Newer antibiotics: their place in geriatric care. Part I.

The third-generation cephalosporins offer considerable appeal for treatment of specific life-threatening infections (nosocomial pneumonia, meningitis, urosepsis) in elderly patients when the disorders are caused by aerobic gram-negative bacilli. Despite the frequent presence of cross-reactive antibodies in the sera of recipients of cephalosporins, clinically evident serious reactions to cephalosporins occur infrequently in patients with known penicillin allergy.

Continuous subcutaneous insulin infusion (CSII) reduces counter-regulatory hormone concentrations in a patient receiving enteral hyperalimentation.

A 61-year-old male, while recovering from a Whipple's procedure for pancreatic carcinoma, was treated for 13 days with an insulin infusion pump for diabetes exacerbated by enteral hyperalimentation. Treatment with continuous subcutaneous insulin infusion resulted in improved blood glucose control. Associated with this improvement was a reduction in plasma cholesterol, triglyceride and free fatty acid levels.

High-density lipoprotein subclasses in diabetes.

This cross-sectional study evaluated high-density lipoprotein subclasses measured by a precipitation technique before and after treatment in men and women with types I and II diabetes. Total high-density lipoprotein cholesterol was lower in subjects of both sexes with untreated type I and type II diabetes, the change occurring primarily in subclass 2. Insulin therapy raised total and subclass 2 high-density lipoprotein levels in men and women with type I and type II diabetes, the predominant rise occurring in subclass 2.

Clinical registration of charge transfer between dental metallic materials in patients with disorders and/or discomfort allegedly caused by corrosion.

Thirty referred patients and 15 control subjects were investigated with reference to the occurrence of bimetallic corrosion in the oral cavity. No differences between patients and controls could be found regarding the registered charge transfer between dissimilar short-circuited dental metallic restorations and/or appliances. However, a relatively large number of periodontal and mucous membrane affections, carious lesions and stomatognathic and/or temporomandibular joint disturbances were found within the patient group.

The effect of glipizide on HDL and HDL subclasses.

The effects of glipizide on HDL subclass levels were prospectively evaluated in 7 women and 2 men with non-insulin dependent (Type 2) diabetes. Total HDL, HDL2 and HDL3 levels were unchanged during the treatment period. Baseline HDL levels were lower when compared to a control population which may have been due to the elevated body weight present in most subjects.

Cerebral carbon dioxide reactivity during nonpulsatile cardiopulmonary bypass.

Five patients undergoing extensive cerebral monitoring during cardiopulmonary bypass (CPB) procedures were subjected to studies on cerebral CO2 reactivity during nonpulsatile CPB. The cerebral monitoring included recording of arterial blood pressure (BP), central venous pressure (CVP), epidural intracranial pressure (EDP), cerebral electrical activity by a cerebral function monitor (CFM), and middle cerebral artery (MCA) flow velocity by transcranial Doppler technique. The cerebral perfusion pressure (CPP) was thus continuously recorded (CPP = BP - EDP).

Metallographic characterization of four alternative alloys intended for fixed prostheses.

Four dental casting alloys intended as alternatives for type III gold alloys were studied with regard to their metallographic appearance. The structures of two low-gold and two silver-palladium alloys were evaluated in the as-cast and hardened conditions and in the condition achieved after annealing for 1 h at 100 degrees C below the solidus temperature. The microstructure was studied by light optical microscopy, scanning electron microscopy, electron microprobe analysis, and X-ray diffraction analysis.

Corrosion in the oral cavity--potential local and systemic effects.

The main current-generating corrosion cells in the oral cavity are the bimetallic cell and the concentration cell, the latter mainly occurring due to differences in access to oxygen in the various parts of the metallic material. Corrosion resistance is not an intrinsic property of a metal or an alloy for it depends on an interaction with the environment. Thus, the contents of the oral cavity, have a decisive influence.

Exercise and diabetes.

Exercise has variable effects on diabetes control. It may cause deterioration in diabetes regulation if patients are hyperglycemic, whereas it may reduce blood glucose levels in well-controlled patients. Factors influencing the magnitude of blood glucose reduction include timing of meal ingestion, peak of insulin activity and whether the extremity injected is exercised.

Mass vaccination programme aimed at eradicating measles, mumps and rubella in Sweden: vaccination of schoolchildren.

In 1982-83, a unique, two-dose programme of immunization with a combined vaccine against measles, mumps and rubella was initiated in Sweden. The first dose was administered at 18 months and the second at 12 years of age. A vaccination study was carried out on 247 12 year old schoolchildren from four schools situated in two urban and two rural areas.

DNA replication and H5 histone exchange during reactivation of chick erythrocyte nuclei in heterokaryons.

Fusion of terminally differentiated chick erythrocytes (CE) with replicating quail myoblasts or established L6J1 rat myoblasts results in reactivation of DNA synthesis in the dormant CE nuclei and in suppression of DNA synthesis in the myoblast nuclei. The nuclei of primary quail myoblasts are more effectively inhibited than the nuclei of established rat myoblasts. Inhibition of DNA replication occurs not only by preventing G1 nuclei from entering S-phase but also by blocking nuclei in S-phase and by delaying nuclei in G2 from undergoing mitosis and starting a new DNA replication cycle.

Alginate impression materials, dimensional stability and surface detail sharpness following treatment with disinfectant solutions.

A study was made of the influence of six dissimilar disinfectants on the dimensional stability and the surface detail sharpness of four alginate impression materials. All combinations of alginates and disinfectant solutions produced quite acceptable results as regards dimensional stability one hour after the impression material had been sprayed with the disinfectant. As regards surface detail sharpness one hour after this spraying certain combinations of alginates and disinfectant solutions showed better results than others.

Auditory perpetual dysfunction in patients with CCI, with implications for therapy.

Injury to the head, as from impact, can result in damaged function of the auditory receptive (peripheral) or perceptual (central) system, or both. The altered function may be clearly apparent, as in a loss of hearing, or may be exposed only through specially devised tests. At the Loewenstein Rehabilitation Hospital tests were designed or adapted to evaluate processing in the auditory periphery, the brain stem and the cortex.

Auditory perception in patients with CVA without aphasia.

Tests of central auditory function were performed variously on 64 patients with hemiplegia who had suffered a single stroke but with minimal or no aphasia symptoms and with essentially normal hearing. Both right and left hemisphere lesions were represented for comparison of effects on the tests. Reports of central auditory dysfunction generally assume localization in the temporal lobes.

The phonemic analysis as a treatment method in dysgraphic aphasic patients.

Two theories have been advanced to explain the underlying process of writing acquisition. The first sees a global registration of whole words in a pictorial (graphic) form; the second is based on an analysis synthesis process of each word into its sound (phonemes), and the translation of each phoneme into its graphic form (grapheme). This paper, derived from the latter theoretical construct, attempts to show that phonemic analysis-synthesis is also an efficient approach in the rehabilitation of dysgraphic aphasics.

The Word Retrieval Fluency Test: what does it assess?

The term fluency in aphasia is ambiguous. It can relate to the rate of speech--normal vs. laborious or the ability to retrieve words.

The transition stages between the main aphasic syndromes.

One of the basic features of most aphasic patients is their clinical dynamics, i.e. the continuous change in language function.

Clinical study of patients referred for investigation regarding so-called oral galvanism.

Fifty-four patients referred to the Faculty of Odontology, University of Umeå, for investigation regarding "oral galvanism" were subjected to a general oral investigation. In addition the following parameters were studied: the highest calculated current between two metallic restorations in contact and the electrogustometrically determined threshold value for each person. No differences were found regarding these two parameters between the patients and a control group consisting of 15 persons.

Hydrolytic degradation of dental composites.

The leakage of filler elements from four composites after storage in water was investigated by use of atomic absorption spectrophotometry. The results confirmed previous findings that leaching of silicon from different composites is strongly dependent on filler composition. Consideration of the total filler surface of each composite material indicated that quartz as well as pyrolytic silica-containing composites leached less silicon than did composites containing fillers of strontium and/or barium glasses.

Insulin pump therapy improves blood glucose control during hyperalimentation.

The present study investigated the feasibility of basal continuous subcutaneous insulin infusion (CSII) in four patients with postoperative sepsis or extensive burns during continuous enteral hyperalimentation with 2,500 to 3,000 calories/day, containing approximately 390 g of simple carbohydrates. The mean duration of CSII treatment was 16.8 days (range, seven to 32 days).

Self-monitoring of blood glucose levels in diabetes. Principles and practice.

Self-monitoring of blood glucose levels has become popular due to the limitations in the use of urine testing for assessing the status of diabetes control. Furthermore, the recent emphasis on the importance of diabetes regulation entails that patients tailor the insulin doses based on blood glucose levels. This review discusses the methodology of capillary blood glucose monitoring and its application to insulin adjustments.