Solvent-associated olfactory dysfunction: not a predictor of deficits in learning and memory

OBJECTIVE: The aim of the study was to evaluate associations between olfactory dysfunction and aberrations in learning and memory after chronic occupational exposure to mixed hydrocarbon solvents. METHOD: This was a cross-sectional, epidemiologic study of 187 paint manufacturing workers. The authors administered quantitative tests of olfactory function (the University of Pennsylvania Smell Identification Test) and neurobehavioral function (eight computer- and examiner-administered tests of learning and memory) to workers for whom detailed information was available on lifetime occupational exposure to solvents. RESULTS: Olfactory function test scores were positively correlated with performance on seven of eight of the tests of learning and memory in bivariate analyses. After adjustment for important confounding variables (i.e., age, vocabulary score, and cumulative exposure to hydrocarbon solvents) with multiple linear regression, olfactory function scores predicted performance only on the Wechsler Memory Scale Delayed Logical Memory test. CONCLUSIONS: Overall, the data did not reveal that olfactory dysfunction was correlated with decrements in various memory functions.     

Effect of disease severity and pharmacotherapy of asthma on oral health in asthmatic children

Abstract – Oral health was studied in a group of asthmatic children (n = 61). The children were divided in two groups, 5–10 and 11–18 yr of age. The individuals with asthma were further sub grouped with respect to the disease severity. Severe asthma was defined as more than 10 asthmatic attacks per year. This patient group had daily medication compared to children with moderate asthma (<10 asthmatic attacks/yr) who medicated temporarily. 55 age matched children from the same area made up the control group. Ail children were examined clinically and two bitewing radiographs were taken. The results showed no statistically significant differences concerning caries prevalence and gingival condition in asthmatic children compared to a healthy control group. The study shows that neither the asthma per se nor the disease severity affected the caries prevalence and gingival condition in asthmatic children.     

Craniofacial growth in bone marrow transplant recipients treated with growth hormone after total body irradiation

Abstract— The effect of growth hormone (GH) treatment on craniofacial development was studied in five children exhibiting growth retardation following bone marrow transplantation. Linear and angular measurements were made on lateral radiographic cephalograms taken prior to the start of GH treatment and after an average treatment time of 1.2 yr. The results showed that the mean growth increments of mandibular length in the GH treated children, exceeded the corresponding values of the control group by 150% during the period of investigation. It is suggested that this dimensional increase in the patients was due to GH stimulation on the chondral growth process in the mandibular condyles.     

Influence of phenytoin on cytoplasmic free Ca2+ level in human gingival fibroblasts

Abstract— Influence of 5,5-diphenylhydantoin (phenytoin;PHT) on the cytoplasmic free Ca²⁺ concentration, [Ca²⁺]ⁱ, was studied in fura 2 loaded adherent monolayers of human gingival fibroblasts derived from three patients before and after 9 months of PHT therapy. In the patient where gingival overgrowth developed during PHT medication (responder), addition of PHT to gingival fibroblasts derived before PHT medication induced a transient extracellular Ca²⁺ dependent increase in [Ca²⁺]ⁱ. In a non-responder patient, where gingival overgrowth did not develop during the same period of PHT therapy, addition of PHT to gingival fibroblasts derived before the start of medication did not significantly affect [Ca²⁺]_i. Under extracellular Ca²⁺ deficient conditions, addition of PHT to serum-starved fibroblasts derived from the two categories of patients before the medication resulted in an increase in [Ca²⁺]_i. In fibroblasts derived from the responder patient during PHT medication, in contrast to those from the non-responders (n = 2), the basal level of [Ca²⁺]_i was significantly decreased. The results indicate that, in the cases studied, there is a relationship between PHT induced alterations in [Ca²⁺]_i in gingival fibroblasts and the clinical development of gingival overgrowth.     

Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide

The major potential adverse effect of use of sulfonylurea agents (SUAs) is a hyperinsulinaemic state that causes hypoglycaemia. It may be observed during chronic therapeutic dosing, even with very low doses of a SUA, and especially in older patients. It may also result from accidental or intentional poisoning in both diabetic and nondiabetic patients. The traditional approach to SUA-induced hypoglycaemia includes administration of glucose, and glucagon or diazoxide in those who remain hypoglycaemic despite repeated or continuous glucose supplementation. However, these antidotal approaches are associated with several shortcomings, including further exacerbation of insulin release by glucose and glucagon, leading only to a temporary beneficial effect and later relapse into hypoglycaemia, as well as the adverse effects of both glucagon and diazoxide. Octreotide inhibits the secretion of several neuropeptides, including insulin, and has successfully been used to control life-threatening hypoglycaemia caused by insulinoma or persistent hyperinsulinaemic hypoglycaemia of infancy. Therefore, this agent should in theory also be useful to decrease glucose requirements and the number of hypoglycaemic episodes in patients with SUA-induced hypoglycaemia. This has apparently been confirmed by experimental data, one retrospective study based on chart review, and several anecdotal case reports. There is thus a need for further prospective studies, which should be adequately powered, randomized and controlled, to confirm the probable beneficial effect of octreotide in this setting.     

Constant current sine wave transcutaneous nerve stimulation for the evaluation of peripheral neuropathy

We have evaluated various forms of peripheral neuropathy with a new device which emits a constant sinusoid stimulus at varying frequencies to quantitate current perception thresholds (CPTs). In normal individuals, CPT measures increase with increasing stimulation frequency, are highest on the toe and lowest on the face. There is a significant effect of age and sex on threshold perception. In patients with neuropathy, there is a marked increase in thresholds on hands and feet, as well as a lesser but still significant increase of facial CPTs. Thresholds furthermore correlated with clinical severity in a group of patients with diabetic neuropathy. Facial thresholds were markedly elevated in the patients with moderate to severe neuropathy, suggesting that the device is sensitive to the systemic nature of peripheral neuropathy. The authors believe the device will be a useful tool in screening for sensory neurologic abnormalities.     

Autonomic and Cardiovascular Responses of Preschool Children to Television Programs

This exploratory study examined the heart rates (HR) and skin temperatures (ST) of 18 preschool children while they viewed two clips of everyday children's television (TV) programming. The measurements were made in a day care setting, in a naturalistic environment designed to mimic the real world of children's TV viewing. The purpose of the study was to determine whether cardiovascular and autonomic arousal to TV programming might occur in some children. Since a large body of psychosocial literature addresses the affects of TV violence on children, HR and ST were examined during exposure to scenes from Mr. Roger's Neighborhood and G.I. Joe cartoons. The Mr. Roger's clip was slow, rhythmic, prosocial, and nonviolent, while the G.I. Joe clip was fast-paced, staccato, colorful, and full of verbal and action violence. The study found a significant effect of exposure to the cartoon violence on HR, with HR increasing. ST decreased, but not significantly, and there was a significant effect of time on the ST, due possibly to habituation. This finding has relevance to nursing assessment, intervention, and education of parents and children, since TV viewing is a pervasive cultural phenomenon. The possibility of excessive or inappropriate autonomic and cardiovascular responsiveness in some children to TV must be considered.     

LWMH与VKA对DVT患者院外抗凝效益-风险对比

【目的】通过对经住院治疗后下肢深静脉血栓形成(deep venous thrombosis,DVT)患者院外分别继续应用低分子肝素(low molecule weight heparin,LMWH)或维生素K拮抗剂(vitamin K antagonists,VKA)的效益-风险比的对比研究,探讨较为有效、安全、简便的抗凝方案。【方法】将2008年12月-2011年3月符合纳入标准的患者随机分为A组(应用低分子肝素钙)和B组(应用华法林),并随访6个月,期间通过定期监测凝血功能及血小板计数,调整用药方案;每2个月做1次全面随访,包括有无出血、肝素诱导的血小板减少和复发事件的发生。【结果】两组均取得有效的抗凝效果,并且A组副作用发生率在各监测点明显低于B组(P<0.05),随访中发现两组DVT复发率无差异(P>0.05),但随着抗凝时间延长,两组患者出血发生率增加。在DVT复发患者中,髂股深静脉血栓形成者复发率最高,其次是股静脉、腘静脉。患者对应用A治疗方案的依从性较高。【结论】DVT患者院外继续应用LWMH抗凝效果可靠,用药安全性高,副作用较小,操作及监测简单,与应用VKA相比效益-风险比较高。