Experimental gingivitis in man

Twelve male dental students with healthy gingiva were subjected to a 3 week period without oral hygiene. During this period 6 subjects rinsed their mouth 3 times daily with a 0.5 per cent solution of vancomycin, while 6 subjects rinsed with distilled water. In both groups gingival plaque accumulated rapidly and after 3 weeks all participants developed gingivitis. Clinically no difference could be detected between the two groups. The microflora of the plaque accumulating in the group rinsing with water developed according to the pattern observed in previous investigations. In the vancomycin group this pattern was not followed. Gram-positive bacteria did not proliferate, and after 5 days rinsing with vancomycin only gram-negative bacteria were seen in stained smears and impression preparations. Spirochetes were never observed. In cultures of bacterial plaque a few gram-positive bacteria were found in most but not all of the samples collected at intervals during the experimental period from subjects in the vancomycin group. It is concluded that a predominantly gram-negative bacterial flora is able to form plaque and elicit gingival inflammation in humans.     

Early craniofacial morphology and growth in children with nonsyndromic Robin Sequence.

PURPOSE: Craniofacial morphology and growth comparisons in children with untreated nonsyndromic Robin Sequence (RS) and a control group with unilateral incomplete cleft lip (UICL) in which the lip was surgically closed at 2 months of age. MATERIAL: The 52 children (7 RS and 45 UICL) included in the study were drawn from a group representing all Danish cleft children born 1976 through 1981. The ages of the children were 2 and 22 months at the time of examination 1 and 2, respectively. METHOD: The method of investigation was three-projection cephalometry. Craniofacial morphology was analyzed by means of linear, angular, and area variables. Growth at a specific anatomical location in a patient was defined as the displacement vector from the coordinate of the corresponding landmark at examination 1 to its coordinate at examination 2. RESULTS: The most striking findings in the RS group were markedly increased posterior maxillary width, increased width of the nasal cavity, short maxilla with reduced posterior height, short mandible, bimaxillary retrognathia, and severe reduction in size of the pharyngeal airway. The amount of facial growth was similar in the two groups; however, a tendency toward a more vertical growth direction was observed in the RS group. CONCLUSION: Facial morphology in children with RS differed significantly from that of children with UICL at both 2 and 22 months of age. The magnitude of facial growth was similar in the two groups, whereas a tendency toward a more vertical facial growth direction was observed in the RS group.     

The effect of chlorhexidine mouthrinses on the human oral flora

The purpose of the present study was to examine the effect of chlorhexidine mouthrinses on the oral flora. Four students rinsed, twice daily, with 10 ml of a 0.2 per cent solution of chlorhexidine gluconate, and four students served as controls on a no oral hygiene programme. The number of bacteria in saliva was estimated by a cultural technique and impression preparations were used for the study of the bacteria on the gingiva and tooth surface. The controls showed a 300 per cent increase in bacterial counts during the experiment. In the chlorhexidine group the number of bacteria per ml saliva was reduced by 85 per cent, after 24 hours, reaching a 95 per cent reduction on day 5. An 85–90 per cent reduction was maintained throughout the experimental period. Impression preparations of the gingival area in the controls showed a heavier accummulation of bacteria than in the chlorhexidine group. In addition an increasing bacterial colonization of the tooth surfaces occurred in the controls throughout the experiment, but was never observed in the chlorhexidine group. Although the number of bacteria in saliva was markedly reduced, large numbers still persisted. It, therefore, appears unlikely that the inhibition of plaque formation is primarily the result of a reduction of the salivary flora.     

Effectiveness and characteristics of multifaceted osteoporosis group education—a systematic review

Summary

The characteristics and effectiveness of osteoporosis multifaceted group education were determined from a systematic review of international literature. Findings showed that these educational programmes may be beneficial in a variety of important factors for the prevention, treatment and management of osteoporosis.

Introduction

This systematic review investigated quantitative studies on osteoporosis multifaceted group education. The purpose was to investigate the characteristics as well as the effectiveness of this form of osteoporosis patient education.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this systematic review. Relevant databases were searched until January 2013.

Results

Seven studies published between 1993 and 2011 including osteoporosis patients with or without fractures were found. The multifaceted educational programmes all consisted of three overall themes: (1) Knowledge of osteoporosis, (2) Medication and diet and (3) Exercise, but with different foci across the studies. Overall, 24 outcome measures representing six topics were applied: (1) Health-related quality of life, (2) Psychosocial function, (3) Pain, (4) Physical activity, (5) Knowledge and (6) Medication and diet. The review showed that multifaceted osteoporosis group education can increase the patients' knowledge of osteoporosis as well as their health-related quality of life, physical activity and psychosocial functioning. It has the potential to increase adherence to both pharmacological and non-pharmacological treatments.

Conclusions

Multifaceted group education may have a positive impact on the patients' ability to engage in preventing and managing osteoporosis. Further research directed towards the complexity of multifaceted group education is needed. In addition, research investigating the educational needs of specific groups of osteoporotic patients is required.     

Procedure and principles in ultrasonically guided puncture

It is the aim in ultrasonically guided puncture to place the tip of an appropriate needle safely and accurately in the suspect lesion or organ, vessel or duct. Thereby representative specimens of fluid or solid tissue are obtained, various agents, e.g. X-ray contrast media may be injected or catheters left for drainage. Simultaneous visualization of the target, the surrounding tissues, part of the needle and its tract has become possible with dynamic scanners of different types. The adjunct of needle steering devices significantly reduces the number of puncture attempts and in most cases the puncture route can be pre-determined precisely, so that readjustment of the puncture direction is unnecessary, unless puncture of different sites in the target is directly intended. The practical performances of such punctures are described together with the necessary equipment and remedies.     

The influence of sex and pre-traumatic headache on the incidence and severity of headache after head injury

Pre- and post-traumatic headache of 168 individuals aged 18-60 years was registered 9-12 months after a head trauma. Headache before the trauma was reported by 39.9%, women being in the majority. After the trauma 64.3% were suffering from headache. Post-traumatic headache was reported by 64 patients (38.1%), of whom 22 patients experienced an increase of already existing headache and 42 patients complained of new headache. Patients suffering from headache before the trauma were not more at risk of having post-traumatic headache than patients who did not suffer from headache before the trauma. Patients who experienced an increase of already-existing pre-traumatic headache used more analgesics than patients first suffering from headache after the trauma. Post-traumatic headache was reported by more women than men (p less than 0.02), the corresponding relative risk being 1.6. Both the use of analgesics and the frequency of headache showed a significant increase for patients with post-traumatic headache when compared with a "control group" of 41 patients with unchanged headache and when compared with all patients with headache before the trauma. There was no significant difference in the location of pain between the groups analysed.     

Free Fatty Acid Uptake in Humans With CD36 Deficiency

Animal models have demonstrated that CD36 facilitates cell membrane free fatty acid (FFA) transport, but its role in human metabolism is not well understood. We measured heart, liver, adipose (three depots), and muscle (truncal postural and thigh locomotive) FFA uptake using [¹¹C]palmitate positron emission tomography (PET) scans in a family of five carrying the Pro90Ser CD36 mutation (2 homozygotes had no CD36) and matched control volunteers. PET scans were done under conditions of suppressed and slightly increased palmitate concentrations. During suppressed palmitate conditions, muscle and adipose palmitate uptake were markedly reduced in homozygotes but not heterozygotes for the Pro90Ser CD36 mutation, whereas when palmitate concentration was slightly increased, uptake in muscle and adipose did not differ between control subjects and homozygous family members. Hepatic FFA uptake was similar in all participants regardless of palmitate concentrations, whereas myocardial FFA uptake was diminished in the Pro90Ser homozygotes during both suppressed and increased palmitate conditions. We conclude that CD36 1) facilitates FFA transport into muscle and adipose tissue in humans when extracellular concentrations are reduced but not when they are modestly elevated, 2) is not rate limiting for hepatic FFA uptake, and 3) is needed for normal cardiac FFA uptake over a range of FFA concentrations from low to slightly elevated.     

Surgical ventricular reconstruction and subendocardial resection for the treatment of refractory ventricular tachycardia

We describe a case of 64-year-old female patient with ventricular tachycardia intractable to medical treatment and acute heart failure following myocardial infarction. Emergency surgical ventricular reconstruction and subendocardial resection was undertaken. We discuss the option of surgical intervention in this difficult and unusual clinical scenario.