A National Study Of Fluoride Mouthrinse Adoption:

The ongoing adoption of school-based fluoride mouthrinse programs in the U.S. has provided the opportunity to study the issues surrounding the adoption and implementation of a health technology by public schools. Findings from a National Study on the Diffusion of Preventive Health Measures to Schools have been selected for analysis with regard to the role of school health personnel in the adoption and delivery of the service. A more visible role for school health personnel as on-site health experts is discussed, as well as the potential ways for increasing their involvement through facilitating initial program adoption, relaying accurate and up-to-date implementation information to decision-makers, developing a constituency for long-term program support and ensuring program accuracy through monitoring and continuing education.     

Coffee drinking and death due to coronary heart disease.

For a series of 649 patients who died of coronary heart disease within 24 hours of onset of symptoms, and an equal number of neighborhood controls, information was obtained on a large number of variables, including coffee consumption. An analysis using multivariate risk scores to control for all available variables yields a maximum likelihood estimate of the risk ratio associated with coffee drinking of 1.1 (95 per cent two-sided confidence limits, 0.8 to 1.6). The estimate of the risk ratio depends somewhat on the number and nature of variables controlled for in the analysis. Overall, our findings, limited to low-risk and middle-risk patients, suggest that the risk, if any, of death from coronary heart disease associated with coffee drinking is small.     

One-day regimen of valacyclovir for treatment of recurrent genital herpes simplex virus 2 infection

OBJECTIVES: To evaluate the efficacy of a 1-day course of valacyclovir in reducing the duration and severity of genital herpes recurrences and to measure the frequency of viral shedding episodes subsequent to antiviral therapy. STUDY DESIGN: In an open-label pilot study, patients with recurrent genital herpes simplex virus 2 (HSV-2) infection were given a 1-day course of valacyclovir (2000 mg given by mouth twice daily) to be taken at the first sign of recurrence or prodrome. Participants maintained diaries of signs and symptoms and collected genital swabs for viral culture while lesions persisted and HSV DNA PCR for 14 days after initiating treatment. RESULTS: Ninety (78%; 41 men, 49 women) of the 115 enrolled persons experienced either a lesional recurrence or prodrome. Seventy-seven (86%) participants developed lesions; 4 (5%) participants experienced a second lesional recurrence during the 14-day study period. The median lesion duration was 5 days, episode duration was 5 days, and pain duration was 3 days. Viral shedding was detected in 60 persons by PCR and 31 persons by culture. Shedding detected by culture lasted for a median of 2 days, and shedding detected by PCR lasted for a median of 3 days. Of 60 participants with viral shedding, 14 (23%) had an additional shedding episode after their initial lesion healed, lasting for a median of 2 days. CONCLUSIONS: A 1-day course of valacyclovir may be a convenient treatment for recurrent genital herpes and comparative trials are warranted.     

A retrospective study of physical activity and coronary deaths

For a series of 568 married white men aged 30-70 years who died from coronary heart diseases, (CHD), and a matched sample of living neighbourhood controls, information was collected on a large number of variables, including physical activity, (PA), classified according to the Health Insurance Plan Study criteria. Increased leisure PA was associated with a decreased risk of coronary death (p less than .001) but there was no association between job activity and coronary deaths. Step-up multiple regression, based on within-pair differences, was used to control for the possible confounding effects of all variables studied. Even when these variables were controlled for there was still a significant association between increased leisure PA and decreased risk of death due to CHD (P less than .001). These data are consistent with the hypothesis that increased leisure PA can contribute to the prevention of death from CHD.