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  • 1
    Electronic Resource
    Electronic Resource
    Sinus tachycardia in term infants preceding sudden infant death (1988)
    Springer
    European journal of pediatrics 147 (1988), S. 74-78 
    Details
    ISSN: 1432-1076
    Keywords: Sudden infant death syndrome ; Sinus tachycardia ; Heart rate variability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The quantities of sinus tachycardia in 24-h recordings of the electrocardiogram from 16 full-term infants (≥37 weeks gestation) who were subsequently victims of the sudden infant death syndrome (SIDS), from 230 randomly selected age-matched full-term survivors and from 64 full-term survivors matched for age and birth weight were measured by computer and manual analysis techniques. Of 16 infants dying of SIDS, 7 had elevated levels of sinus tachycardia (〉95th centile in controls) (P〈0.01). Although high levels of sinus tachycardia might be of value in identifying infants at high risk of SIDS, these encouraging findings must first be validated by further prospective studies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00442617
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  • 2
    Electronic Resource
    Electronic Resource
    Medication errors in paediatric practice: insights from a continuous quality improvement approach (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 769-774 
    Details
    ISSN: 1432-1076
    Keywords: Key words Medication errors ; Iatrogenic disease ; Adverse incident reporting ; Continuous quality improvement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective was to assess the incidence and consequences of medication errors, highlight sources of recurrent error and institute changes in practice to prevent their recurrence. Utilising a continuous quality improvement approach, a 2-year prospective cohort study was undertaken using an adverse incident reporting scheme. A multidisciplinary committee analysed medication error reports, classifying them according to type (prescription, supply or administration), severity (serious or not serious) and clinical outcome. Changes in policy and practice were implemented to reduce the frequency of errors. There were 441 reported medication errors in the study period, during which 682 patients were admitted for 5315 inpatient days. Errors were more seven times likely to occur in the intensive care setting. Doctors accounted for 72% of errors and prescription errors doubled when new doctors joined the rotation. Most errors (68%) were detected prior to drug administration. Twenty-four serious medication errors were not detected in advance, but only 4 had overt clinical consequences. Excluding prevented errors and appropriate deviations from prescribed therapy, there were 117 actual medication errors (1/5.8 admissions, or 1/45 inpatient days). During the 2nd year of the scheme, the incidence of all reported errors, administration errors and serious errors fell, but the prescription error rate remained constant. Conclusions Medication errors occurred commonly in this study, but adverse consequences were rare. The non-punitive, multidisciplinary approach to medication errors utilised in this study increased staff vigilance, highlighted sources of recurrent error, and led to changes in drug policies and staff training, which resulted in improved patient safety and quality of care.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050932
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  • 3
    Electronic Resource
    Electronic Resource
    A randomized cross-over study of enalapril in congestive heart failure: Haemodynamic and hormonal effects during rest and exercise (1988)
    Springer
    European journal of clinical pharmacology 34 (1988), S. 323-331 
    Details
    ISSN: 1432-1041
    Keywords: enalapril ; congestive heart failure ; haemodynamic-/hormonal effects ; plasma renin/-aldosterone ; antidiuretic hormone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary We performed a randomized double-blind placebo controlled cross-over study of enalapril in 16 patients with chronic congestive heart failure, to assess haemodynamic and hormonal effects at rest and on exercise. Acute effects were measured 4 h after enalapril 10 mg, and chronic effects after 6 weeks treatment with enalapril 10–20 mg per day. Exercise tolerance, assessed by the duration of a maximal bicycle ergometer test, was not altered by enalapril. Mean blood pressure was reduced after enalapril, at rest and on exercise, acutely by 7% and 8% respectively, and chronically by 14% and 16%. Systemic vascular resistance was reduced by 16% at rest both acutely (NS) and chronically (p〈0.05). The resting pulmonary capillary wedge pressure was reduced by 28% with chronic treatment. In the acute study, total body oxygen consumption on exercise was 26% higher after enalapril. Chronically, resting oxygen consumption was reduced by 13% after enalapril, with mixed venous oxygen saturation increasing by 16%. In the acute study enalapril increased plasma renin activity at rest and on exercise by 181% and by 189%, and reduced aldosterone by 49% (NS) and 39% (p〈0.05), and these effects were sustained after 6 weeks. Enalapril increased antidiuretic hormone concentrations at rest acutely by 73% (NS) and chronically by 34% (p〈0.05) but not on exercise; the increase in the acute study correlated with plasma enalaprilat levels (r=0.66, p〈0.05). Enalapril did not alter plasma catecholamine concentrations. Patients preferred enalapril to placebo, and radiographic heart size was reduced during chronic treatment. There were no serious adverse effects. We conclude that enalapril is an effective angiotensin converting enzyme inhibitor of clinical value in chronic heart failure, but study design and methods of assessment of benefit can have a major influence on the results of pharmacological studies in such patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00542431
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  • 4
    Electronic Resource
    Electronic Resource
    The magnitude and duration of the effects of some mouthrinse products on salivary bacterial counts (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of clinical periodontology 21 (1994), S. 0 
    Details
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. The persistence of action or substantivity of an antimicrobial agent in the mouth relates to the plaque inhibitory action of that compound. Substantivity can be assessed by measuring the magnitude and duration of the fall in salivary bacteria following single rinses with antimicrobials. This was a randomised single-blind, cross-over study measuring the effects of single 60-s rinses of 5 mouthwash products on salivary bacterial counts in 14 healthy human volunteers. Effects over a 7-h period were compared with a chlorhexidine rinse product (positive control) and saline (negative control). All but one rinse, containing cetylpyridinium chloride (CPC), significantly reduced bacterial counts compared to saline up to 5–7 h. No rinse produced the magnitude or duration of effect noted for chlorhexidine and decrements from baseline, with one exception, were highly significantly lower than with the chlorhexidine product. Comparing the 2 CPC rinses, the findings suggest that the activity of one product was vitiated by some other ingredient. The triclosan/copolymer, the essential oil/phenolic and one CPC products exhibited similar persistence. In those cases where information is available, these data are consistent with comparative plaque inhibitory findings for the products or their active ingredients. Again, it is concluded that the method is a useful screening and comparison test for the potential plaque inhibitory activity of antimicrobial oral hygiene products.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-051X.1994.tb00736.x
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  • 5
    Electronic Resource
    Electronic Resource
    The effect of oxidising mouthrinses compared with chlorhexidine on salivary bacterial counts and plaque regrowth (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of clinical periodontology 22 (1995), S. 0 
    Details
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract For various clinical indications, oxidising agents have been used in dentistry for many years. Little is known, however, of their antibacterial activity and their ability to inhibit plaque formation. In this study, 2 mouthrinses containing peroxyborate (Bocasan) and peroxycarbonate (Kavosan) were compared alongside a negative control saline rinse and a positive control chlorhexidine rinse (Corsodyl) for their ability to inhibit plaque reformation. Employing a randomised four replicate 4x4 latin square cross over design and, whilst omitting all other oral hygiene, plaque was measured by area and index after rinsing for 4 days. In a second study, in vivo antibacterial effects of the rinses were assessed by measuring salivary bacterial counts following single rinses with the preparations at various time intervals over 7 h, Plaque inhibition by chlorhexidine was significantly greater than the other rinses. All rinses were significantly better than the saline rinse at inhibiting plaque. For plaque area, the peroxycarbonate rinse was significantly better than the peroxyborate rinse at inhibiting plaque. Salivary bacterial count reductions were significantly greater compared to saline with chlorhexidine at all time intervals up to 7 h. Whilst both peroxyborate and peroxycarbonate rinses produced greater reductions in bacterial counts than saline up to 3 h, at no time interval were the differences significant. The findings of these studies would suggest oxidising mouthrinses may inhibit plaque formation not by a direct antibacterial effect, but by some other mechanism. The magnitude of plaque reductions obtained with the peroxyborate and more so peroxycarbonate rinses would suggst a need for further study of these preparations when used as adjuncts to normal toothbrushing.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-051X.1995.tb00257.x
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  • 6
    Electronic Resource
    Electronic Resource
    A study into the plaque-inhibitory activity of experimental toothpaste formulations containing antimicrobial agents (2005)
    Oxford, UK : Munksgaard International Publishers
    Journal of clinical periodontology 32 (2005), S. 0 
    Details
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background/Aims: The use of specific antimicrobial agents in toothpastes may help reduce plaque and gingivitis. There would also appear to be some value in formulating products that contain combinations of such agents that may potentiate any activity present. The aims of this exploratory and pragmatic study were twofold:- (1) exploratory: to compare the effects on plaque re-growth of two zinc citrate/triclosan formulations, one of which contained bromochlorophene and hence demonstrate any additional beneficial effects produced by the addition of the phenol. (2) pragmatic: to assess whether both pastes were significantly better than a benchmark control, proprietary fluoride toothpaste at inhibiting plaque formation.Methods: Following an initial prophylaxis to remove all plaque and calculus, toothpaste slurry rinses were used over a 96 h period by 24 volunteers, while omitting all other oral hygiene procedures. After 24, 48 and 96 h, plaque was measured by plaque area and by plaque index. For comparative purposes, a conventional commercial fluoride toothpaste rinse was also used as a benchmark control in this triple cross-over double-blind study.Results: With one exception, comparisons between the three pastes failed to show any significant differences in plaque accumulation at 96 h whether assessed by plaque index or area. At this time period, significantly more plaque was seen with the zinc citrate paste without bromochlorophene, compared with that of the control paste.Conclusions: The findings from this study failed to demonstrate a plaque-inhibitory action from the two novel formulations beyond that of a conventional benchmark toothpaste, although overall levels of plaque formed by the volunteers, especially on the control paste were generally lower than in previous studies. Nevertheless, it remains to be determined whether the test formulations could exert a direct anti-inflammatory action against gingivitis by way of the triclosan delivery system. Neither test formulation was subsequently marketed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-051X.2005.00762.x
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  • 7
    Electronic Resource
    Electronic Resource
    Investigation of erosion and abrasion on enamel and dentine: a model in situ using toothpastes of different abrasivity (2003)
    Oxford, UK : Munksgaard International Publishers
    Journal of clinical periodontology 30 (2003), S. 0 
    Details
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Studies in vitro suggest that abrasion and erosion may act synergistically to produce wear of enamel and dentine. Methods in situ are recently available to study separately erosion and abrasion of dental tissues. The aim of this study was to combine two in situ protocols to study the interplay between erosion and abrasion of enamel and dentine.Method: The study was a single-blind, randomised, five-treatment cross-over design involving 15 healthy volunteers. During each 10-day study period, subjects wore from 0900 to 1700 h an upper removable acrylic appliance holding one polished enamel and one polished dentine specimen. The specimen treatment regimens were:〈list xml:id="l1" style="custom"〉1Drinking water and brushing with toothpaste A.2Drinking water and brushing with toothpaste B.3Drinking orange juice.4Drinking orange juice and brushing with toothpaste A.5Drinking orange juice and brushing with toothpaste B.Drinking and brushing times were around 0900, 1100, 1300 and 1500 h. Drinks were consumed as 250 ml over 10 min and brushing ex vivo for 1 min to each specimen. Measurement of tissue loss was made on days 5 and 10 of each period using a profilometer.Results: All treatments produced increasing tissue loss over time, which was considerably greater for dentine than enamel. For enamel, the data at days 5 and 10 showed a significant effect for erosion (i.e. orange juice was significantly more erosive than water), but no significant effect for abrasion (i.e. no significant difference between the two toothpaste treatments). The combined orange juice and toothpaste effects were directional for synergy but did not reach significance. For dentine at day 10, many specimens exceeded the 50 μm set limit of the profilometer and only day 5 data were considered. There were significant effects for erosion (orange juice produced significantly more erosion than water) and for abrasion (paste A was significantly more abrasive to dentine than paste B). The synergy effect could not be examined for dentine due to the truncation effect as the set limit of the profilometer was exceeded.Conclusions: Erosion increases the susceptibility of enamel to toothpaste abrasion. Dentine is considerably more susceptible than enamel to erosion and abrasion alone or combined. Dentine loss appears to correlate with toothpaste abrasivity (RDA value).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1600-051X.2003.00367.x
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  • 8
    Electronic Resource
    Electronic Resource
    Studies in vitro of abrasion by different manual toothbrush heads and a standard toothpaste (2000)
    Copenhagen : Munksgaard International Publishers
    Journal of clinical periodontology 27 (2000), S. 0 
    Details
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Loss of dentine at the buccal cervical region of teeth has a multifactorial aetiology. However, a considerable amount of circumstantial evidence, supported by laboratory experiments, implicates toothbrushing with toothpaste as a consistent factor. Most interest has centred around the abrasivity of toothpastes, particularly since a toothbrush alone has negligible effects on dentine. The influence of filament stiffness on toothpaste abrasion was the subject of some studies, mostly at least 2 decades ago, and produced conflicting conclusions. Numerous changes to toothbrush design and construction have taken place in recent years.〈section xml:id="abs1-2"〉〈title type="main"〉Aims:The aim of this study was to measure the abrasion of a standard substrate, acrylic, by a standard toothpaste carried on modern brands of toothbrushes classified by manufacturers as hard (3 brands), medium (3 brands) and soft (6 brands).Method: The substrate was brushed for 20,000 strokes with at least 6 heads from each brand. Measurements of substrate loss were made at 5000 stroke increments by profilometry.Results: Substrate loss for all brushes showed a pattern of abrasion which was to a first approximation linear. Overall, hard brushes caused least abrasion and soft brushes the most, with differences between groups being significant. Within-group differences between brands reached significance for soft and medium brushes but not hard brushes.Conclusions: The results could be explained by increased retention of toothpaste by smaller diameter filaments and denser tufts on soft brushes and the greater flexion of filaments increasing the area of contact with the surface. Calculations on the clinical outcome of these data in vitro indicate that toothbrushing with toothpaste alone would produce minimal damage to dentine even over many years. Differences between brushes therefore are probably of little clinical significance. Certainly, the data do not support the use of hard brushes, particularly in view of the potential detrimental effects to gingival tissues.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1600-051x.2000.027002099.x
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  • 9
    Electronic Resource
    Electronic Resource
    A study to assess the plaque inhibitory action of a newly formulated triclosan toothpaste (2001)
    Copenhagen : Munksgaard International Publishers
    Journal of clinical periodontology 28 (2001), S. 0 
    Details
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background/aims: Triclosan containing toothpastes have been noted for their potential to inhibit plaque and gingival inflammation. The aim of this study was to determine whether a toothpaste containing triclosan and an enhanced fluoride system would inhibit de novo plaque formation beyond that of a non-triclosan, conventional fluoride toothpaste.Methods: This study used a 4-day plaque regrowth model in which 24 volunteers used toothpaste rinses as the only form of oral hygiene. Following a prophylaxis and a single brushing with the toothpastes, 2× daily rinsing with toothpaste slurries was used over the following 96 h.Results: After 24 h, there was no difference in plaque area between the triclosan paste and its control paste. After 96 h, a reduction in plaque score of 5% was noted for the test toothpaste compared to the control paste which was statistically significant (p=0.028). For plaque area this reduction was increased to 16%, which was also significant (p=0.006).Conclusions: These findings would appear to warrant further investigation into the potential value of the paste in inhibiting both plaque and gingivitis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-051X.2001.280113.x
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  • 10
    Electronic Resource
    Electronic Resource
    Comparative effects of quaternary ammonium mouthrinses on 4-day plaque regrowth (2000)
    Copenhagen : Munksgaard International Publishers
    Journal of clinical periodontology 27 (2000), S. 0 
    Details
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Quaternary ammonium compounds constitute a large group of antibacterial chemicals with a potential for inhibiting plaque and gingivitis. One compound, benzalkonium chloride (BC), may be of value, although there is a dearth of evidence to support efficacy. The aim of this study was to measure the ability of 2 BC mouthrinses (0.05% and 0.1%) to inhibit de novo plaque reformation.Method: A 4-day plaque regrowth model. For comparative purposes, a commercial mouthrinse containing cetyl pyridinium chloride (CPC) and a positive control chlorhexidine (CX) mouthrinse were also evaluated.Results: Compared to water control, a reduction in plaque scores of 52% was noted for the CX mouthrinse, 22.5% for CPC and 5% and 6% for the 2 BC rinses. For plaque area, reductions of 84%, 47%, 16% and 15% were found for CX, CPC, and the 2 BC rinses, respectively. Significant reductions in plaque area compared to the water rinse were also seen with the 2 BC rinses (p〈0.05). However, for both plaque score and plaque area, the CX and CPC rinses significantly reduced plaque compared to the BC rinses (p〈0.0001).Conclusions: These findings would suggest that the 2 benzalkonium rinses would only have a limited value at inhibiting plaque formation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1600-051x.2000.027001037.x
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