Caries prevalence, salivary Streptococcus mutans and dietary scores in 13-year-old Swedish schoolchildren

388 13-yr-old schoolchildren from Karlstad, Sweden, participated. Dental caries experience was expressed as number of decayed (D) and filled (F) tooth surfaces (S), and registered on bite-wing radiographs and obtained from records. Salivary Streptococcus mutans counts were determined by a spatula method. A dietary score was calculated for each individual based on an interview concerning the intake frequency of 23 sugar-containing products. Significantly lower DFS values were found in the group with no detectable S. mutans compared to three of the four groups with salivary S. mutans (P less than 0.01). No differences were found between the DFS values of individuals with high, moderate or low dietary scores. There was no statistically significant association between dietary scores and levels of S. mutans. Among the children with no detectable S. mutans, there were higher DFS-values with increasing intake frequency. No relationship between initial caries lesions, S. mutans and diet was found.     

Oral findings in adults with osteogenesis imperfecta

This paper describes oral findings in an adult population with osteogenesis imperfecta (OI) in Norway (n = 94).
All participants underwent a structured interview and an oral examination. Panoramic radiographs were analyzed. The findings were compared with data from other Nordic epidemiological studies.
Seventeen individuals (19%) had clinical signs of dentinogenesis imperfecta (DI). Persons with OI had twice as many missing teeth as the general population, and the number of endodontically treated teeth was higher than in the general population. All persons in the study had an acceptable state of tooth tissue loss. Almost all (97%) of the participants in the study group visited a dentist or a dental hygienist regularly. The results of the study indicated a low prevalence of clinical DI compared with previous reported studies. Oral health was not as good in the population with OI when compared with the general population, although daily oral health habits were good and dental visits were regular.     

Effect of reserpine on the brain uptake of carbon 11 methamphetamine and its N-propagyl derivative, deprenyl

The enantiomers of methamphetamine (MAMP) and its N-propagyl derivative, deprenyl, were labelled with carbon 11, and the tissue distribution of these labelled compounds in mice was studied. Both enantiomers of 11C-MAMP rapidly entered into the brain and then disappeared according to a single exponential curve. The enantiomers of 11C-deprenyl were also rapidly distributed to various organs in the same manner. With regard to elimination, however, a stereoselective, long-term retention of radioactivity in the brain, heart and lung, due to its irreversible binding with monoamine oxidase B, was observed for L-11C-deprenyl. In reserpinized mice, the initial brain uptake of both the L and D forms of 11C-MAMP was significantly decreased. On the other hand, the brain uptake of both enantiomers of 11C-deprenyl was slightly increased by pretreatment with reserpine. A significant and non-stereoselective elevation of the lung uptake of 11C-deprenyl was also seen in reserpinized mice. In addition, both the relative tissue distribution and ratios of radioactivity in the brain compared with blood or heart at 1 and 5 min after the injection of 11C-labelled methanol in mice were not changed by reserpine. These results indicate that the transport or binding processes of these amines rather than the blood flow might be altered by reserpine. There would be an important role of the pKa values of amines in both processes. The reduction of brain uptake as well as the change in ratio between brain and heart of L-11C-MAMP in reserpinized mice 1 min after injection were reversed by treatment with amphetamine in a dose-related manner.(ABSTRACT TRUNCATED AT 250 WORDS)     

Digital skeletal radiography : Reduction of absorbed dose by adaptation of exposure factors and image processing

Purpose: The possibility to reduce the absorbed dose to the patient by increase of tube potential while maintaining the same exposure to the image plate and sufficient image quality in skeletal radiography has been investigated.Material and Methods: Image processing parameters were adjusted to account for an increase in tube potential by 20 kV. Revision of image processing parameters was based on measurements with phantoms constructed to simulate the histogram shape recorded for clinical images. Image quality was evaluated both using image quality criteria and visual grading analysis. Energy imparted was calculated from measurement of the kerma-area-product.Results and Conclusion: Energy imparted was reduced by 20-30% using the modified technique with increased kV. All images were considered of accurate quality for diagnosis and the difference in image quality score was marginal. There was, however, a significant shift towards lower grades for the "high kV" technique using visual grading analysis.     

Factors associated with discontinuation of long-term lithium treatment

Sixty-four outpatients with major affective disorder according to DSM-III and on continuous lithium treatment for an average duration of 7.8 years were first investigated in 1980 and then followed for 7 years. The predictive value of patients' attitudes to their lithium, the prognostic influence of psychiatric status, side effects, and anamnestic and laboratory data including lithium parameters were studied. At the end of the 7-year follow-up, 61% of the patients were still on lithium maintenance treatment, 25% had discontinued lithium for clinical reasons, and 14% of the patients had died. Side effects of lithium were the major clinical reason for discontinuing treatment, while attitudes towards medication were of minor importance. Approximately one fourth of the patients who discontinued lithium were differentiated from those who continued treatment by showing a high frequency of the neurologic side effects incoordination, paresthesia, and disturbed sensibility in addition to having more severe tremor. In yet another fourth of those who discontinued for clinical reasons, lithium was stopped by the treating psychiatrist as maximal urine osmolality values were considered to be too low. These patients did not show any signs of clinically significant impairment of renal functions. Their psychiatric status was excellent in terms of extremely low CPRS scores. The patients who died during the follow-up period were differentiated from those who continued treatment by a much higher frequency of alcohol and drug abuse prior to the initiation of lithium therapy. The total number of side effects and the number of severe side effects were significantly larger than in continuers on lithium. The most common causes of death were cardiovascular disease and suicide. In no case was the cause of death attributed to lithium therapy.     

Swelling kinetics of poly(N-isopropylacrylamide) gel

In many gel applications the swelling and shrinking kinetics are very important, e.g. in controlled/slow release, where the kinetics determine the rate of out-diffusion of the active component, and in gel extraction where the gel is swollen and shrunk several times. In this study swelling kinetics of poly(N-isopropylacrylamide) gel (NiPAAm gel) was determined by monitoring the swelling process using a stereo microscope and a video camera. The swelling of spherical gel bodies could conveniently be studied after a temperature change. The results obtained were treated according to the approach of Tanaka and Fillmore, in which the swelling and shrinking of a gel is described as a motion of the gel network according to the diffusion equation. This was shown to be valid when the temperature changes are kept below the critical point of the gel. However, the model fails to describe the shrinking process when passing from below to above the critical temperature. The collective diffusion coefficient (D), defined as the osmotic bulk modulus divided by the friction factor, was determined by fitting to the experimental data. D was found to increase with temperature according to the Wilke–Chang relation D=2.0·10⁻¹¹ +7.6·10⁻¹⁷ ·T/μ. The results were used to simulate the swelling/shrinking process. The simulations show the importance of having sufficiently small gel bodies to achieve a short swelling time.     

Late asthmatic reactions and bronchial variability after challenge with low doses of allergen

Late allergic inflammatory reactions are probably of major importance for the development of asthma. In order to study the occurrence of early and late asthmatic reactions after challenge with different doses of allergen, inhalation provocation tests were performed in 13 patients with mild or moderate symptoms of allergic asthma. The provocation series was started with a low allergen dose (0.1-10 BU), which was then increased in successive ten-fold increments at intervals of 1 week until a pronounced bronchial reaction developed. Three different reaction patterns were observed. Six patients showed an isolated late reaction to relatively low doses of allergen. In four patients an immediate reaction was followed by a late reaction--a so-called dual response, and in three patients only an immediate reaction occurred. In four of the six patients who showed only a late reaction a higher allergen dose was given and this resulted in dual reactions in all four. One patient was challenged with an even higher dose, to which she reacted with an immediate response alone. After a late reaction, bronchial variability with low PEF values was observed over a period of several days. It is thus possible for an isolated late asthmatic reaction to be provoked by a low dose of inhaled allergen. This can be of clinical importance, repeated small doses of allergen may be unnoticed but still give bronchial inflammation and asthmatic symptoms.     

Treatment and outcome in post-resuscitation care after out-of-hospital cardiac arrest when a modern therapeutic approach was introduced

BACKGROUND: The outcome among patients who are hospitalised alive after out-of-hospital cardiac arrest is still relatively poor. At present, there are no clear guidelines specifying how they should be treated. The aim of this survey was to describe the outcome for initial survivors of out-of-hospital cardiac arrest when a more aggressive approach was applied. PATIENTS: All patients hospitalised alive after out-of-hospital cardiac arrest in the Municipality of G?teborg, Sweden, during a period of 20 months. RESULTS: Of all the patients in the municipality suffering an out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation (CPR) was attempted (n=375), 85 patients (23%) were hospitalised alive and admitted to a hospital ward. Of them, 65% had a cardiac aetiology and 50% were found in ventricular fibrillation. In 32% of the patients, hypothermia was attempted, 28% underwent a coronary angiography and 21% had a mechanical revascularisation. In overall terms, 27 of the 85 patients who were brought alive to a hospital ward (32%) survived to 30 days after cardiac arrest. Survival was only moderately higher among patients treated with hypothermia versus not (37% versus 29%; NS), and it was markedly higher among those who had early coronary angiography versus not (67% versus 18%; p<0.0001). CONCLUSION: In an era in which a more aggressive attitude was applied in post-resuscitation care, we found that the survival (32%) was similar to that in previous surveys. However, early coronary angiography was associated with a marked increase in survival and might be of benefit to many of these patients. Larger registries are important to further confirm the value of hypothermia in representative patient populations.     

How bystanders perceive their cardiopulmonary resuscitation intervention; a qualitative study

The importance of bystander cardiopulmonary resuscitation (CPR) prior to arrival of the emergency medical service is well documented. In Sweden, CPR is initiated prior to emergency medical services (EMS) arrival in about 30% of cardiac arrests out-of-hospital, a figure which should be improved urgently. To do so, it is of interest to know more about the bystanders' perceptions of their intervention. A qualitative method inspired by the phenomenographic approach was applied to 19 bystanders who had performed CPR. In the analysis, five main categories and 14 subcategories emerged. The main categories were: to have a sense of humanity, to have competence, to feel an obligation, to have courage and to feel exposed. Interviews described how humanity and concern for another human being were the foundation of their intervention. CPR training offers the possibility to give appropriate help in this emergency. If the aim of CPR training was extended beyond teaching the skill of CPR to include preparation of the rescuer for the intervention and his/her reactions, this might increase the number of people able to take action in the cardiac arrest situation.