Preference for brand-name buprenorphine is related to severity of addiction among outpatients in opioid maintenance treatment

As a form of opioid maintenance treatment, high-dose buprenorphine is increasingly being used in the United States. On the French market since 1996, it is the most commonly prescribed and frequently employed opioid maintenance treatment. For unknown reasons, the brand-name form is used far more often than the generic form (76–24%). The objective was to show that the patients' levels of addiction were differentiated according to the form of buprenorphine currently being used and to their previous experience of a different form. An observational study in 9 sites throughout France used self-assessment questionnaires filled out in retail pharmacies by all patients to whom their prescribed buprenorphine treatment was being delivered. The 151 canvassed pharmacies solicited 879 patients, of whom 724 completed the questionnaires. Participants were statistically similar to non-participants. The patients using the brand-name form subsequent to experience with the generic form exhibited a more elevated addiction severity index and a higher dosage than brand-name form users with no experience of a different form. Compared to generic users, their doses were higher, their was addiction more severe, and their alcohol consumption was more excessive; they were also more likely to make daily use of psychotropic substances. However, the level of misuse or illicit consumption was similar between these groups. Preferring the brand-name buprenorphine form to the generic form is associated with a higher level of severe addiction, a more frequent need for daily psychotropics, and excessive drinking; but the study was unable to show a causal link.     

Histopathologic quantification of viable tumor versus treatment effect in surgically resected recurrent glioblastoma

Journal of Neuro-Oncology - The prognostic impact of the histopathologic features of recurrent glioblastoma surgical specimens is unknown. We sought to determine whether key histopathologic...     

Kleinwuchs und Therapie

Short stature is a diagnostic challenge because of the enormous spectrum of physiological maturation and growth patterns in childhood. A carefully drawn growth chart and calculation of the familial target height are required for a correct analysis. A low growth velocity, a height below the familial target, severe short stature and disproportionate or syndromic short stature are rational reasons for referral to a growth specialist. For clinical assessment a small for gestational age (SGA) patient history, presence of minor or major anomalies and skeletal disproportions should guide the diagnostic approach. Bone age estimation may enable the differentiation between inborn (primary) and acquired (secondary) growth failure. Growth hormone (GH) stimulation tests should only be performed if GH deficiency is very likely based on the foregone diagnostics. Constitutional delay of growth and puberty should not be confused with GH deficiency. A GH therapy is effective in GH deficiency and allows a normal growth within the familial target range in the majority of treated children. In addition, the diagnosis and therapy of Turner syndrome, SGA short stature and short stature homeobox-containing gene (SHOX) deficiency are discussed.     

Colony forming unit levels of salivary Lactobacilli and Streptococcus mutans in orthodontic patients

The purpose of this study was to compare the levels of Lactobacilli (LB) and Streptococcus mutans (SM) colony forming units (CFU) in the saliva of subjects before and after orthodontic appliance placement. This was a controlled, prospective two-group, two-measurement, clinical trial performed on 64 study patients, 12-15 years old. Subjects in the experimental group were sampled for LB and SM in stimulated saliva collected on the same day but prior to band and bracket placement. The subjects in the control group were sampled on their first screening appointment two months prior to band and bracket placement. The second samples of LB and SM were taken from the experimental and control groups after two months. Saliva was transferred to a selective agar carrier and incubated for 48 hours at 37 degrees C / 99 degrees F. LB and SM colonies forming units were compared with standard densities. The experimental group wearing orthodontic appliances had significantly higher mean LB CFU counts than the control group at the 2 month follow-up (3.25 vs. 2.57, p = 0.0036). The two groups, however, did not show any difference in mean SM CFU counts at the 2 month follow-up (3.0 vs. 3.1, p = 0.66). The results of this study showed that a higher number of CFUs of LB were associated with the group wearing orthodontic appliances after two months and may play a role in the increased levels of plaque seen in many orthodontic patients.