Removal of extrinsic stain using a 7.0% sodium hexametaphosphate dentifrice: a randomized clinical trial

A nine-week, randomized and controlled clinical trial was conducted to compare the stain removal efficacy of a 0.243% sodium fluoride dentifrice containing 7% sodium hexametaphosphate (5% hexametaphosphate anion) to that of a 0.243% sodium fluoride control dentifrice. Following prophylaxis and a three-week pre-treatment period to induce extrinsic stain, healthy adult volunteers with tooth stain were randomized to the sodium hexametaphosphate dentifrice or the control. Stain area and intensity were assessed at baseline, three and six weeks. At both three and six weeks, the sodium hexametaphosphate dentifrice was statistically significantly superior to the control for all overall stain measures (p < 0.04). After six weeks of product usage, the sodium hexametaphosphate dentifrice demonstrated reductions of 29% in composite stain, 24% in stain intensity, and 25% in stain area relative to the control. Significant reductions in composite stain were seen on both gingival and body regions for the sodium hexametaphosphate dentifrice versus the control at three and six weeks. Both products demonstrated favorable safety profiles, as determined by oral soft tissue evaluations and recording of subject-reported adverse events.     

An Exploratory Study of Canadian Aboriginal Online Health Care Forums

Internet-based discussion forums provide access to health information and social support, and serve as a resource for others. This investigation analyzed health-oriented Aboriginal Internet discussion forum (Forum A; Forum B) conversations. The findings were framed with Nutbeam's model of health literacy. Discussions within Forum B were centralized around issues of political activism and advocacy regarding Aboriginal health care. Activity in Forum A encouraged the development of “virtual” social capital, with health care discussions providing a “just-in-time” model for health education. Members of Forum A functioned as a smoking cessation self-help group and as health educators. The Internet provided a venue for the dissemination of health information and also served as a virtual voice for lifestyle coaching, political action, community building, and advocacy.     

Measure patient harm in real time

A California healthcare system incorporates clinical information technology to mine data for adverse events.     

Sleep disorders in breast cancer survivors

Purpose

The purpose of this study was to evaluate the feasibility, acceptability, and initial results of a structured assessment of sleep disorders in breast cancer survivors (BCS). Our goal was to determine whether the assessment could be easily used and whether it would capture problems suggestive of one or more underlying sleep disorders that require referral to a specialist for diagnostic validation through polysomnography and appropriate specialty treatment.

Methods

A cross-sectional, feasibility study using convenience sampling.

Results

A total of 38 BCS completed the study. Recruitment procedures were adequate in finding eligible BCS, however, procedures used to establish possible patterns of sleep disorders (e.g., interview) were not feasible for screening for sleep disorders in the clinical setting due to the time it took to complete each interview. A total of seven sleep disorder categories were identified in the data with the majority of women having at least one possible sleep disorder.

Conclusions

Study findings suggest that population-based screening for sleep disorders in clinical practice should be a priority for BCS reporting chronic sleep problems.

     

Factors of an unfavorable prognosis in patients with B-cell chronic lymphoid leukemia: a retrospective analysis of 206 cases

AIM: To assess factors of an unfavourable prognosis in a group of intermediate risk of B-cell chronic lymphoid leukemia (BCCLL). MATERIAL AND METHODS: 206 BCCLL patients (mean age 55.5 years, male/female = 1.66) entered the study conducted by Hematological Research Center in 1992-2000. RESULTS: Nine patients under 35 years of age did not survive 5 years except one female who achieved a complete remission on fludarabin. The type of bone marrow infiltration (diffuse vs interstitial and nodular), the time of lymphocyte count doubling (under or over 12 months) discriminate the patients by prognosis in the group of intermediate risk: medians of overall survival 65 months vs 148 months and 72 vs 133 months, respectively (p < 0.005 for both curves, log-rank criterion). Survival medians in groups with low (< 50% cells) and high (> 50% cells) expression of CD38+ cells in the group of intermediate BCCLL risk comprise 55 and 106 months (p = 0.005). The type of bone marrow infiltration and time of doubling of lymphocyte count overlap: > 70% patients with a diffuse type of bone marrow infiltration have the time of doubling under 12 months and vice versa while expression of CD38 do not overlap with these values. Combination of two signs (type of bone marrow infiltration and CD38 expression or time og lymphocyte count doubling and CD38 expression) allows more precise identification of prognostically unfavourable groups. Medians of survival for combination of the first two signs (two positive against two negative) comprise 51 months vs 169 months (p < 0.0001), for combination of the latter two signs 55 months vs 106 months was not reached (p < 0.001). Although most patients with a tumor form of BCCLL are referred to stage II, the prognosis in this form is much worse than in stage II, survival medians are 44 and 69 months, respectively (p < 0.05). A mutation status of the genes of a variable region of immunoglobulins enable identification of the group of patients with a relatively benign course of BCCLL (survival medians 61 and 289 months, p < 0.0001). CONCLUSION: In patients under 35 years of age BCCLL runs unfavourably and seems to require intensive polychemotherapy. Usage of a combination of the signs (CD38, time of doubling of lymphocyte count and type of bone marrow infiltration) is a simple and reliable method of identification of prognostically different categories of patients in the group of an intermediate BCCLL risk. Prognosis in patients with a tumor form of BCCLL is unfavourable: medians of survival in patients with a tumor form and stage III-IV are comparable. Mutational status of the genes of immunoglobulin variable region may serve a marker of a long-term prognosis.     

Potential limitations of presumed consent legislation

A causal link has been proposed between presumed consent (PC) and increased donation; we hypothesized that too much heterogeneity exists in transplantation systems to support this inference. We explored variations in PC implementation and other potential factors affecting donation rates. In-depth interviews were performed with senior transplant physicians from 13 European PC countries. Donation was always discussed with family and would not proceed against objections. Country-specific, nonconsent factors were identified that could explain differences in donation rates. Because the process of donation in PC countries does not differ dramatically from the process in non-PC countries, it seems unlikely that PC alone increases donation rates.     

Online conversations among Ontario university students: Environmental concerns

As the 'next generation' guardians of the environment, there appears to be limited inquiry into young Canadians' environmental concerns. At the same time, online social networking is a predominant method of communication among young adults. This research explored online conversations regarding environmental concerns among young Canadian adults targeting the university student population. A qualitative content analysis was conducted using posted conversations from the online social media network Facebook. Conversations addressing environmental issues were summarized into four major themes. The first theme, 'Built Environment' (127 postings) centred on housing and transportation. The second theme, 'Natural Environment' (55 postings) accounted for issues of air quality, pollution and water quality. The third theme, 'Environmental Restoration' (52 postings) highlighted young Canadian adults' plans for environmental recovery. The fourth theme, 'Engagement and Activism' (31 postings) underscored students' use of the online social networking site for environmental advocacy. Young adults appeared to be environmentally conscious and, through the use of social networking, exchanged knowledge and opinions, and advocated for environmental change. Online social networking sites, such as Facebook, can serve as a communication channel that facilitates health information sharing and more importantly cultivates community capacity focused on environmental health promotion among young adult users.