bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study of Disturbed Mineralization of Rat Incisor Enamel Induced By Strontium and Fluoride Administration
Authors: Suga S. , Aoki H. , Yamashita Y. , Tsuno M. , Ogawa M. 
Published: January 2017

The disturbed pattern of mineralization of developing enamel of the rat incisor after the oral administration of SrCl2 and NaF was investigated in an attempt to disclose possible mechanisms which might not be readily detectable under normal conditions, but which may control the progressive mineralization of developing enamel, especially during the maturation stage. Undemineralized ground sections of upper incisors were examined by contact microradiography, tetracycline labeling, and electron microprobe analysis. It was clear that Sr and F disturb the pattern of mineralization during the maturation stage in a characteristic fashion. Sr inhibits the early stage of maturation in which mineralization progresses from the surface toward the middle layer, whereas F accelerates the same stage prominently. At the late stage of maturation, the pattern of hypomineralization is different in the enamel of Sr- and F-treated rats. Mineralization in the inner and innermost layers of the Sr-treated rats and that in the outer layer of the F-treated rats ceases earlier than that in the controls, although the enamel is still hypomineralized. At the latest stage of maturation, Fe penetrates more deeply into the hypomineralized enamel of the Sr- and F-treated rats, because of the higher porosity of the matrix. These results suggest that the maturation stage is not a simple, continuous process, but rather is composed of substages (phases) which have different control mechanisms and in which mineralization progresses in different modes and rates.
Dental Amalgam: Reactor Response
Authors: Marek M.I. 
Published: January 2017

Dental amalgam continues to be an important restorative material; both fundamental and applied research should be encouraged. The criteria for replacement of amalgam restorations should be re-examined to determine if the integrity of the margins should continue to receive the dominant research interest. In the studies of mechanical properties, first attempts have been made to apply fracture mechanics analysis to dental amalgam. The heterogeneous structure and time-dependent strain of dental amalgam will have to be considered in future studies. More attention should be given to the effects of zinc, which has been shown to improve resistance to marginal fracture. The corrosion properties have been studied in depth, but there are some important unanswered questions. The pathways of corrosion attack in high-copper amalgams and the kinetics of attack in amalgams of different composition should be examined. Biocompatibility of dental amalgam has recently received renewed interest and will have to be examined in more detail. The clinical significance of the release of metallic elements from restorations is generally unknown. Dental amalgam faces strong competition from non-metallic restorative materials. Future research should be more strongly focused on the critical issues. The involvement of scientists from related disciplines should be encouraged, and no effort should be made to restrict the talent pool by a centralization of resources.
The Role of Toothbrushing in the Prevention and Treatment of Periodontal Disease: Personal Experience of Both Clinical and Experimental Observation for More than Thirty Years
Authors: Ishikawa J. 
Published: January 2017

There have been dramatic developments in the theory and therapy of periodontal disease in the last few decades. This paper focuses on the role of toothbrushing in the treatment and prevention of periodontal disease, based on the author's personal experience gained from both clinical and experimental observations for more than 30 years. Even in the recent past, periodontal disease was considered to be untreatable because of various misconceptions regarding its etiology. Attention was concentrated mainly on systemic factors. As a result, periodontallyinvolved teeth were extracted mostly due to lack of technical know-how. The author devoted his primary investigative efforts to systemic factors and found that those were only minimally significant. Later, after using wild and captive monkeys to make extensive experimental studies on local factors, he was convinced that food habit (hard, fibrous, or soft) contributes directly to the etiology of periodontal disease which is restricted in the oral environment itself. Today it is well-established that accumulation of bacterial plaque on the tooth surface is the most important single factor responsible for periodontal disease, and systemic influence can merely modify the condition. Therefore, the accumulated plaque should be mechanically removed by toothbrushing. The essence of mechanical toothbrushing is not only to remove the plaque but also to compensate for the mechanical stimulation of the gingiva (gingival massage), which is lacking with modern soft food. This lecture reviews the effect of methodical toothbrushing obtained from both clinical and experimental studies in animals.
Diversity of IgG Antibody Responses in the Patients with Various Types of Periodontitis
Authors: Ishikawa I. , Watanabe H. , Horibe M. , Izumi Y. 
Published: January 2017

Serum IgG antibodies to seven periodontopathic bacteria were assessed with an enzyme-linked immunosorbent assay (ELISA) in 56 patients with periodontitis. Patients were selected according to the severity of bone loss, and were also classified into three categories by age: juvenile periodontitis (JP), advanced destructive periodontitis (ADP), and adult periodontitis (AP). Bacteroides gingivalis, B. loescheii, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, Eikenella corrodens, B. intermedius, and Capnocytophaga ochracea were the bacterial strains of interest. Antigens were prepared by cold ultrasonication of washed bacterial cells. Association of high- or low-IgG antibody titer to the bacteria was evaluated. High or low titers of IgG were based on ELISA measurements in 28 healthy subjects. Values exceeding 100% above or below the normal standard deviation were classified as high or low titers, respectively. Most patients with three types of periodontitis (76.8%) exhibited high-IgG antibody titers against various periodontopathic bacteria. The sera mostly included high-IgG titer against one or some of B. gingivalis, E. corrodens, F. nucleatum, and/or A. actinomycetemcomitans. B. gingivalis was predominantly associated with three categories of periodontitis (60.7%). However, high-IgG antibody titer against B. gingivalis alone was found in relatively low percentage (21.4%). Most of the cases were associated with one or more of the other periodontopathic bacteria. High-IgG titer against A. actinomycetemcomitans was found in a few patients (12.5%), who showed severe and more rapid bone loss. Nine patients (16.1%) showed lower IgG antibody titer than did the healthy control subjects. Of the nine, three patients who belonged to the JP category showed the chemotaxis dysfunction of their PMNs. Some immunodepression was suspected in these patients.
Ultrastructure and Composition of Enamel in Human Dental Fluorosis
Authors: Yanagisawa T. , Takuma S. , Fejerskov O. 
Published: January 2017

Materials used in this work were 13 permanent molars exhibiting dental fluorosis (between 5 and 9 on the Thylstrup-Fejerskov scale, 1978) obtained from adults (aged 20-40 years) living in regions with 3.5 ppm fluoride in the water supplies. Small but deep occlusal caries lesions necessitated extraction. Light and polarized microscopic, microradiographic, electron microscopic, and electron-probe- and ion-micro-analytical studies were made. Enamel surfaces were generally cloudy to opaque, with several pits or defects of various sizes and degrees of brown-staining. An extensively hypomineralized area extended from the inner enamel to the surface layer, which was mineralized to a high degree. The hypomineralized area contained sparsely arranged, flattened, hexagonal crystals with either perforated centers or defects extending from the perimeter and indicating either no or low fluoride content. The highly mineralized surface layer, however, was composed of many large, flattened, hexagonal crystals and extremely small, irregularly shaped crystals. Both types were free of central perforations and defects. A high fluoride concentration was determined in the highly mineralized surface layer. These findings suggest that the hypomineralized area undergoes caries-like changes in terms of crystal dissolution and that the highly mineralized surface layer contains hydroxyapatite and fluoridated-hydroxyapatite, or fluorapatite, or both.
Casting Alloys: Side-Effects
Authors: Hensten-Pettersen Arne 
Published: January 2017

Side-effects from dental materials are a minor problem, but should be recognized. In recent questionnaire surveys about side-effects, the incidence was estimated to be 1:300 in periodontics and 1:2600 in pedodontics. None of these reactions was related to dental casting alloys. In prosthodontics, the incidence was calculated to be about 1:400, and about 27% were related to base-metal alloys forremovable partial dentures (cobalt, chromium, nickel) and to noble/goldbased alloys for porcelain-fused-to-metal restorations. The complaints consisted of intra-oral reactions (such as redness, swelling, and pain of the oral mucosa and lips), oral/gingival lichenoid reactions, and a few instances of systemic reactions. In orthodontics, the incidence was 1:100, and most reactions (85%) were related to metal parts of the extra-oral anchorage devices. Even though the extensive use of base-metal alloys has been of major concern to the dental profession, relatively few case reports substantiate this concern. Allergy to gold-based dental restorations has been more commonly reported. Palladium-based alloys have been associated with several cases of stomatitis and oral lichenoid reactions. Palladium allergy seems to occur mainly in patients who are very sensitive to nickel. All casting alloys, except titanium, seem to have a potential for eliciting adverse reactions in individual hypersensitive patients. Tolerance induction may be a possible benefit of the use of intra-orally placed alloys. In non-sensitized individuals, oral antigenic contacts to nickel and chromium may induce tolerance rather than sensitization. A variety of systemic diseases and reactions has been claimed to be caused by dental materials. The claims are generally poorly documented. Further controlled clinical trials are necessary for assessment of the problems associated with metal allergy and dental treatment procedures, and for development of a scientific basis for training clinicians in proper treatment planning for hypersensitive patients.
Faculty Turnover within Academic Pharmacy Departments
Authors: Carter Orly , Nathisuwan Surakit , Stoddard Gregory J , Munger Mark A 
Published: January 2017

BACKGROUND: Pharmacy faculty manpower has been debated within the academic pharmacy community over the last several decades. Previous investigations studied job satisfaction among faculty members, but have not evaluated faculty retention and turnover among academic pharmacy departments. OBJECTIVE: To evaluate retention and turnover rates in the departments of Pharmacy Practice and Basic Science (Pharmacology/Toxicology, Pharmaceutics, Medicinal Chemistry) over the last 5 years. METHODS: Individual instructors and assistant, associate, and full professors across 80 colleges of pharmacy in the US were tracked between the years 1996 and 2001 using the American Association of Colleges of Pharmacy published rosters. Differences between departments were analyzed by year-stratified cross-tabulation table analysis. RESULTS: A greater percentage of Pharmacy Practice faculty resigned (10.6%) compared with Basic Science faculty (6.0%; percent ratio 1.76; 95% CI 1.58 to 1.95; p < 0.001), which remained constant across each academic year. Approximately 2.7 faculty members left their academic institutions per year in Pharmacy Practice compared with 1.1 faculty members in the aggregate of Basic Science departments. A higher percentage of women resigned in Pharmacy Practice (13.2%) than did men (8.7%; percent ratio 1.5; 95% CI 1.34 to 1.68; p < 0.001), despite a 1.3-fold male to female ratio. Likewise, regardless of a 4.1-fold male to female ratio in the Basic Science group, a higher percentage of women resigned (8.0%) than men (5.5%; percent ratio 1.45; 95% CI 1.18 to 1.78; p < 0.001). CONCLUSIONS: Over a 5-year period, Pharmacy Practice exhibited a higher turnover compared with Basic Science. Women displayed significantly higher turnover than men across all pharmacy academic departments. New retention approaches, especially for female faculty members, should be explored.
Resolution of Risperidone-Induced Hyperprolactinemia with Substitution of Quetiapine
Authors: Kunwar Arun Raj , Megna James L 
Published: January 2017

OBJECTIVE: To report a case of risperidone-induced hyperprolactinemia that was successfully managed with quetiapine. CASE SUMMARY: A 30-year-old white woman with schizoaffective disorder, depressive type, and comorbid alcohol and cocaine abuse was treated successfully for her psychotic symptoms with risperidone until she developed adverse effects consistent with hyperprolactinemia. This was confirmed by laboratory blood tests, as her prolactin level was 186.9 ng/mL (normal for nonpregnant women 2.8–29.2). The woman had experienced similar effects in the past, which had led to noncompliance and subsequent psychotic relapse. Normalization of prolactin levels and associated adverse effects were achieved upon switching to quetiapine. No psychotic symptoms reoccurred. DISCUSSION: Dopamine type 2 (D2) receptor blockade in the mesolimbic tract is thought to mediate the therapeutic effects of antipsychotics. This action in the tuberoinfundibular system produces prolactin level elevation. Risperidone has a relatively higher affinity for the D2 receptor in comparison with other atypical antipsychotics, which may explain why it is associated with a higher incidence of hyperprolactinemia. Quetiapine, which has one of the lowest D2 receptor affinities, is not known to increase prolactin levels to any significant degree. This pharmacologic property allows quetiapine to be a reasonable treatment option for patients who develop risperidone-induced hyperprolactinemia. CONCLUSIONS: Quetiapine may be a suitable substitute when a patient taking risperidone develops hyperprolactinemia.
Clopidogrel-Associated Leukopenia
Authors: McCarthy Michelle W , Kockler Denise R 
Published: January 2017

OBJECTIVE: To report a case of leukopenia in a patient receiving clopidogrel following intracoronary stent placement. CASE SUMMARY: A 58-year-old white man presented to the emergency department (ED) with fever and chills. Seven days prior to presentation, he underwent intracoronary stent placement and clopidogrel 75 mg once daily was initiated. In the ED, laboratory evaluation revealed leukopenia with negative blood and urine cultures. The patient was released but returned the following day with fever and sweating. Infectious complications were ruled out, and clopidogrel was discontinued. Leukopenia resolved within 7 days, and the patient has experienced no further hematologic complications. Based on the Naranjo probability scale, the leukopenia was rated as a probable reaction to clopidogrel. DISCUSSION: Ticlopidine and clopidogrel are the 2 commercially available thienopyridine antiplatelet agents. Risk of myelotoxicity with ticlopidine is well known and requires frequent hematologic monitoring. Clopidogrel is better tolerated, less toxic, and has more extensive indications, including use in acute coronary syndrome. These factors have resulted in the replacement of ticlopidine by clopidogrel. The 4 previously published reports of clopidogrel-associated white blood cell (WBC) toxicity are described. The mechanism of myelotoxicity with clopidogrel is not known. CONCLUSIONS: Better tolerability, reduced toxicity (particularly hematologic), and the convenience of once-daily dosing have resulted in the replacement of ticlopidine with clopidogrel. WBC toxicity associated with clopidogrel therapy is very infrequent and has occurred weeks to months following therapy initiation. Clinicians should be aware of the potential for this adverse effect.
Desloratadine: A Nonsedating Antihistamine
Authors: Limon Lynn , Kockler Denise R 
Published: January 2017

OBJECTIVE: To review information on desloratadine, a nonsedating antihistamine. DATA SOURCES: An English-language MEDLINE search was conducted (1966–July 2002). References of identified articles were subsequently reviewed for additional data. Schering Corporation provided unpublished information. STUDY SELECTION/DATA EXTRACTION: Articles and abstracts pertaining to desloratadine were considered for inclusion, with emphasis on randomized, placebo-controlled, double-blind trials. DATA SYNTHESIS: Desloratadine is approved for the treatment of symptoms associated with seasonal allergic rhinitis (SAR), perennial allergic rhinitis (PAR), and chronic idiopathic urticaria (CIU) in patients aged ≥12 years. In placebo-controlled trials, desloratadine demonstrated superior efficacy as a once-daily treatment of SAR, PAR, and CIU. Data suggest that desloratadine has antiinflammatory and decongestant activity. CONCLUSIONS: Desloratadine appears to be a “me-too” agent, with no major differences compared with other second-generation antihistamines.
Nesiritide: A Novel Approach for Acute Heart Failure
Authors: Vichiendilokkul Aungkana , Tran Alison , Racine Eric 
Published: January 2017

OBJECTIVE: To review preclinical and clinical information related to nesiritide, a recombinant form of B-type natriuretic peptide approved for treatment of acutely decompensated heart failure. DATA SOURCES: Primary and review articles were identified by MEDLINE search (1966–May 2002) using the key words natriuretic peptide and heart failure, and through secondary sources. Natrecor's document submitted for the Food and Drug Administration (FDA) New Drug Application were obtained from the FDA Web site. STUDY SELECTION/DATA EXTRACTION: Peer-reviewed articles and abstracts of randomized clinical trials in humans were included in this review. DATA SYNTHESIS: Nesiritide has beneficial actions for treatment of heart failure, including arterial and venous dilatation, enhanced sodium and urinary excretion, and suppression of the renin–angiotensin–aldosterone and sympathetic nervous systems. It has been shown to improve hemodynamic parameters, primarily pulmonary capillary wedge pressure, as well as clinical symptoms in patients with acutely decompensated heart failure. Nesiritide produced more rapid hemodynamic improvement and caused significantly fewer adverse effects than intravenous nitroglycerin. The incidence of hypotension, the most common adverse effect, was comparable between nesiritide and nitroglycerin. Additionally, nesiritide is associated with a lower incidence of arrhythmias than dobutamine and has a neutral effect on mortality. CONCLUSIONS: Nesiritide offers an alternative for management of acutely decompensated heart failure. It is considered an option for patients who do not respond to other vasodilators, inotropes, or diuretics and for those at high risk of arrhythmias. Further pharmacoeconomic investigations for nesiritide are warranted.
Feasibility of Symbolic Directions on Prescription Labels
Authors: Hardie Nancy Richardson , Gagnon Jean Paul , Eckel Frederick M. 
Published: January 2017

This project presents the results of a study designed to evaluate the usefulness of graphic labels in assisting functionally illiterate patients to understand how and when to take medication. The project's results indicate that comprehension of symbolic directions did not increase as rapidly as comprehension of typed directions. Symbolic directions did, however, reduce the variation in interpretation of directions among patients with a 0–4 grade education. Neither age, nor sex, nor the order of label presentation affected level of comprehension of typed or symbolic prescription labels. The results of this study indicate that use of symbols may not be the sole answer to the problem of assisting patients with inadequate reading abilities. Symbolic prescription directions should be evaluated before their use. Then, when used, they should be accompanied by oral reinforcement.
Narcotic Use in the Hospital: Reasonably Safe?
Authors: Whipple Julianne K. , Ausman Robert K. , Quebbeman Edward J. 
Published: January 2017

OBJECTIVE: To determine the causes and frequency of overdoses associated with the administration of opioid analgesics in hospitalized patients. DESIGN: Case series. SETTING: Two acute care teaching hospitals. PATIENTS: Eighty-one hospitalized patients who received naloxone for a clinically suspected narcotic overdose. INTERVENTIONS: Three investigators reviewed each patient who received naloxone during a 12-month period. The patients were judged to have a narcotic overdose if caregivers documented an immediate improvement in mental status, respiratory rate, or blood pressure after naloxone administration. MAIN OUTCOME MEASURES: The number and causes of narcotic overdoses were determined. The frequency of morphine and meperidine overdoses was calculated. The number of incidents reported using incident or adverse drug reaction reports or the appropriate International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code. RESULTS: In the 22 overdoses that occurred, 14 (64 percent) were caused by medication prescribing, compounding, or administration errors and potentially were preventable. The remaining eight patients experienced an overdose despite receiving appropriate amounts of opioids. The frequency of overdoses was 0.4 and 0.2 percent of total patients receiving morphine or meperidine, respectively, at the two hospitals. Nonreporting of these narcotic overdoses was frequent. In one hospital, 1 incident report and 3 adverse drug reactions were reported for 17 overdoses. At the second hospital, 1 incident report and 1 adverse drug reaction were reported for 6 overdoses. None of the patient charts included an ICD-9-CM code that documented the problem. CONCLUSIONS: The causes of overdoses are not limited to prescribing and administration errors. Some patients, despite proper execution of appropriate orders, develop a narcotic overdose. Caregivers must be aware of this problem and monitor patients for a decrease in mental status and respiratory rate. In addition, we conclude that an important number of hospitalized patients develop an overdose even though the frequency is low related to the number of patients receiving narcotics.