Influence of topical application of chlorhexidine on chronic gingivitis and gingival wound healing in the dog

Abstract— The present study examines the effect of topically applied chlorhexidine gluconate on chronically inflamed gingiva and standardized gingival wounds. Five beagle dogs were fed a soft "gingivitis inducing" diet for a period of 5 months. Subsequently, a 2 % chlorhexidine solution was applied daily for 42 days to the left molars, premolars, and canines of three dogs, the corresponding teeth in the right quadrants serving as controls. The degree of gingivitis, plaque, gingival exudation, and number of crevicular leukocytes were assessed on days 0, 11, 28, 35, and 42. The healing after gingival biopsy was studied in two dogs using the same parameters on days 0, 4, 7, 14, 28, and 42. In one of the dogs chlorhexidine was applied daily to the teeth and gingiva; the other dog had saline treatment. Biopsies for histologic examination were obtained at the beginning and the end of the experiment. From these criteria, it was shown that one daily topical application of 2 % chlorhexidine gluconate to the teeth and gingiva of the dog removes plaque and resolbes a well-established chronic gingivitis. It is concluded that in the dog it is passible through topical applications of chlorhexidine to establish and maintain a plaque- and gingivitis-free dentition.     

Tuberculous meningitis in pregnancy

Four women with tuberculous meningitis in association with pregnancy are described to illustrate both the serious nature and varied presentation of this condition. Mortality or neurological morbidity may occur more frequently during pregnancy, but in general correlate closely with delay in diagnosis and initiation of appropriate therapy. Treatment often needs to be started empirically, and neurosurgical intervention may prove life saving.     

Enhanced Reliability and Renewed Applications of the Deltopectoral Flap in Head and Neck Reconstruction

Bakamjian introduced the deltopectoral skin flap in 1965, and thereafter it was used extensively for reconstructive surgery of the head and neck. Flap failure rates of 10% to 25% were reported, necessitating the development of alternative methods of reconstruction and eventually relegating the flap to historical references. Since 1991, we have used the deltopectoral flap in 24 patients for reconstruction after head and neck tumor surgery. Simple technical modifications have been used to enhance the reliability of this flap, with no observed failures or even partial flap loss. The deltopectoral flap remains a versatile and reliable tissue source that can be used simultaneously with the pectoralis major myocutaneous flap for a variety of complex head and neck reconstructions. Laryngoscope, 106:1230-1233, 1996     

CNS tumours in south-western Finland: high location, high incidence

The Department of Paediatrics at the University Central Hospital of Turku, Finland has 130 000 children under 17 y of age within its catchment area. We collected all 103 cases of newly diagnosed CNS tumours from the 15-y period of 1981–95. The incidence was 5. 3: 100 000, a figure twofold those usually presented. During the period 1981 -85 the incidence was lower (4) than during the subsequent 5-y periods (5. 7 and 6. 2). There were no statistical differences between the incidences of the supra- vs infratentorial brain tumours. Optic glioma was unusually common (17%, CI 13. 9–20%).     

Prepregnancy counselling: experience from 1,075 cases.

OBJECTIVE: To assess the activity of a prepregnancy counselling clinic in terms of investigations, counselling, treatment and subsequent pregnancy outcome. DESIGN: Review of 1,075 couples attending over a nine year period. SETTING: University Hospital offering a tertiary referral service for fetal medicine. SUBJECTS: Couples referred to the clinic from a variety of sources. MAIN OUTCOME MEASURES: Categories of referral, value of diagnostic tests, and subsequent pregnancy outcome. RESULTS: The main categories of referral were: previous miscarriage (44.4%); previous fetal abnormality (19.6%); chronic maternal disease (22.3%); and others (13.7%). Routine investigations produced a low yield of abnormality (1%), in contrast to investigations selected for specific reasons (12%). Subsequent pregnancy outcome, which was unaltered in either the previous miscarriage or fetal abnormality groups, did improve in the chronic maternal disease group. CONCLUSIONS: This study does not prove the value of prepregnancy counselling. However, it does illustrate the importance of making an accurate assessment of previous problems and current health as a means of determining both maternal and fetal risks in a subsequent pregnancy, a process which seems to lead to an improved outcome within selected groups. The importance of continuity of care in all couples, especially when there has been a previous adverse pregnancy outcome is emphasized.     

Mucosal melanoma of the nasal cavity and paranasal sinuses

Background. Mucosal melanomas of the nasal cavity and paranasal sinuses are rare and do poorly. Methods. Seventeen patients treated from 1981 to 1993 at a single referral center were retrospectively reviewed. Results. Thirteen patients underwent surgical resection, with seven receiving postoperative radiotherapy. Eight had microscopically negative margins. The actuarial 2-year and 5-year survivals for this group of 13 were 67% (8 of 12) and 20% (2 of 10). The local recurrence rate was 85% (11 of 13) and distant metastases occurred in 31% (4 of 13) patients. In the absence of metastatic disease, resection of recurrent tumor correlated with disease-free intervals ranging from 3 months to 40 months. Conclusions. Those who received postoperative radiotherapy appeared to have done better with increased disease-free intervals and prolonged survival. Negative surgical margins were not predictive of a more favorable outcome. Surgical resection followed by postoperative radiotherapy is appropriate and resection of recurrent tumor should be considered. © 1995 Jons Wiley & Sons, Inc.     

How are nations trying to prevent suicide? An analysis of national suicide prevention strategies

Recent increases in suicide rates internationally have focused attention on suicide as an important area of public health concern. In this review, strategies developed by various countries to halt this trend are compared. Nine out of 15 countries respond to enquiry about the state of development of suicide prevention strategies and programmes. Comprehensive strategies have been or are being developed by Finland, Norway, Australia, New Zealand and Sweden. The organization of these strategies differs between countries. The interventions have similar targets and are presented in detail. There are some similarities in strategy content but evident differences in organization. Further developments should not only be based on research, but also consider the diverse experiences of other countries, and they should incorporate appropriate structures for monitoring and evaluation.