Desire for information about drugs: a survey of the need for information in psychiatric in-patients

Background Promoting therapy adherence requires understanding various psychosocial parameters, including patients need for information. Drug information adapted to patients needs may empower them and increase their confidence in drug therapy. Objectives: To explore psychiatric in-patients information preferences and to test the reliability of a Dutch version of the Intrinsic Desire for Information (IDI) scale in psychiatric institutions in Flanders.Methods Standardised interviews were conducted with psychiatric patients in 11 hospitals. The interview consisted of the IDI-scale and five open questions. Patient demographics collected were sex, age, number of medicines taken, diagnosis, number of admissions during the past year, marital status, education level and occupation.Results 279 patient interviews were completed. A factor analysis on the original 12-item scale yielded 3 factors. An abbreviated scale was derived from the first factor (F1). This 6-item scale measured extent of information desired: (EID) and consisted of six items (Cronbachs = 0,73). A second factor (F2) measured information provider preference (IPP) ( = 0,56) and a third factor (F3) measured inhibited information desire (IID) ( = 0,69). EID was associated with number of medicines taken, duration of hospitalisation and marital status.Conclusion The internal reliability of the EID-factor appears to be reproducible in the specific setting of psychiatric hospitals. It may be useful to help healthcare professionals develop pharmaceutical care towards psychiatric patients. Validation of the scale remains to be completed. Information need in psychiatric in-patients measured by the EID-score was comparable to the need measured in general hospitals during earlier research in England. Targeted information services seem to be desirable to enhance therapy adherence and quality of life in psychiatric patients.     

Mutation of the DRY motif reveals different structural requirements for the CC chemokine receptor 5-mediated signaling and receptor endocytosis

CC chemokine receptor 5 (CCR5) is a G protein-coupled receptor that governs migration of leukocytes and serves as a coreceptor for the R5 tropic strains of human immunodeficiency virus (HIV). CCR5-mediated signaling in response to CC chemokines relies on G protein activation. Desensitization, which rapidly turns off G protein-dependent signaling, involves phosphorylation of CCR5 that promotes interaction of the receptor with beta-arrestins for endocytosis. Whether coupling to G proteins, desensitization, and endocytosis of CCR5 require the same structural determinants remains a matter of investigation. Here, we show that CCR5 displayed agonist-independent coupling to G proteins. This constitutive activity of the receptor was abrogated by TAK779 (N,N-dimethyl-N-[4-[[[2-(4-methylphenyl)-6,7-dihydro-5H-benzocyclohepten-8-yl]carbonyl]amino]benzyl]tetrahydro-2H-pyran-4-aminium chloride), a nonpeptidic CCR5 ligand that inhibits HIV infection and was found to depend on the integrity of the Asp-Arg-Tyr (DRY) motif. Changing Arg-126 by the neutral residue Asn (R126N-CCR5 mutant) abolished CCR5-mediated activation of G proteins, either constitutively or in response to agonists. In contrast, R126N-CCR5 not only retained agonist-promoted phosphorylation and beta-arrestin-dependent endocytosis but also displayed a higher basal phosphorylation than wild-type CCR5. Expression of beta-arrestin in R126N-CCR5-expressing cells resulted in receptor down-regulation, thereby suggesting that R126N-CCR5 spontaneously interacts with beta-arrestins. However, although expression of beta-arrestin favored wild-type CCR5-mediated chemotaxis, it failed to promote migration of cells expressing R126N-CCR5. Overall, these data indicate that structural requirements for CCR5-mediated activation of G proteins, albeit not involved in receptor desensitization and internalization, are needed for beta-arrestin-mediated chemotaxis. These results have implications for how distinct biological responses of CCR5 might rely on a different set of receptor conformations.     

Bacillus spores in the mail: “Ironing” out the anthrax problem

Introduction

Following a terrorist release ofBacillus anthracis spores through the U.S. Postal Service, it was suggested that decontamination of spores in mail envelopes could be accomplished at home by utilizing the steam heat from a household iron. This study investigated the use of a standard household iron, in a dry heat mode, for sterilizing mail envelopes laced with bacterial spores.

Methods

TheBacillus subtilis var. niger spore, a more heat resistant spore, was used as a surrogate forB. Anthracis spores. Standard mail envelopes containing 2.1 × 10⁶ spores were sealed and subjected to various levels of dry heat from a standard household iron for periods of 5, 10, and 15 minutes. Envelope contents were then cultured in soy broth for seven days to detect any bacterial growth, and in addition envelopes and contents were visually inspected for evidence of damage and readability of words.

Results

At a temperature range of 160.01°C –204.5°C for a period of 5 minutes,B. subtilis var. niger spores were effectively sterilized and, at 7 days, no bacterial growth was observed. No gross evidence of envelope damage was observed and the legibility of words was not compromised.

Conclusions

Dry heat from a common household iron is capable of destroyingBacillus spores in mailing envelopes without grossly altering the envelope or affecting the legibility of words.     

Dependence of in vitro fracture strength of adhesive core buildup and crown complexes on preparation design and cementation technique

PURPOSE: To evaluate the fracture resistance of teeth restored using an adhesive core material placed under artificial crowns without pins or posts and to assess the effect of different preparation designs and cementation techniques (glass ionomer compared with adhesive cementation) used for the crowns. MATERIALS AND METHODS: Eighty-three intact molars were collected. Sixty-seven teeth were decoronated (test groups and one control group), a 2-mm circular ferrule design was prepared, and four different preparation designs (2-mm- or 1-mm-deep cavities and 2-mm- or 1-mm-thick walls) were used. Three control groups were also established. Cores were built up using an adhesive material. After preparation, standardized artificial crowns (cobalt-chromium alloy) were fabricated. Half of the crowns in the test group (n = 32) were cemented using Panavia (P group); glass-ionomer cement was used for the other half (KC group). All teeth were exposed to 10,000 thermal cycles and loaded until fracture. Statistical analysis was performed, including nonparametric tests (Mann-Whitney U-test) and ANOVA. RESULTS: In the P group, the fracture strength was significantly (p = 0.004) higher (591.75 +/- 177.95 N) than in the KC group (430.18 +/- 193.67 N). The effect of the preparation design was more pronounced in the KC group. In all groups simulating the most moderate type of tooth decay (2-mm-deep cavity and a 2-mm-thick wall), the fracture strength was comparable with that of intact teeth. Results from ANOVA showed that the type of cementation of the crowns affected fracture strength. CONCLUSION: Fracture strengths of adhesive core/crown complexes are greater when an adequate cavity for retention (at least 2 mm deep) is prepared and the crown is luted.     

Spatial distribution of groundwater fluoride levels and population at risk for dental caries and dental fluorosis in Sri Lanka

Objectives: To investigate the distribution of groundwater fluoride levels in Sri Lanka in relation to its population distribution to determine the population at risk for dental caries or dental fluorosis. Methods: The study used the most upgraded spatial distribution map of groundwater fluoride levels in Sri Lanka, and it was overlaid with a census of population data of the country. Results: The results indicated that 12% of children aged <12 years were at risk for dental fluorosis, while 81.4% of those who lived in low-fluoride zones were vulnerable for development of dental decay. Overall, 82.4% of the country’s population lived in low-fluoride zones and 11.2% were at risk of potential health hazards posed by ingestion of excessive fluoride. Conclusion: The spatial approach provides a useful decision-support tool for developing an oral health strategy of safe fluoride use based on predicted oral health risks in communities.Key words: Groundwater, dental fluorosis, dental caries, spatial distribution     

Influence of bony defects on implant stability

Introduction: The purpose of this study was to analyze the evolution of implant mechanical stability in different types/sizes of bony defects using both Periotest and Osstell devices as “objective tools.” Materials and methods: Thirty‐two implants were randomly allocated to one of the four types of bone defects: marginal bone loss, peri‐apical bone defect, constant width dehiscence and constant length dehiscences. Periotest/Osstell measurements were completed before and during staged bone removal (to enlarge defect size). Results: Significant differences (P<0.05) with initial values were found after a 2 mm marginal bone removal (Osstell/Periotest); for a peri‐apical bone lesion, after removal of 5 mm (Osstell) or 8 mm (Periotest); for a 6‐mm‐long dehiscence, after removal up to 180° of the implant perimeter (Osstell/Periotest); for a 3‐mm‐wide dehiscence, after removal of 10 mm (Osstell) or 6 mm (Periotest). Conclusion: Periotest and Osstell are in general not very sensitive in the identification of peri‐implant bone destruction, except for marginal bone loss. To cite this article:
Merheb J, Coucke W, Jacobs R, Naert I, Quirynen M. Influence of bony defects on implant stability.
Clin. Oral Impl. Res. 21 , 2010; 919–923.
doi: 10.1111/j.1600‐0501.2010.01932.x     

Anterior and posterior neck muscle activation during a variety of biting tasks

Bruxism may be involved in the aetiology of myofascial neck pain. The objective of this study was to test the hypothesis that anterior and posterior neck muscles co-contract during jaw clenching. Ten test subjects developed different feedback-controlled submaximum bite forces in a variety of bite-force directions by means of bite-force transducers. The electromyographic activity of the sternocleidomastoid and supra/infrahyoidal muscles, and of the semispinalis capitis, semispinalis cervicis, and multifidi muscles was recorded by use of surface electrodes and intramuscular wire electrodes, respectively. For normalization of electromyography data, maximum voluntary contraction tasks of the neck muscles were conducted in eight different loading directions. The results confirmed co-contraction of the neck muscles in the range of 2-14% of the maximum voluntary contraction at a bite force ranging from 50 to 300 N. Significant activity differences were observed as a result of the different force levels and force directions exerted by the jaw muscles. Long-lasting tonic activation of specific neck muscles triggered by the jaw-clenching tasks was also detected. These findings support the assumption of a relationship between jaw clenching and the activity of the neck muscles investigated. The low level of co-contraction activity, however, requires further study to elucidate possible pathophysiological interactions at the level of single motor units.