg doxycycline twice daily) is indicated as an adjunctive treatment for periodontitis. Doxycycline downregulates the activity of matrix metalloproteinases (MMPs), key destructive enzymes in periodontal disease. Current understanding of periodontal pathogenesis suggests that MMPs play a major role in the destruction of periodontal tissues, leading to the clinical signs of periodontitis. Research supports that downregulation of MMPs by SDD confers benefit to patients with periodontitis. METHOD: We review the clinical, microbiological and safety data relating to the use of SDD in patients with periodontitis, and consider the historical events that led to the development of adjunctive SDD as a treatment for periodontitis. RESULTS: Studies have shown that SDD, when prescribed as an adjunct to scaling and root planing (SRP), results in statistically and clinically significant gains in clinical attachment levels and reductions in probing depths over and above those that are achieved by SRP alone. SRP must be thorough and performed to the highest standard to maximise the benefits of adjunctive SDD. SDD does not result in antibacterial effects, or lead to the development of resistant strains or the acquisition of multiantibiotic resistance. The frequency of adverse events is low, and does not differ significantly from placebo. CONCLUSIONS: Adjunctive SDD confers clinical benefit to patients with periodontitis. A comprehensive treatment strategy is suggested, involving patient education and motivation, reduction of the bacterial burden by SRP, host response modulation with SDD, and periodontal risk factor modification.     

表面水分和不同种类的手套对于硅橡胶印模材聚合时间的影响

目的:本文研究了表面水分和不同种类的手套对于硅橡胶印膜材料聚合时间的影响.方法:使用3种手套:一次性聚乙烯塑料薄膜手套,灭菌橡胶医用手套(无粉),以及橡胶检查手套(预撒粉),分别在潮湿和干燥环境下手动混合DENT SILICONE-PLUS重体型硅橡咬印模材,并记录其硬化时间.结果:干燥情况下使用塑料薄膜手套时,橡胶印模材聚合时间最短,平均2分10秒;乳胶材料和表面水分均可延长聚合时间,达到3～分钟时间;而预撒粉则可显著延长聚合时间,超过1小时.结论:临床运用硅橡胶制取印模时,建议使用一次性聚乙烯塑料薄膜手套在干燥环境下进行操作,预撒粉的橡胶检查手套必须更换,以避免操作失败.     

镇痛药物及其应用

镇痛药物是医生们进行疼痛治疗的重要工具。镇痛药物根据作用机制可分为阿片类镇痛药、非阿片类镇痛及辅助性镇痛药。阿片类镇痛药以吗啡、芬太尼等为代表药物,近来其他人工合成的可待因衍生物如羟可酮、氢可酮等也逐渐被用于临床。非阿片类镇痛药物主要包括非甾体类抗类药,其中环氧化酶-2抑制剂如塞来昔布等高选择抑制剂具有副作用较小的优点。此外氯胺酮、可乐定等非阿片类药物的镇痛作用近来也被重新研究和应用。辅助性镇痛药物以抗惊厥、抗精神病药物为主,对于阿片类药物不敏感的患者,可作为辅助用药。     

Pharmacology and clinical experience with tiagabine

Tiagabine (TGB), a recently approved anti-epileptic drug (AED), has a specific and unique mechanism of action involving the inhibition of γ-aminobutyric acid (GABA) re-uptake into neurones and glia. TGB is potent and has linear and predictable pharmacokinetics. It does not induce or inhibit hepatic metabolism and has no clinically significant effects on the serum concentrations of other AEDs or commonly used non-AEDs. Double-blind, placebo-controlled studies in primarily hepatic enzyme-induced patients showed that TGB 30 - 56 mg/day is an effective add-on treatment for all subtypes of partial seizures. The most common adverse effects in the trials were dizziness, asthenia (weakness), somnolence, accidental injury, infection, headache, nausea and nervousness. These side effects were usually mild to moderate in severity and generally did not require medical intervention. Long-term safety studies show continued efficacy of TGB over time and no evidence of tolerance for efficacy. Open studies confirm that patients with medically refractory partial epilepsy can be successfully converted to TGB monotherapy and that TGB may be effective for other seizure types, such as infantile spasms.     

手部多功能支具联合弹力手套在手部烧烫伤术后的康复治疗

目的探讨手部多功能支具联合弹力手套在手部烧烫伤术后康复中的临床疗效。方法2017年6月-2018年6月对手部烧烫伤术后住院治疗的40例患者,按1∶1的比例,随机分为观察组和对照组,分别予手部多功能支具联合弹力手套治疗和弹力手套治疗。于术后第3周(治疗前)、康复治疗12周后分别观察记录两组的明尼苏达手灵巧度测试(MMDT)、普渡钉板测验(PPBT)、疼痛程度评分(VAS),并在末次随访时,对手功能恢复情况进行总主动活动度(TAM)评定。结果两组均获得8~16周随访。治疗前两组基本资料及各观察指标比较,差异均无统计学意义(P>0.05)。治疗12周后,两组MMDT、PPBT、VAS评分均有明显改善,差异有统计学意义(P <0.05);组间比较显示,观察组的MMDT、PPBT、VAS评分改善均较对照组显著,差异均有统计学意义(P <0.05);末次随访时,观察组和对照组TAM评定优良率分别为95%和65%,差异有统计学意义(P <0.05)。结论手部多功能支具联合弹力手套治疗方案能有效预防手部烧烫伤术后软组织粘连、瘢痕增生及挛缩的发生,对术后恢复手部功能安全有效,值得临床推广应用。     

安全型无指硬底约束手套在防止患者术后拔管中的应用

目的：探讨安全型无指硬底约束手套对术后患者的约束效果。方法采用随机抽样的方法，将100例术后患者随机分为观察组（50例）和对照组（50例），分别应用安全型无指硬底约束手套及常用约束带对患者进行防护性约束。结果观察组患者拔管及并发症的发生率显著低于对照组（ P＜0．05、P＜0．01）。结论安全型无指硬底约束手套的防护性约束效果明显优于目前常用的约束带。