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.     

The impact of substance dependence on HIV sexual risk-reduction among men with severe mental illness

We explored the impact of substance dependence on the efficacy of an HIV sexual risk reduction intervention previously shown to be effective among men with severe mental illness by comparing rates of high-risk sexual behaviors among men with (n = 26) and without (n = 31) a lifetime history of substance dependence. We sub-divided subjects by alcohol and drug dependence status, comparing each intervention sub-group to the corresponding control sub-group. At each follow-up interval (six, 12 and 18 months), the intervention group as a whole and the non-substance dependent participants showed a significant reduction in risk; the substance-dependent men showed no difference from controls. These data suggest that among men with severe mental illness, substance dependence may be a further impediment to HIV risk reduction.     

Antipsychotic dosage at hospital discharge and outcomes among persons with schizophrenia

OBJECTIVE: Applying the schizophrenia treatment guidelines established by the Patient Outcomes Research Team (PORT) project, this study evaluated whether antipsychotic medication dosage influenced patient outcomes in routine clinical settings. METHODS: The associations between discharge antipsychotic medication dosage and short-term clinical, social, and service use outcomes were observed in a sample of 246 patients with schizophrenia or schizoaffective disorder. RESULTS: Patients who were given high dosages of antipsychotic medication at hospital discharge (more than 1,000 chlorpromazine milligram equivalents) had greater severity of symptoms three months after discharge than patients who were given guideline-recommended dosages (300 to 1,000 chlorpromazine milligram equivalents) (adjusted mean Brief Psychiatric Rating Scale scores of 45 and 39, respectively). Patients who were given low dosages of antipsychotic medication at hospital discharge (less than 300 chlorpromazine milligram equivalents) were less likely to report side effects (adjusted OR=.24) and slightly more likely to be nonadherent (21 percent of those within the recommended dose range compared with 39 percent of the those with low doses, not statistically significant after Bonferroni correction). No other differences related to medication dosage were observed in patient outcomes. CONCLUSIONS: Treatment that falls within antipsychotic medication dosage guidelines is associated with improvement in a limited, but critical, range of short-term patient outcomes in routine clinical settings.     

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.     

Inquiries About and Initiation of Buprenorphine Treatment in an Inner-City Clinic

ABSTRACT

Despite increases in opioid dependence, availability of buprenorphine treatment remains limited. Reasons may include health center concerns about becoming overwhelmed or attracting patients who differ from the local community. This study documents inquiries about and initiation of buprenorphine treatment in an inner-city health center. From 2006–2008, we collected demographic information and subsequent treatment data for everyone who inquired about treatment. Of the 324 people who inquired, 55.6% initiated treatment. The number of inquiries increased gradually over time, and most came from local community residents (80.4%). These results may allay health center concerns, and can help planning for buprenorphine treatment.