COMPARISON OF THE INCIDENCE AND NATURE OF CARDIAC ARRHYTHMIAS OCCURRING DURING ISOFLURANE OR HALOTHANE ANAESTHESIA: Studies During Dental Surgery

Seventy-six Chinese patients aged between 15 and 30 yr, undergoing3rd molar extraction, were randomly allocated to two groups.One group received halothane and the other isoflurane. The incidenceof arrhythmia during surgery under anaesthesia with isofluranewas significantly less than with halothane. Sinus tachycardiawas a significant feature under anaesthesia with isoflurane.Under anaesthesia with halothane, the arrhythmias occurringmost frequently during surgery were ventricular ectoplcs, thecommonest being ventricular bigemlny. The frequency and natureof arrhythmias during surgery on right and left sides were similar.In three patients a slight decrease in arterial pressure wasrecorded in association with the arrhythmia, but on stoppingthe stimulus, both rhythm and arterial pressure returned tonormal. The incidence of arrhythmia with halothane in the Chinesepopulation in this study was significantly higher than thatreported previously in non-Chinese patients.     

An in vivo investigation of salivary properties,enamel hypomineralisation,and carious lesion severity in a group of Iraqi schoolchildren

International Journal of Paediatric Dentistry 2013; 23: 2–12 Background. Hypomineralised enamel is a prevalent, congenital defect vulnerable to deteriorate post‐eruptively particularly in the presence of an unfavourable oral environment. Aims. To assess the influence of salivary characteristics on the clinical presentation of hypomineralisation lesions diagnosed in first permanent and second primary molars and to evaluate caries severity in relation to the defect’s clinical presentation. Design. Recruitment consisted of 445 seven‐ to nine‐year‐old participants, of whom 152 were diagnosed as having molar hypomineralisation (MH); the remaining unaffected subjects (N = 293) were considered their controls for saliva analysis. Dental caries status was assessed in 300 subjects of saliva sub‐sample, equally divided as MH‐affected and non‐affected children. The International Caries Detection and Assessment System was used for caries detection. Salivary flow rates, viscosity, pH, and buffering capacity were determined. Results. Molar hypomineralisation‐affected children have significantly higher mean caries scores compared to the non‐affected group. Dentinal carious lesions were ten times more frequent in teeth with post‐eruptive breakdown (PEB) than with teeth with opacities only. Low salivary flow rates (LSFR), moderately viscous saliva, and low pH were significantly more common in the affected group. LSFR and moderate and highly acidic saliva were more likely associated with PEB. Conclusion. Demarcated hypomineralised enamel is a dynamic defect highly influenced by individual characteristics of the oral environment.     

Tumours of the posterior pharyngeal wall: the use of the platysma flap

Posterior pharyngeal wall tumours are infrequent neoplasms with a very poor prognosis. The 5 year survival rate ranges from 3% to 32%. Most authors agree that the treatment of choice is surgery with post-operative radiotherapy. The results of treatment of 36 patients (tumour excision plus bilateral neck dissection and post-operative radiotherapy) in which the posterior pharyngeal wall defect was closed with a platysma myocutaneous flap were compared with other forms of repair (13 patients). The 5 year survival rate was 17.2% in the whole group. Laryngeal voice was achieved in 79% of patients having a platysma flap reconstruction. The platysma myocutaneous flap is very satisfactory for the repair of the posterior pharyngeal wall as it is easy to perform, it is oncologically safe and its functional results match well with other forms of reconstruction, with the advantage of laryngeal preservation.     

Extended supraglottic laryngectomy for primary base of tongue carcinomas

A retrospective review of 56 patients with a primary base of tongue carcinoma was undertaken to determine the value of supraglottic laryngectomy. All the patients had a supraglottic laryngectomy and a total of 77 neck dissections. Forty-three (76.8%) patients received post-operative radiotherapy. The incidence of local recurrence was 23.2%, neck relapse being seen in 16.1% of patients. The 3 year survival was 47%. The overall survival of the whole series and by stage was not improved by combined therapy compared with surgery alone.     

Analysis of the Role of Nitric Oxide in the Relaxant Effect of the Crude Extract and Fractions from Eugenia uniflora in the Rat Thoracic Aorta

This study has evaluated the possible role played by the l-arginine-nitric oxide pathway in the vasorelaxant action of the hydroalcoholic extract from Eugenia uniflora, and fractions from the extract, in rings of rat thoracic aorta. The addition of an increasing cumulative concentration of hydroalcoholic extract from E. uniflora (1–300 μg mL^?1) caused a concentration-dependent relaxation response in intact endothelium-thoracic aorta rings pre-contracted with noradrenaline (30–100 nm). The IC50 value, with its respective confidence limit, and the maximum relaxation (R_max) were 7.02 (4.77–10.00) μg mL^?1 and 83.94 ± 3.04%, respectively. The removal of the endothelium completely abolished these responses. The nitric oxide synthase inhibitors N^ω-nitro-l-arginine (l-NOARG, 30 μm) and N^ω-nitro-l-arginine methyl ester (l-NAME, 30 μm), inhibited the relaxation (R_max) to ?10.43 ± 7.81% and ?3.69 ± 2.62%, respectively. In addition, l-arginine (1 mm), but not d-arginine (1 mm), completely reversed inhibition by l-NOARG. Methylene blue (30 μm), a soluble guanylate cyclase inhibitor, reduced the relaxation induced by the extract to 14.60 ± 7.40%. These data indicate that in the rat thoracic aorta the hydroalcoholic extract, and its fractions, from the leaves of E. uniflora have graded and endothelium-dependent vasorelaxant effects.     

Cost-effectiveness of ambulatory surgery in Cali, Colombia

To compare the cost and effectiveness of a system of simplifiedambulatory surgery against traditional in-patient surgery, westudied a surgical procedure commonly performed in both settings- non-recurrent elective inguinal herniorrhaphy. We comparedthe 17 operations performed in an ‘intermediate healthunit’ (IHU) or outpatient hospital in Cali, against the15 performed in a traditional secondary hospital from mid-Januarythrough mid-April, 1989. Pre-surgical characteristics of thepatients were similar. After the operation, the IHU patientshad few complications, were more satisfied, and resumed theirusual activities sooner than the hospital patients (34 versus52 days, respectively). The average cost per procedure was US$39.12in the IHU as compared to US$148.76 in the hospital-a four-folddifference. Intermediate health units seem to offer importantadvantages for uncomplicated surgery in both cost and outcome.     

Urease activity does not reflect the degree of colonization by Helicobacter pylori in children

BACKGROUND: Urea breath test is an accurate method for the diagnosis of Helicobacter pylori infection in children. This test could estimate the bacterial load by measuring the urease activity in gastric mucosa. The aim of the study was to correlate the result of 13C-urea breath test (13C-UBT) and histological estimative for bacterial colonization and severity of inflammatory infiltrate. METHODS: Forty-four patients (mean age 8.54 +/- 3.9 years) with dyspeptic symptoms were evaluated. Patients were evaluated through endoscopy and 13C-UBT. Helicobacter pylori infection was defined by histology, rapid urease test and 13C-UBT. Breath test results were expressed by delta over baseline (DOB) and urea hydrolysis rate (UHR). Test results were treated logarithmically for statistical analysis. RESULTS: There was a significant inverse correlation between age and Log DOB (-0.501, P= 0.0005), but there was no relationship between Log UHR and age (-0.148, P= 0.336). The study did not find correlation between the breath test result and histological grades for mononuclear infiltrate, neutrophilic infiltrate and bacterial density. CONCLUSION: The 13C-UBT does not estimate the severity of histological findings in children with Helicobacter pylori infection. The results of the breath test should be interpreted in a qualitative way.