World Workshop on Oral Medicine VI: a systematic review of medication‐induced salivary gland dysfunction

The aim of this paper was to perform a systematic review of the pathogenesis of medication‐induced salivary gland dysfunction (MISGD). Review of the identified papers was based on the standards regarding the methodology for systematic reviews set forth by the World Workshop on Oral Medicine IV and the PRISMA statement. Eligible papers were assessed for both the degree and strength of relevance to the pathogenesis of MISGD as well as on the appropriateness of the study design and sample size. A total of 99 papers were retained for the final analysis. MISGD in human studies was generally reported as xerostomia (the sensation of oral dryness) without measurements of salivary secretion rate. Medications may act on the central nervous system (CNS) and/or at the neuroglandular junction on muscarinic, α‐and β‐adrenergic receptors and certain peptidergic receptors. The types of medications that were most commonly implicated for inducing salivary gland dysfunction were those acting on the nervous, cardiovascular, genitourinary, musculoskeletal, respiratory, and alimentary systems. Although many medications may affect the salivary flow rate and composition, most of the studies considered only xerostomia. Thus, further human studies are necessary to improve our understanding of the association between MISGD and the underlying pathophysiology.     

Microaggregate counts in frozen-preserved erythrocytes: effects of washing in three blood processors and filtration

Since microaggregates have been implicated in posttransfusion pulmonary insufficiency, their elimination has become an active concern in blood transfusion. Various types of filters, as well as frozen-preserved erythrocytes, have been used to provide blood relatively low in microaggregates. We have counted particles in frozen-stored blood before deglycerolization, after washing in each of three cell processing systems, and after filtration through a 40-micrometer filter. Washing frozen erythrocytes reduced the total particle counts by an average of 89%. Slight differences were found among the three blood processors with respect to particle removal. Passing washed blood through a 40-micrometer filter did not result in significant further reduction in particle counts. Hence, the use of such filters in a frozen-preserved blood system is not warranted.     

A “PET” area of interest: myocardial metabolism in human systolic heart failure

Myocardial substrate metabolism provides the energy needed for cardiac contraction and relaxation. The normal adult heart uses predominantly fatty acids (FAs) as its primary fuel source. However, the heart can switch and use glucose (and to a lesser extent, ketones, lactate, as well as endogenous triglycerides and glycogen), depending on the metabolic milieu and superimposed conditions. FAs are not a wholly better fuel than glucose, but they do provide more energy per mole than glucose. Conversely, glucose is the more oxygen-efficient fuel. Studies in animal models of heart failure (HF) fairly consistently demonstrate a shift away from myocardial fatty acid metabolism and toward glucose metabolism. Studies in humans are less consistent. Some show the same metabolic switch away from FA metabolism but not all. This may be due to differences in the etiology of HF, sex-related differences, or other mitigating factors. For example, obesity, insulin resistance, and diabetes are all related to an increased risk of HF and may complicate or contribute to its development. However, these conditions are associated with increased FA metabolism. This review will discuss aspects of human heart metabolism in systolic dysfunction as measured by the noninvasive, quantitative method—positron emission tomography. Continued research in this area is vital if we are to ameliorate HF by manipulating heart metabolism with the aim of increasing energy production and/or efficiency.     

Use of healthcare a long time after severe burn injury; relation to perceived health and personality characteristics

Purpose.?The aim of the study was to evaluate which factors are associated with the use of healthcare a long time after severe burn injury.

Method.?After a review process based on clinical reasoning, 69 former burn patients out of a consecutive group treated at the Uppsala Burn Unit from 1980?–?1995 were visited in their homes and their use of care and support was assessed in a semi-structured interview. Post-burn health was assessed with the Burn-Specific Health Scale-Brief (BSHS-B) and personality was assessed with the Swedish universities Scales of Personality (SSP).

Results.?The participants were injured on average eight years previously. Thirty-four had current contact with healthcare due to their burn injury and had significantly lower scores on three BSHS-B-domains: Simple Abilities, Work and Hand function, and significantly higher scores for the SSP-domain Neuroticism and the SSP-scales Stress Susceptibility, Lack of Assertiveness, and lower scores for Social Desirability. There was no relation to age, gender, time since injury, length of stay, or to the surface area burned.

Conclusions.?A routine screening of personality traits as a supplement to long-term follow-ups may help in identifying the patient's need for care.     

Plasma glucose kinetics in a well-trained cyclist fed glucose throughout exercise.

We hypothesized that when plasma glucose availability is maintained by carbohydrate (CHO) ingestion, trained cyclists can utilize plasma glucose at very high rates during the later stages of prolonged exercise (10). To test this hypothesis, a well-trained male cyclist was studied during exercise to fatigue at 70% VO2max when ingesting glucose throughout exercise. A primed continuous infusion of [U-13C]glucose was begun after 60 min of exercise to measure rates of plasma glucose appearance (Ra), disappearance (Rd), and oxidation (R(ox)). Ra and Rd rose progressively throughout exercise, peaking at 6.85 and 6.99 mmol/min, respectively, at fatigue (i.e., 133 min). Most (93%) of this glucose was oxidized; during the final 30 min of exercise, R(ox) averaged 6.10 mmol/min and accounted for approximately half of total CHO oxidation. These results support the hypothesis that trained cyclists can oxidize plasma glucose at very high rates during the later stages of prolonged exercise when fed CHO.     

薄层扫描法测定熊胆引流物中胆汁酸含量

熊胆向以贵重药材闻名,被称之为稀有药品,为开发熊胆资源,解决熊胆奇缺问题,我校解剖教研室已成功地完成了人工引流熊胆汁技术,可随时进行人工引流获取熊胆汁。为了确定胆汁的质量指标,了解其主要成分,我们进行了引流胆汁与天然熊胆的分析。文献报道,熊胆中主要含熊去氧胆酸(ursodesoxycholic acid,UDCA)、鹅去氧胆酸(cheno desoxycholic acid,CDCA)、胆酸(cholic acid,CA)、去氧胆酸(deoxycholic,acid DCA)等。     

Risk–taking behaviours in a sample of New Zealand adolescents

Abstract: We surveyed the risk–taking behaviour of students aged 16 years and over in two New Zealand high schools, with a particular focus on road safety, substance use, sexual behaviour and personal safety. The questionnaire was completed by 471 students, a participation rate of 99 per cent. We found that seven out of 10 students who had ridden either a bicycle or motorcycle in the previous 12 months had not always worn a helmet; that 56 per cent had driven a car without a licence; and 23 per cent had been involved in a motor vehicle crash. A lifetime incidence of 63 per cent for cigarette smoking, 34 per cent for marijuana use and 78 per cent for alcohol use was found. Forty per cent of the students reported ever having sexual intercourse. During the previous 12 months, 49 per cent of these had not always used contraceptives and 61 per cent reported not always wearing condoms as protection for sexually transmitted diseases. Twenty–five per cent had physically harmed another person and 10 per cent reported carrying a weapon with the intent of harming someone else. This study shows that adolescents are willing to provide information on risk taking and that they are engaging in high levels of health–harming behaviour. Such information is important for designing health promotion programs to address adolescent risk taking. ( Aust N Z J Public Health 1997; 21: 455–61)