The influence of a hydrogen peroxide and glycerol containing mouthrinse on plaque accumulation: a 3-day non-brushing model

Abstract: Aim: To evaluate the inhibition of plaque growth by an experimental mouthrinse (BioXyl^®) based on hydrogen peroxide/glycerol. Design: It was a double‐blind, randomized study involving 40 volunteers in good general health. At the start of the trial, all participants received a dental prophylaxis to remove all plaque deposits. During the next 3 days subjects refrained from any mechanical oral hygiene procedure, except for the allocated mouthrinse being either the hydrogen peroxide (H₂O₂; 0.013% H₂O₂/0.004% glycerol) or the placebo without H₂O₂. At the third day of appointment, plaque levels were assessed at six sites per tooth. Results: The test group had a mean overall plaque score of 2.66 and the placebo group of 2.70. The difference in plaque scores between the two groups was not statistically significant. Conclusions: The results of this pilot study showed that there was no statistically significant difference between the H₂O₂/glycerol group and the placebo group with respect to plaque inhibition within this study design.     

Pulmonary nodules: detection using magnetic resonance and computed tomography

Detection of pulmonary nodules using spin-echo magnetic resonance (MR) imaging was compared with detection using computed tomography (CT). Of the 25 patients studied independently by two radiologists, no lung nodules were detected in 11 (CT or MR), ten had a single nodule, and four had multiple nodules. The lesions not seen using CT or MR were less than 1.3 cm in diameter. The greater spatial resolution of CT enabled better detection of nodules close to the diaphragm, the pleura, or to each other, whereas the better contrast resolution of MR enabled the detection of several nodules close to blood vessels. With MR, nodules were best seen on images with long repetition times (2.0 sec). Most pulmonary nodules are seen using both CT and MR. CT generally enables the detection of more small nodules than MR does, and some low-density nodules near blood vessels are better displayed using MR.     

Remediation of low ABSITE scores

PURPOSE: In 2000, a program was initiated to improve American Board of Surgery In-Training Exam (ABSITE) scores below the 40th percentile (PGY-1 and -2) and the 30th percentile (PGY-3 and -5) for categorical residents. The goal of this program is to maintain scores above this standard. METHODS: One faculty member was designated to meet with each resident with ABSITE scores below the standard described above. In April, individual study plans were designed with each resident, which emphasized practice questions and strategic planning for study, and the ABSITE test structure and results were reviewed. Two subsequent meetings were held between November and December to monitor progress. Emphasis was placed on minimizing the stigma of poor scores and on maximizing the efficiency of study time. If the resident scored above-standard that year, further support was not required. RESULTS: From 2000 to 2004, 12 (9.5%) ABSITE scores were below-standard, which resulted in 8 (20.5%) residents receiving program support 9 times. All but 1 program encounter resulted in above-standard scores the following year (improvement range, 16 to 65 percentile points; average, 34 points). Two residents had recurrent below-standard scores in subsequent years despite above-standard scores immediately after the program. One resident did not participate in the program, despite it being designated as mandatory. During the same interval, the ABSITE scores of residents not involved in the program decreased by an average of 3.7 percentile points per examination (improved scores 31 times; 39.2%, range 1 to 46, average 13.5, worse scores 45 times; 57%, range 1 to 65, average 15.2, and no change 3 times, 3.8%). CONCLUSIONS: An individualized program that minimizes the stigma of poor test results, the time commitment required by the residents, and maximizes the benefits of a question-based study system and the knowledge of approach to the ABSITE resulted in significant improvements in scores the next year. However, maintenance of these results needs continued evaluation because 3 residents had recurrent poor scores in subsequent years.     

Usage of antimicrobial agents in a private primary healthcare setting in South Africa

Objective The aim of this study was to investigate the prescribing of antimicrobials in a private primary healthcare setting in South Africa. Setting A group of private primary healthcare clinics in South Africa. Method A retrospective, drug utilisation study was conducted on nine clinics that were randomly selected from 33 clinics situated in different geographical areas of South Africa, and whose data were electronically available. Data were obtained from the central database of the private primary healthcare provider and extracted for the period January 1, to December 31, 2001. Key findings The study population consisted of the total patient population (n = 83 655) who visited the clinics during this one‐year period. The total number of medicine items prescribed was 515 976 at a total cost of R1 716 319 ($17 163). Of these, antimicrobials represented 18.69% (n = 96 421) of all medicine items prescribed at a cost of R1 045 108 ($10 451) (60.89%). Antimicrobials were prescribed during 72.72% of consultations at the nine clinics during the one‐year period. The antimicrobials most frequently prescribed were penicillins (38.17%) followed by sulphonamides (22.49%), antiprotozoals (9.88%) and tetracyclines (9.34%). The most common diagnoses for which antimicrobials were prescribed were viral influenza, upper respiratory tract infections, hypertension, acute bronchitis, and common cold. Conclusions The high percentage of antimicrobial prescribing obtained in this study could indicate excessive use of antimicrobials in the private primary healthcare setting. The prescribing of antimicrobials in respiratory tract infections could indicate overuse and inappropriate use of these agents. This could have an effect on the health of the patients needing care, and the general budget for healthcare services. It is recommended that further investigations on the prescribing protocols of antimicrobial usage be done.