糖尿病与重症牙周病相关的证据

数据来源：检索MEDLINE数据库从1970年1月至2003年10月出版的所有文献．并手工检索参考文献中的相关文献。纳入标准：以人为对象的临床试验或观察性研究，且以英语发表的文献。数据提取和合成：由3位作者分别提取数据，意见不同则由讨论解决。记录一系列指标：菌斑指数（PI）、牙石指数、牙龈指数（GI）、探诊出血指数（BOP）、牙周探诊深度（PPD）、临床附着丧失（CAL）、牙龈退缩、牙周指数和骨丧失指数。用血液中糖化血红蛋白百分浓度显示糖尿病控制与否。评估各牙周参数的整体差异，并应用固定效应模型或随机效应模型计算相应的95％CI。用Q检验进行同质性检验。用漏斗图检测发表偏倚。结果：18个横断面对照研究、3个前瞻性队列研究和2个临床试验的基线资料入选。     

Prevention in practice: results of a 2-year follow-up of routine health promotion interventions in general practice

BACKGROUND.: The effectiveness of health promotion activity in general practiceon risk factor reduction for coronary heart disease remainsthe subject of active debate. OBJECTIVE.: The study aimed to assess the impact of practice-based healthcheck-ups on health behaviours over a 2-year period. METHOD.: A general practice cohort of 7123 patients from 18 practiceswas surveyed. Eight hundred and forty (12%) patients had beenoffered a heafth check within a 12-month period from September1992 and 621 (9%) received one. Two hundred and fifty patients(40%) were asked back for follow-up after their health check. RESULTS.: Over a 2-year period there was no difference in smoking cessation,alcohol consumption, weight loss nor the amount of exercisetaken between those who attended for a health check and thosewho did not. The food score chosen to assess dietary change(Oxcheck) showed a statistically significant 1.16-point risefor the whole sample over the survey period. There was a significantdifference in mean food score change between heafth check attendersand non-attenders (Mann-Whitney U test: P << 0.002). Maintenanceof dietary improvement over a 2-year period was not affectedby health check attendance. CONCLUSIONS.: This study confirms the low impact of health checks on the selfreported modification of cardiovascular risk factors and showsthat maintenance of appropriate health behaviour change is nomore likely in those who have received a health check. Keywords. Health promotion, general practice.     

Blepharitis

In both blepharitis squamosa and ulcerosa removal of the crusts and defattening of the lidmargin, by rubbing with light petroleum and carbon tetrachloride solution, is the first step in treatment. Concomitant staphylococcal infection should be treated with antibiotherapy. Empirically this can be best done with oxytetracycline as in Terracortril^® suspension. Probably the reason oxytetracyclines work best, is that they also reduce the secretion of meibomian glands. The steroid treatment is necessary to reduce tylosis of the lidmargins. In blepharitis squamosa maintenance therapy consists of application of antiseborrhoic agents in a non-irritating base.     

Work in progress: the application of temporal filtering techniques to hybrid subtraction in digital subtraction angiography

Temporal filtering methods were applied to iodine signal-to-noise ratio (SNR) restoration in intravenous hybrid subtraction digital subtraction angiography (DSA). For equal detected exposure rates hybrid subtraction had approximately 35% of the SNR of temporal subtraction. When matched filtering was applied to a DSA run, the filtered result had approximately two times higher SNR than the peak contrast image in the run. Thus, when matched filtering techniques were applied to the hybrid image sequence, the resultant SNR increased to about 70% of that of temporal subtraction. With an additional factor-of-two increase in exposure rate for the hybrid run, SNR parity with temporal subtraction could be achieved. This compared with a factor-of-nine increase in exposure that would be required if no filtering were performed. Experimental hybrid matched filter results, generated with intravenous canine DSA studies, supported the predictions in SNR performance.     

SUXAMETHONIUM-INDUCED HYPERKALAEMIA IN PATIENTS WITH SEVERE INTRA-ABDOMINAL INFECTIONS

In nine patients, undergoing repeat operations because of severeintra-abdominal infection developing after major abdominal surgery,serum potassium concentrations were monitored during inductionof anaesthesia. Four patients showed an increase of serum potassiumranging from 2.5 to 3.1 mmol/ litre above baseline values within3–6 min after suxamethonium 100 mg i.v. In five patientsthere was no change. The four patients demonstrating an increasehad suffered from pyrexia and leucocyt-osis for at least 2 weeks.The other five had signs of infection for no more than 9 days.It is concluded that patients with signs of severe intra-abdominalinfection lasting longer than 1 week represent an additionalcategory susceptible to suxamethonium-induced hyperkalaemia.They should receive only non-depolarizing muscle relaxants.When the use of suxamethonium is unavoidable, the injectionof a non-depolarizing muscle relaxant before the administrationof suxamethonium is recommended.     

MALIGNANT HYPERTHERMIA IN BELGIAN LANDRACE PIGS RESTED OR EXCERCISED BEFORE EXPOSURE TO HALOTHANE

Thirteen of 31 Belgian Landrace pigs developed malignant hyperthermia(MH) after breathing halothane. A short period of exercise 1h before the administration of the triggering agent increasedthe incidence of the syndrome to 100% in eight similar pigs.Clinical symptoms were more marked and developed more rapidlyin the exercised pigs. All the reacting pigs became typicallyacidotic, developed rigor and died. Serum Na⁺, K+, Ca2⁺, c.p.k.,l.d.h. and protein concentrations were increased to a variableextent during the reaction and there was an increase in p.c.v.also. No hyper-glycaemia was detected in pigs which were restedbefore receiving halothane. Four of the eight exercised pigsbecame markedly hyperglycaemic and plasma noradrenaline increasedto higher values. Phosphocreatine and ATP decreased to low valuesand lactate increased in the muscles of all pigs which reacted.At the time of death, muscle glycogen had decreased significantlyin the rested, but not in the exercised, MH pigs. ^*Present address: ARC Meat Research Institute, Langford, BristolBS18 7DY.