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PubMed1987

Aerosol deposition in automatic dosimeter nebulization.

A new dosimeter nebulization method was studied in 10 asthmatics and 8 normal volunteers by delivering fixed doses of 99mTc-traced radioaerosol in 0.2 s periods of tidal breathing. Two separate inspiratory phases were studied with the onset of nebulization, when in the earlier phase 15% and in the later phase 60% of tidal volume was inhaled. Further, bronchodilator administration was analogically assessed in the asthmatics. In healthy subjects, the total lung deposition was 17% greater in the earlier phase (p less than 0.005) than in the later one. In asthmatics, the difference was not significant. The losses of aerosol outside the lower respiratory tract were minimized, in the mouthwashing 0.3% and in the exhaled air 1.4%. The onset of nebulization (early or late) had no significant effect on bronchodilation with salbutamol in asthmatics. We conclude that the present dosimeter method is useful for efficient delivery of radioaerosols and drugs, and for standardization of bronchoprovocation.

Adult↗

PubMed1985

Pharmacokinetics of benzydamine.

Clinically, benzydamine can exert its action locally or systemically. Consequently the pharmacokinetics of this drug have been studied after its administration by several different routes. Oral doses of benzydamine are apparently well absorbed and plasma drug concentrations reach a peak fairly rapidly (e.g. 0.8 micrograms/ml after a 100-mg dose) and then decline with a half-life of about 13 h. Less than 20% of the drug is bound to plasma proteins. Assuming complete oral systemic availability, values of 193 ml/min and 213 litres respectively were calculated for the systemic clearance and volume of distribution of benzydamine. Cutaneous doses of benzydamine are more slowly absorbed and lead to peak drug levels about three-fold lower, but more persistent than those after oral administration. Although local drug concentrations are relatively large, the systemic absorption of mouthwash-gargle, vaginal and rectal doses of benzydamine is relatively low compared to oral doses: this lower absorption should greatly diminish the potential for any systemic drug side-effects when benzydamine is administered by these routes. Benzydamine is metabolized primarily by oxidation, conjugation and dealkylation.

Absorption↗

PubMed1979

Inhaled corticosteroid aerosols and candidiasis.

A three-month controlled study was performed to assess the cumulative incidence of oral Candida carriage and thrush in patients starting to take betamethasone valerate aerosol (800 microgram/day) for control of their asthma. Four of 41 patients on the corticosteroid aerosol developed thrush compared with none of 40 in the control group. However, the number of cumulative saliva culture positives for C. albicans rose by a similar amount (approximately 20%) in each group. A simple mouthwash procedure was shown to have no prophylactic benefit in the aerosol group. Oral candidiasis was not, however, clinically important.

Administration, Oral↗

PubMed1995

High-throughput method for determination of apolipoprotein E genotypes with use of restriction digestion analysis by microplate array diagonal gel electrophoresis.

Molecular epidemiological research has identified the association of a common apolipoprotein E (apo E) isoform (E4 as opposed to E3), with risk both of coronary artery disease and of Alzheimer dementia. In addition, the role of apo E genotype (usually E2/E2) in Type III hyperlipidemia is well known. However, both for diagnostic and research purposes, apo E genotyping is cumbersome. The preferred approach is electrophoretic sizing of restriction digestion fragments, enabling simultaneous analysis of the two codons (112 and 158) that represent the six common genotypes (E2/E2; E2/E3; E2/E4; E3/E3; E3/E4; E4/E4). However, the consequent demands of high-yield PCR, high-resolution, high-throughput electrophoresis, and sufficient detection sensitivity have left shortfalls in published protocols. In conjunction with a high-throughput electrophoresis system we described recently, microplate array diagonal gel electrophoresis (MADGE), we have constructed extensively optimized, simplified protocols for DNA isolation from mouthwash samples for PCR setup and high-yield PCR, for restriction digestion, and for subsequent MADGE gel image analysis. The integral system enables one worker to readily undertake apo E genotyping of as many as hundreds of DNA samples per day, without special equipment.

Apolipoproteins E↗

PubMed1995

Treatment of post-operative pain.

The effectiveness of three treatments for alveolar osteitis was compared. It was found that chlorhexidine gluconate mouthwash treatment and 2.5 percent Lidocaine ointment treatment reduced the number of days a patient was symptomatic compared to the conventional eugenol-impregnated iodoform gauze treatment. With the conventional use of eugenol-impregnated iodoform gauze, the severity of the patient's symptoms were reduced more effectively than with the other two treatments, but the symptoms lasted longer.

Analysis of Variance↗

PubMed1994

Preventive oral health care: a review for family physicians.

Good oral health is essential for both good nutrition and systemic health, in addition to the ability to taste, chew, swallow and speak. Oral diseases include dental caries, periodontal disease, oral mucosal alterations, precancerous lesions and cancer, and oral trauma. Dental caries can be prevented through good oral hygiene and regular professional cleaning, a healthy, low-sugar diet and the use of fluoride and dental sealants. Periodontal disease can be delayed by brushing with fluoride and obtaining professional scaling. Antibacterial mouthwashes may also be helpful. Careful denture cleaning and regular observation for medication side effects can decrease periodontal disease. Tobacco is the most common cause of cancerous oral lesions. Trauma can be avoided by wearing proper protective gear during contact sports and while riding bicycles and motorcycles. Persons in lower income and educational groups have a higher risk of poor oral health. Regular attention to this area by family physicians will decrease the chance of oral disease in patients.

Dental Caries↗

PubMedDate not supplied

[The burning mouth syndrome. A clinical study].

Burning mouth syndrome (BMS) is a distinct clinical entity characterized by a chief complaint of unremitting oral burning concomitant with no oral mucosal clinically observable lesions. Numerous causes of this condition have been suggested, including local factors, systemic factors, and psychogenic disorders. A total of 36 consecutive subjects, 32 women and 4 men, complaining of BMS, who had attended the Dental Clinic of the University of Ferrara during a period of 2 years, was studied. The method of assessment followed closely a strictly co-ordinated management protocol based on conventional guidelines, namely history, clinical examination and special investigations. A detailed history was taken of duration of the condition, site affected, and pattern of burning. The severity and the response to treatment were assessed with a Visual Linear Analogue Scale (VLAS). A full medical history was taken, with regard to xerostomia-inducing drug assumption. The presence and the severity of menopausal symptoms were explored. Inquiries were made on use of mouthwashes. For the denture-wearers, specific questioning was directed to the length of denture-wearing experience, temporal association of the symptom with the wearing of dentures, relationship to burning sensation of any relines or repairs, denture cleaning technique, and use of fixatives. A complete routine intraoral and extraoral examination was performed. The presence of parafunctional habits, such as tongue thrusting, clenching, grinding, lip and cheek biting, was investigated. If dentures were worn, their design and condition were examined. In particular, the relation between the vertical and horizontal components of the jaw and the denture base extension was assessed and the freeway space measured.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1994

Mass screening for cystic fibrosis heterozygotes: two assay systems compared.

Two different assay systems were used to detect mutant cystic fibrosis alleles in mouthwash samples from pregnant women attending antenatal clinics. In the first phase of the study, comprising 3110 consecutive samples, we compared the performance of an in-house system and a commercial amplification refractory mutation system (ARMS). Successful analyses were completed at first attempt in approximately 90% of samples, and the patient resampling rate was 1.1%. There were no false positives and only one detected false negative. In the second phase, comprising 3333 consecutive samples, only ARMS was used. Again, there were no false positives and the patient resampling rate dropped to 0.5%. On the basis of convenience and reduced operator time, we have elected to use ARMS for further screening for cystic fibrosis heterozygotes.

Cystic Fibrosis↗

PubMed1995

[Psychology of nursing personnel in home care nursing].

UNLABELLED: In a random survey questions were put to 100 employees of home care centers (51 qualified nursing staff, 28 assistants and/or trainees, 21 young people doing community service as an alternative to military service). MAIN RESULTS: (1) The job motivation is primarily of a private nature: social commitment, achievement motivation, being responsible for solving diverse human problems are at the centre of job orientation. (2) Huge disappointments (neglect of patients, stress, arrangement of working hours, bureaucracy, lack of self-responsibility) are in 62% of the cases the reasons for changing from a clinic to the home care centre. (3) The psychological results of home care nursing are only positive in 62% of the cases; 26% have thought of giving notice, 37% would not choose their job again. (4) The training qualification for home care nursing is only adequate for 60% of those questioned; deficiencies are experienced with regard to consulting competence, gerontopsychiatry, specific knowledge about illnesses, legal questions. Essential further training is neglected. Also initial instruction in the home care service is to a great extent unsatisfactory. (5) For economic reasons it is frequently necessary to limit daily care to basic nursing; the patients' communicative needs have to ignored. One's occupational self-importance dwindles away; the job increasingly becomes an everyday stress factor. (6) The high risk of infection in the case of home-care patients is considered to be above-average (bedsores, infection risks with regard to changing bandages/catheters, anuspraeter aids, incontinence, fungal diseases, food risks: not keeping to diets, food not suitable for the elderly, lack of appropriate storage for leftovers. (7) Nursing staff, as well as patients, regard soap, cleansing lotion, shampoo, tooth brushes and toothpaste as the main items for personal hygiene, for the prevention and treatment of bedsores. Beyond that, compared with nursing staff, patients have a greater need for personal hygiene products (deodorants, mouthwash, perfume, etc.): personal hygiene providing mental stimulation. (8) Doctors are not integrated sufficiently into the social network of nursing home-care patients. The required quality of cooperation with the nursing staff only exists in part. (9) Contact to the overworked relatives is generally positive. Cooperation can be optimized by imparting basic nursing knowledge, by getting the relatives to participate in one's own work, by enlisting the home-care centre early on and through psychological support by third parties (e.g. discussion courses).

Adult↗

PubMed1996

Synthesis of ethylammonium iodides of omega-dialkylaminoethyl ethers of 5-(arylmethylene)-1,3,3-trimethyl-2-oxabicyclo [2.2.2.] octan-6-hydroxyimines as potential cosmetic ingredients.

The synthesis of nine quaternary ammonium iodides derived from omega-dialkylaminoethyl ethers of 5-(arylmethylene)-1,3, 3-trimethyl-2-oxabicyclo[2.2.2]octan-6-hydroxyimines, as potential cosmetic ingredients, is described. They are routinely prepared starting from cineole aminoethers by reaction with iodoethane and their physics-chemical data are reported. These substances were studied for their UV absorption and three of these compounds were also submitted to microbiological assays on five test organisms. The substances have their UV absorption maxima at 284-321 nm, and one compound is active on Staphylococcus aureus, Streptococcus faecalis and Candida albicans. These preliminary findings seem to indicate that some of these compounds could be considered as potential UV sunscreens; one compound, having a moderate antimicrobial activity, could be considered a potential active compound in cosmetics as deodorants, toothpastes, mouthwashes and other oral care products.

Anti-Infective Agents↗

PubMedDate not supplied

[Topical treatment of atrophic-erosive oral lichen planus with clobetasol in bioadhesive gel as well as chlorhexidine and miconazole in oral gel].

The study was performed to evaluate the efficacy of the combination of a topical corticosteroid with topical antimicrobic drugs in the therapy of the atrophic-erosive forms of oral lichen planus. Clobetasol propionate, a very potent corticosteroid in the Miller and Munro classification, was used in a 4% hydroxy ethylcellulose bioadhesive gel and applied twice daily for the first four months and once daily for the last two months. Because of the high frequency of candidal infections during corticosteroid therapy, chlorhexidine 0.12%, 3 mouthwashes daily, and miconazole gel, once daily, were added for the whole period of the treatment. Twenty-five patients (17 female, 8 male) participated in the study; 20 concluded the six months of therapy and the six months of follow-up. All 20 patients (100%) had an improvement, while 75% had a complete remission of oral signs. No cases of oral candidiasis were seen. After six months from therapy suspension, 65% of patients were stable in their oral conditions. Our study confirms the efficacy of the combination of a topical corticosteroid with topical antimicrobic drugs in the therapy of the atrophic-erosive forms of oral lichen planus. The stability of our results suggests that, extending the therapy, control of the disease is better.

Administration, Topical↗

PubMed1997

Heteroplasmic point mutations of mitochondrial DNA affecting subunit I of cytochrome c oxidase in two patients with acquired idiopathic sideroblastic anemia.

Mitochondrial iron overload in acquired idiopathic sideroblastic anemia (AISA) may be attributable to mutations of mitochondrial DNA (mtDNA), because these can cause respiratory chain dysfunction, thereby impairing reduction of ferric iron (Fe3+) to ferrous iron (Fe2+). The reduced form of iron is essential to the last step of mitochondrial heme biosynthesis. It is not yet understood to which part of the respiratory chain the reduction of ferric iron is linked. In two patients with AISA we identified point mutations of mtDNA affecting the same transmembrane helix within subunit I of cytochrome c oxidase (COX I; ie, complex IV of the respiratory chain). The mutations were detected by restriction fragment length polymorphism analysis and temperature gradient gel electrophoresis. One of the mutations involves a T --> C transition in nucleotide position 6742, causing an amino acid change from methionine to threonine. The other mutation is a T --> C transition at nt 6721, changing isoleucine to threonine. Both amino acids are highly conserved in a wide range of species. Both mutations are heteroplasmic, ie, they establish a mixture of normal and mutated mitochondrial genomes, which is typical of disorders of mtDNA. The mutations were present in bone marrow and whole blood samples, in isolated platelets, and in granulocytes, but appeared to be absent from T and B lymphocytes purified by immunomagnetic bead separation. They were not detected in buccal mucosa cells obtained by mouthwashes and in cultured skin fibroblasts examined in one of the patients. In both patients, this pattern of involvement suggests that the mtDNA mutation occurred in a self-renewing bone marrow stem cell with myeloid determination. Identification of two point mutations with very similar location suggests that cytochrome c oxidase plays an important role in the pathogenesis of AISA. COX may be the physiologic site of iron reduction and transport through the inner mitochondrial membrane.

Aged↗

PubMed1997

Third molar surgery in general dental practice.

A survey to determine the treatment procedures adopted by general dental practitioners for the removal of impacted third molar teeth was undertaken. Questionnaires were mailed to a sample of 100 practising dentists. Of the 67 per cent that responded, 41.8 per cent (28) indicated that they would attempt the procedure while the remaining 51.2 per cent (39) would not do so. Neither the length of professional experience nor whether they practised in metropolitan or country areas had a bearing on whether the impacted tooth would be removed or not. In general, South African general dental practitioners routinely removed overlying bone by means of a bur, sutured the mucosal incision wound, prescribed antibiotics, analgesics and a mouthwash, and recalled their patients for a post-operative review. Steroids were not prescribed.

Adolescent↗

PubMed1996

Third molar surgical procedures: practices by maxillofacial and oral surgeons in South Africa.

An audit of the treatment procedures routinely adopted by maxillofacial and oral surgeons for the removal of impacted third molars under general anaesthesia was undertaken in South Africa. Most maxillofacial and oral surgeons agree on the method of bone removal, the prescribing of antibiotics, analgesic agents and mouthwashes, the suturing of the incision wound and the post-operative review of patients. The results were compared to a similar study undertaken by Falcon and Roberts (1992) in the UK. With the exception of the method of bone removal, maxillofacial and oral surgeons in both groups share a similar approach to the treatment procedures adopted in the removal of impacted third molars. Some variability, however, existed in both studies with regard to the use of intra-operative local anaesthetic agents, the administration of peri-operative steroids and the use of non-steroidal anti-inflammatory agents.

Adolescent↗

PubMed1992

Disseminated histoplasmosis: aspects of oral diagnosis.

This paper reports two cases of histoplasmosis in Natal: histoplasmosis is a granulomatous mycosis caused by H. capsulatum. The Indian mynah may possibly have a rôle in the epidemiology of this disease. In-vitro culture of the organism is the definitive step in confirming the diagnosis of histoplasmosis. The overgrowth of contaminants often precludes culturing; but a clinical regimen of topical antifungal agent and mouthwash may improve the chances of culturing H. capsulatum.

Adult↗

PubMed1997

Detecting and treating oral and nonoral malodors.

This article suggests methods on how to detect and treat the various oral and nonoral malodor conditions with which patients present. These conditions are separated into those emanating from the nasal passage, sinuses and upper respiratory sources; the mouth; the tongue; the oropharynx; the lower respiratory tract; and the lungs. Foul odors also develop as a result of systemic and gastrointestinal disorders and diseases, as well as the normal breakdown of odiferous ingested foods. The available detection methods are described and future methods are suggested. The overall conclusions made from this review are that currently available management methods will be able to treat most cases. A careful, knowledgeable clinician can usually determine the patient's problem by the use of a thorough history and examination. Occasionally medical consults will be needed; and, in these cases, the approach that must be taken is a combined treatment approach. For example, effective therapy might require a combination of periodontal disease treatment, correction of dental restoration-based food traps and a rigorous daily mechanical debridement of the tongue. The above treatments will often have to be supplemented by the most appropriate mouthwash for the patient's specific condition. Finally, this article hopes to encourage manufacturers of "halitosis products" to support and conduct well-designed clinical trials on their products so that the field is advanced and treatments become more predictable.

Breath Tests↗

PubMed1996

Dental caries and sugar consumption into the 21st century.

New trends towards the effect and role of sugar consumption in the etiology of dental caries into the 21st century are presented, analyzed and discussed. Many factors such as the amount of sugar consumed, the frequency of sugar intake and the kind of sugars ingested have to be taken into consideration. Over the years, the relative importance of these factors has changed. For a very long time, sugar has been "blamed" as a primary etiological factor in the development of dental caries. However, a number of recent reports have attributed a much less important role to carbohydrates. Sugar consumption only does not affect caries prevalence as much as it used to. It is obvious that the role of sugar in the etiology of caries must be reviewed. Additional factors like overall nutrition, the number of meals and snacks per day, education and motivation, fluoride (in tablets or drops, in mouthwashes, toothpastes, baby foods, formulas, beverages, milk, vitamin supplements and/or fluoridated water ingested), socioeconomic group, ethnicity, oral hygiene status, use of preventive methods and sweeteners other than sucrose are presented.

Africa↗

PubMed1976

Origin and location on the oral activity in sequential salivary gland scintigraphy with 99mTc-pertechnetate.

Conflicting views exist regarding the origin and location of the oral radioactivity seen in salivary gland scintigraphy with 99mTc-pertechnetate. The normal accumulation of oral activity was studied in a series of healthy subjects by sequential scintigraphy (anterior and lateral views) after intravenous injection of 2 mCi of 99mTc-pertechnetate. Ligation of the parotid ducts and/or cannulation of the submandibular ducts, which prevented their secretions from reaching the oral cavity, established that the oral activity was due entirely to radioactive saliva secreted by the parotid and submandibular glands. Pertechnetate mouthwash studies confirmed that radioactive saliva is absorbed to oral mucosa and that adsorption to the lingual mucosa in the major contributor to the oral activity. Pertechnetate uptake in sublingual and minor salivary glands of the oral cavity was not visualized, thereby invalidating scintigraphy in the study of these glands. In the diagnosis of salivary gland disorders, oral activity is a useful indicator of major salivary gland function.

Adsorption↗