Effectiveness of dental health educational programs in schools

The largest and most important group that may be reached by health education is found in the school system. Children not only are fast learners and anxious to acquire new skills but also are at risk for the development of dental health problems. Therefore, regardless of the equivocal nature of the evidence regarding the effectiveness of school dental health educational programs, it is important that they continue to be developed. The programs created should have objectives, pretesting, participatory and cognitive experiences, periodic review of dental health program by an advisory committee, a liaison between school personnel and health professionals, and realistic models to assess the effects of the program on health. Because dental disease preventive programs and regimens such as water fluoridation, topical fluorides, dental sealants, and oral hygiene regimens are available that have the potential to eliminate dental disease, effort should be made to increase the awareness of the children who can benefit from them.     

Preventive dental prosthesis for the patient with bulimia

Bulimia is a distinct diagnostic eating disorder with its most noted manifestation being the rapid ingestion of large quantities of food followed by its elimination through the mouth. Because of the dental implications of highly acidic stomach contents chronically being regurgitated, the dentist is in a unique position to help identify the patient with bulimia. Dental erosion is not only the most easily noted but also the most destructive of the many oral problems caused by bulimia. This report of case describes a preventive dental prosthesis that can be used by the patient with bulimia to protect those teeth that are most affected by dental erosion. The construction of the prosthesis is easily completed with materials in the dental office and provides a great service to the patient with bulimia.     

Effects of tolazamide and exogenous insulin on pattern of postprandial carbohydrate metabolism in patients with non-insulin-dependent diabetes mellitus. Results of randomized crossover trial

To determine whether therapy with exogenous insulin or sulfonylureas results in a postprandial pattern of carbohydrate metabolism in patients with non-insulin-dependent diabetes mellitus (NIDDM) that resembles that in nondiabetic individuals, we employed a dual-isotope technique combined with forearm catheterization to examine meal disposition in NIDDM patients, before and after 3 mo of therapy with tolazamide and after 3 mo of therapy with exogenous insulin, with a randomized crossover design. Results were compared with those observed in nondiabetic subjects. Although both forms of therapy improved chronic glycemic control (glycosylated hemoglobin concentration went from 9.6 +/- 0.7 to 7.6 +/- 0.5 and 7.1 +/- 0.2%, respectively, P less than .01), exogenous insulin resulted in a lower postprandial glycemic response than tolazamide (P less than .001). Both agents comparably increased (P less than .01) fasting and integrated postprandial insulin concentrations. However, the initial rate of postprandial increase was greater with exogenous insulin (P less than .05). Tolazamide (P less than .05) but not exogenous insulin increased postprandial C-peptide concentrations. However, tolazamide did not improve the deficient early insulin release. Both agents (P less than .05) lowered postabsorptive hepatic glucose release (from 2.8 +/- 0.3 to 2.3 +/- 0.2 mg . kg-1 . min-1), but not to normal rates (1.8 +/- 0.1 mg . kg-1 . min-1).(ABSTRACT TRUNCATED AT 250 WORDS)     

Full-length ureteric splintage in the management of bilharzial ureteric strictures

Our experience with full-length ureteric splintage is reviewed with a note on the technique and its outcome. It is safe, effective and simple, easy to teach and easy to learn. It is recommended as the operation of choice in bilharzial ureteropathy.     

Management of iron overload in the pediatric patient

Iron overload is a major complication of long-term transfusion therapy. In the absence of treatment, the excessive iron causes diffuse organ damage, usually culminating in death from heart disease. Deferoxamine, an iron-chelating drug, removes tissue iron, prevents iron-induced organ dysfunction, and prolongs life. Proper administration of deferoxamine requires careful attention to dose, route and duration of administration, and compliance. Better chelators are needed but are unlikely to be available soon. Other methods for preventing or reducing iron accumulation involve alterations in the transfusion program or the blood product. Prevention of iron overload should improve the lives of patients with transfusion-dependent anemias and extend the usefulness of transfusion in chronic hematologic disorders.     

Caffeine and the benign encephalopathy of pregnancy

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