Malaria control in South Malabar,Madras State

The author describes the activities and achievements of a two-year malaria-control demonstration-organized by WHO, UNICEF, the Indian Government, and the Government of Madras State-in South Malabar.Widespread insecticidal work, using a dosage of 200 mg of DDT per square foot (2.2 g per m(2)), protected 52,500 people in 1950, and 115,500 in 1951, at a cost of about Rs 0/13/0 (US$0.16) per capita.The final results showed a considerable decrease in the size of the endemic areas; in the spleen- and parasite-rates of children; and in the number of malaria cases detected by the team or treated in local hospitals and dispensaries.     

Sutureless Repair of Postinfarction Cardiac Rupture

A 62-year-old female with a history of progressive angina experienced an acute myocardial infarction. Seven days later, cardiac rupture ensued. She underwent surgical repair without the aid of extracorporeal circulation. A Teflon patch was glued over the myocardial tear with medical adhesive. She recovered and is leading a normal life, 15 months after surgery.     

Evaluation of Microbial Reduction in Root Canals Instrumented with Reciprocating and Rotary Systems

Objective

This in vitro study aimed to evaluate the efficacy of the disinfection of root canal systems carried out with Reciproc^TM and ProTaper Universal^TM systems using 1% sodium hypochlorite (NaOCl).

Methods

Forty human single-rooted mandibular premolars were infected with Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus and Candida albicans, and twenty were not infected. The specimens were randomly divided into 6 groups (n = 10): Group 1: ProTaper Universal^TM + 1% NaOCl; Group 2 (positive control): ProTaper Universal^TM + saline; Group 3 (negative control without microorganisms): ProTaper Universal^TM + saline; Group 4: Reciproc^TM + 1% NaOCl; Group 5 (positive control): Reciproc^TM + saline; Group 6 (negative control without microorganisms): Reciproc^TM + saline. Samples were collected before and after the completion of specific treatments, and plated in specific media cultures. The Fisher exact test was used for the statistical analysis of differences in terms of presence or absence of microbial growth among groups. For all tested pathogens, significant differences (p < 0.001) were verified between the instrumentation systems used.

Results

ProTaper Universal^TM associated with 1% NaOCl completely eliminated all microorganisms. Microbial growth, however, was observed when Reciproc^TM was used associated with 1% NaOCl.

Conclusion

According to the protocol executed for this study, the Reciproc^TM system associated with 1% NaOCl was not able to completely eliminate E. faecalis, P. aeruginosa, S. aureus and C. albicans from the root canal systems.Key words: endodontic treatment, Enterococcus faecalis, single-file instrumentation, sodium hypochlorite     

When Water Hurts

Deglutition syncope refers to an uncommon cause of neurally mediated syncope induced by swallowing. We briefly review a case of a 66-year-old man who experienced recurrent syncope episodes during ingestion of beverages, mainly water. Our investigations documented several short asymptomatic episodes of asystole and one prolonged complete atrioventricular block of around 15 seconds associated with the syncopal events, during swallowing. Barium x-ray and manometry evaluations revealed only a nonspecific esophageal dysmotility. An underlying sick-sinus syndrome was found on electrophysiologic study. A DDD pacemaker implantation was performed leading to total disappearance of patient's symptoms.     

PSYCHIATRIC MORBIDITY AMONG THE ELDERLY IN A PRIMARY CARE SETTING—REPORT FROM A SURVEY IN SÃO PAULO,BRAZIL

Brazil has been experiencing a steady increase in the elderly population during the past few years, and as a result old age health-related problems are increasing continuously in number. Psychiatric symptoms are among the most prevalent health problems of the elderly and are an important source of distress for patients and carers, being also associated with significant growth in the costs and demand for the provision of health care services. This study aimed to investigate the prevalence of mental health problems among the elderly attending a regional primary care unit in the city of São Paulo, Brazil. A total of 351 patients older than 60 were assessed during a 6-month period with the SRQ-20 (a scale for the detection of minor psychiatric problems), four questions on psychotic symptoms, AMTS (a scale for the assessment of cognitive functioning) and CAGE (a scale for the assessment of alcoholism); demographic variables were also recorded. Subjects' mean age was 71.22 (CI=70.51–71.92) and 83.5% were female. Thirty-two per cent of subjects were considered ‘cases’ as they scored more than 7 on the SRQ-20 (26.8% of total), or more than 1 on the CAGE (1.4% of total), or at least 1 on the questions assessing psychotic symptoms (12.2% of total). There was a significant excess of women among those found to suffer from psychiatric problems (90.1% vs 80.4%). Cases were also more likely to be illiterate (23.4% vs 12.1%) and to have a lower income (2.21 vs 4.01 minimum wages). Depressive symptoms and tension were highly prevalent (72.9% of subjects). Somatic complaints and signs of inefficient functioning were also common (50.4% and 45.9% respectively). Only five patients answered affirmatively two or more CAGE questions and 12.2% scored at least 1 on the questions assessing psychotic symptoms. Cognitive deficit, as determined by the AMTS, was observed in 13.4% of the sample and was associated with ageing, being illiterate and having higher total SRQ-20 scores. We suggest, that the organization of health care services should take into account the needs of this population, and should also emphasize professional training for the correct assessment and treatment of the most frequent mental health problems in old age. © 1997 John Wiley & Sons, Ltd.