The dental management of patients with bipolar disorder

Bipolar disorder (manic depressive disease) affects 1% of the United States population. These persons suffer from prolonged episodes of extreme elation and depression. There is a significant incidence of dental pathosis and a need for dental care among these patients. The medications used for the treatment of this disease, their physiologic effects, and their interactions with the drugs used in dentistry are reviewed.     

Supraoptic nucleus afferents from the main olfactory bulb--II. Intracellularly recorded responses to lateral olfactory tract stimulation in rat brain slices

To establish the functional nature of the anatomically demonstrated main olfactory bulb inputs to the supraoptic nucleus, electrophysiological responses of intracellularly recorded supraoptic neurons to lateral olfactory tract stimulation were recorded in horizontal slices of basal forebrain and hypothalamus. A total of 71 synaptically influenced neurons were studied in slices from adult rats of both sexes. Of these, 60 cells (84%) were monosynaptically activated by olfactory tract stimulation; seven cells (10%) were activated via polysynaptic pathways; and four cells (6%) were characterized by long latency inhibitory responses. Lucifer Yellow was injected into 64 cells and subsequent immunocytochemical identification of 44 of these neurons showed that both oxytocin and vasopressin cells, in approximately equal numbers, were excited by olfactory stimulation. Polysynaptically mediated excitation, however, was only associated with oxytocin cells (six of the six identified cells). These results corroborate anatomical tract tracing data showing main olfactory bulb efferents to both supraotic neurons and to neurons of the perinuclear zone. Also supported are earlier speculations of olfactory participation in release of oxytocin and vasopressin during various physiological states.     

Differences in aerodynamic characteristics of new and dysfunctional Provox®2 voice prostheses in vivo

Tracheoesophageal voice prostheses need to be replaced due to increased airflow resistance or retrograde leakage of fluid into the trachea as a consequence of biofilm formation. Previous in vitro studies show a change of aerodynamic features of biofilm covered voice prostheses after removal of the prostheses out of the patient. To assess these changes in an in situ situation, aerodynamic characteristics were measured within 45 patients at the beginning and at the end of the wearing process of the Provox 2 voice prosthesis. As a consequence, the influence of biofilm formation on aerodynamic characteristics can be evaluated. In the majority of cases, leakage through the prosthesis was the reason for replacement. No differences were found in the total flow, volume range and intratracheal pressure (ITP) of the voice prostheses measured. The airflow resistance of biofilm covered prostheses was significantly reduced compared to new clean prostheses. However, no correlation was found between the extent of biofilm and the different aerodynamic features measured. Biofilm formation on the Provox 2 is responsible for both reduction in airflow resistance and leakage through the prosthesis by deterioration of the silicone rubber material.