Staphylococcus aureus Bacteremia in Patients with Hematological Malignancies and/or Agranulocytosis

ABSTRACT. A total of 6 253 cases of Staphylococcus aureus bacteremia, including 274 (4.4%) endocarditis cases, were registered in Denmark in the period 1975–1984. Patients with hematological malignancies and/or agranulocytosis accounted for 479 of the bacteremia cases. The incidence of endocarditis in this group of patients was only 0.4% as compared to 4.7% in other patients with staphylococcal bacteremia (p<0.01). The lower incidence of endocarditis complicating bacteremia in these patients may justify a shorter course of therapy than usually recommended for suspected endocarditis. Patients with hematological malignancies and other patients with agranulocytosis had a higher mortality (49 and 46%, respectively) than other patients with S. aureus bacteremia (33%). The highest mortality was found in patients with multiple myeloma (71%, p<0.01), the lowest in patients with acute lymphocytic leukemia (28%, p<0.01). The higher mortality in these patients may indicate that empiric antibiotic regimens in granulocytopenic patients should include a specific anti-staphylococcal agent.     

Pattern of periodontal breakdown in adult Tanzanians

Abstract – A total of 170 adult Tanzanians aged 30- 691 yr were examined for loss of attachment, gingival recession, plaque, calculus and gingival bleeding on all surfaces, of all teeth. The severity of loss of attachment varied considerably between tooth types. Irrespective of age, mandibular incisors and first and second molars were the teeth most affected by loss of attachment. In all age groups heavy plaque deposits and gingival bleeding occurred more frequently in posterior than in anterior teeth, Dental calculus was most frequently observed in the maxillary posterior and mandibular anterior teeth. The distribution of calculus within the dentition showed a close resemblance with the patterns of loss of attachment and gingival recession. The variation of the severity of periodontal breakdown within individuals indicates that the use of mean values to describe periodontal breakdown may give the impression of a greater uniformity than really exists.     

Replica patterns on composite restorations performed in vitro with different acid-etch procedures and dentin adhesives

Abstract — 160 experimental Class V restorations using two chemically cured composite resins were inserted in extracted human teeth wjth conventional and modified acid-etch restorative procedures. The modifications included cavity treatment with non-composite resin, ethanol, or four different dentin adhesives. Following deemineralization of the teeth the fillings were examined in the SEM cuncerning their replica patterns 01 the etched cavity walls. In vitro conditions favored resin penetration into pretreated cnarnel and dentin; but resulted in minor variations between diltrerent acid-etch procedures compared with those previously seen on resin restorations plawd in viva in teeth with vital pulps.     

Effect of ethanol and NPG-GMA on replica patterns on composite restorations performed in vivo in acid-etched cavities

Abstract 29 experimental Class V restorations using a chemically cured composite resin were inserted in human third molars in cavities which after acid-etching had been treated with absolute ethanol. After extraction and demineralization of the teeth, the fillings were examined in SEM concerning their enamel and dentin replica patterns on the inner cavity-faced surface. The SEM findings were compared with previous findings concerning the replica patterns on fillings from acid-etched cavities and from cavities which after acid-etching had been treated with an ethanol solution of the surface active comonomer N-phenylglycine-glycidyl methacrylate (NPG-GMA). It was found that cavity treatment with absolute ethanol further improved the increased enamel replica patterns obtained with the NPG-GMA/ethanol comonomer solution while only the NPG-GMA/ethanol treatment improved the dentin replica patterns. Based on these results the effect of each of the two main components in the comonomer solution on replica patterns on resin restorations could be disclosed.     

Caries experience in urban Tanzanian children 1973–84

Abstract – In 1973 and 1984 the caries status of 624 and 394 children, respectively, was recorded in an urban area of northern Tanzania where the water fluoride content was 2.0–3.5 ppm. Although slightly different scoring criteria were used, the data showed very low levels of caries, and little evidence of increases in caries experience over the 10-yr period. The distribution of caries lesions was markedly skewed, such that a minority of individuals accounted for most of the caries. The levels of caries were low by international standards and equivalent to those found in children from low fluoride areas of Tanzania.     

Tooth mortality and periodontal conditions in 60–80-year-old Chinese

Abstract — The study comprised 544 persons aged 60 yr or more from two urban Residential Areas and one rural village (including a nursing home) of Beijing area. Overall, the sample accounted for 81% of the total population of elderly aged 60 yr or more in the village/areas so defined. Each person was examined for dental status, plaque, calculus, gingivitis, loss of attachment, pocket depth and tooth mobility. Edentulousness was seen in 0–29% of trie persons examined, depending on age and sex. The mean number of teeth present ranged from 6.9 to 23.9, depending on age, sex, and area. The oral hygiene was poor; approximately 50% of all surfaces had immediately visible plaque deposits and calculus. About 50% of the surfaces had a loss of attachment ≥4 mm, while less than 15% presented pockets ≥4 mm. More than 50% of the individuals had loss of attachment ≥4 mm on more than 40% of their surfaces. The proportion of surfaces per person with loss of attachment ≥7 mm; and pockets ≥4 mm, respectively, showed a pronounced skewed distribution. These findings indicate that a subfraction of individuals is responsible for a substantial proportion of the severe periodontal breakdown leading to loss of teeth. This, in turn, raises important questions as to the most appropriate strategies for the prevention and control of periodontal diseases for the Chinese population.     

Compstatin, a peptide inhibitor of C3, prolongs survival of ex vivo perfused pig xenografts

Fiane AE, Mollnes TE, Videm V, Hovig T, Høgåsen K, Mellbye OJ, Spruce L, Moore WT, Sahu A, Lambris JD. Compstatin, a peptide inhibitor of C3, prolongs survival of ex vivo perfused xenografts. Xenotransplantation 1999; 6: 000-000 ©Munksgaard, Copenhagen Compstatin, a newly described C3-binding peptide, inhibits complement activation by blocking C3 convertase-mediated cleavage of C3. As the complement activation is an essential part of the rejection reaction, we evaluated the ability of Compstatin to delay or prevent hyperacute rejection in an ex vivo xenograft model. Porcine kidneys were perfused with fresh human blood containing either Compstatin (n=6) or a control agent (n=6). Graft survival and activation of complement, leukocytes and platelets both in the fluid phase and in the tissue were examined. The survival of the Compstatin-perfused kidneys (median, 380 min) was significantly (P=0.0036) longer than that of the controls (median, 90 min). The classical complement pathway (C1rs-C1inhibitor and C4bc) was significantly and equally activated in both groups during the first 60 min. C3 activation products increased fivefold and terminal complement complex eightfold in the control group, but no increase occurred in the Compstatin group during this period. Immunohistochemistry showed less C3 and fibrin deposition and immuno-electron microscopy showed less terminal SC5b-9 complement complex deposition in the Compstatin group. A significant change in total white cells, neutrophils, myeloperoxidase, and expression of the surface activation markers CD11b (CR3) and CD35 (CR1) and CD62 L ( l -selectin) was observed in both groups. Leukocyte activation was lower in the Compstatin group but the difference was not statistically significant. There were no differences in platelet counts, thrombospondin, soluble P-selectin or β-thromboglobulin between the groups. We conclude that Compstatin prolongs graft survival and suggest that it may be a useful agent for attenuating hyperacute rejection by inhibiting C3 and thus terminal complement pathway activation.     

Replica patterns on composite restorations performed in vivo with different acid-etch restorative procedures

Abstract 243 experimental Class V restorations using a chemically cured composite resin were inserted in human third molars with the conventional acid-etch restorative procedure and eight modifications of this technique. The teeth were extracted after 4 months and, following demineralization, the fillings were examined in SEM concerning their enamel and dentin replica patterns on the inner cavity faced surface. Results showed a significant correlation between the enamel replica patterns and the marginal adaptation of the restorations while the dentin replica patterns did not influence the in vivo adaptation. Furthermore it was found that the improved adaptation obtained by low viscous resin applied as an intermediary layer in etched cavities is due to fewer porosities in the restorative material interface with enamel and dentin. Beveling of preparations prevents stress-induced fractures of unsupported enamel prisms along the cavity periphery. Treatment of etched cavities with the surface active comonomer NPG-GMA increases the general interfacial contact between resin restoratives and cavity walls, and surface coating of finished and re-etched restorations fills up spaces created along cavity margins during the filling and finishing procedure.     

The longevity of different restorations in primary teeth

Background and aim.  This paper reviews three published papers and adds results from a fourth study which aimed to determine which restorative material would be the best alternative(s) to amalgam (AM) in primary teeth.
Design.  All studies had a practice-based design and were part of the routine treatment of children and adolescents. The clinicians were assigned which materials to use in a randomised matter in the first three studies which lasted for 7–8 years. In the fourth study conducted 4 years after the initial studies, the clinicians were free to select the restorative materials.
Results and conclusions.  Resin modified glass ionomer (RMGI) and compomer (COM) restorations showed similar longevity compared with AM, whereas conventional GI restorations showed significantly shorter longevity. The studies indicated that the 'new and improved' materials based on in vitro tests did not always show enhanced clinical properties. In the last study, where clinicians freely selected the restorative materials they used in their practices, seven used COM, one used conventional GI materials and one used a combination of the two types of material.