A comparison of mebendazole and albendazole in treating children with Trichuris trichiura infection in Durban, South Africa.

OBJECTIVE: To compare the efficacy of mebendazole 500 mg and albendazole 400 mg single-dose treatments of Trichuris trichiura infection in children in the Durban area of KwaZuluNatal, South Africa. DESIGN: A single-blind randomised trial in children with a documented moderate infection of T. trichiura. Ova were counted in stool specimens before and 10 days after treatment by the formal-ether concentration method. SETTING: Two shelters for abandoned and orphaned children in Durban. PARTICIPANTS: Ninety-six children aged between 2 and 12 years. OUTCOME MEASURES: The number of children who showed reduced T. trichiura ova counts after the treatments, and reductions in ova counts, both expressed as percentages. Statistical analysis using the Wilcoxon 2-sample test and the chi-square test. RESULTS: Eighty-two children completed the trial; 42 received mebendazole and 40 albendazole. Of the mebendazole group 85% showed a reduction in T. trichiura ova count, compared with 75% of children who received albendazole. Mebendazole treatment was associated with a median percentage reduction in ova count of 72.2%, which significantly exceeded the 44.1% reduction after albendazole (P = 0.024). CONCLUSION: The mebendazole 500 mg single-dose therapy was more efficacious than the albendazole 400 mg single-dose therapy in treating T. trichiura infection in these children.

Clinical advances of the pulsed Nd:YAG laser in periodontal therapy.

Since the Nd:YAG laser was first developed in the 1960s, its spectrum of capabilities has continued to expand in the medical field. In dentistry, treatment of both hard and soft tissue has been affected, with the most noticeable change occurring in the management of periodontal disease. The learning objective of this article is to review the utilization of the pulsed Nd:YAG laser (American Dental Technologies, Southfield, MI) in the management of periodontal disease. Cases are presented to document the clinical aspects, and directions of future research are indicated.

Localized prepubertal periodontitis--nonsurgical treatment of an adolescent patient: a case report.

The treatment of localized juvenile periodontitis has been previously described in the literature, utilizing primarily a long-term (2 to 6 week) antibiotic regimen, notably tetracycline. This case report of juvenile periodontitis with extensive bone loss describes a short-term treatment (8 days), using a combination of two antibiotics and mechanical debridement. Clinical treatment included instruction of proper oral hygiene techniques. Initial scaling and root planing were performed to remove supragingival and subgingival accretions, followed by 2-month maintenance recalls. Pre- and postoperative radiographs, taken one year after the treatment, are used to document the evidence of natural bone regeneration. The learning objective of this article is to present an effective method of treatment-a debridement/antibiotic combination, followed by bone regeneration.

Curettage revisited: laser therapy.

The Nd:YAG laser is being used for gingival curettage in certain clinical circumstances as an alternative to classical curettage. The technique, described in this article, appears to be uncomplicated for the practitioner and may result in less pain for the patient. Four case summaries are also presented that depict the application of this technique.

Cross reactions in the immunodiagnosis of schistosomiasis and cysticercosis by a cerebrospinal fluid enzyme-linked immunosorbent assay.

Cerebrospinal fluid was collected from 3 groups of patients (suspected cysticercosis patients, myelopathy patients, and neurological patients) and assayed for antibodies to Cysticercus cellulosae and schistosome soluble egg antigen. In the myelopathy and neurological patients there was a significant correlation (P less than 0.05) between seropositivity for the two diseases. Samples which were positive in both assays were tested by inhibition assay with the heterologous antigen to determine the specificity of the reaction. In one of 5 cases the reaction to cysticercus antigen was completely inhibited by addition of schistosome soluble egg antigen. In the reverse assay there was minimal inhibition by cysticercus antigen.

The frenectomy: a comparison of classic versus laser technique.

When an abnormal labial frenum causes certain complications, frenectomy should be considered. In this article, the indications for frenectomy are outlined, classical and laser frenectomy techniques are described, and the advantages and disadvantages of both techniques are discussed.

The value of immunological approaches to the diagnosis of schistosomal myelopathy.

Myelopathy due to schistosome infection is a rare, yet probably frequently unrecognized, form of schistosomiasis. This condition is clinically difficult to diagnose, and without specific biopsy evidence final confirmation relies largely on circumstantial evidence. We describe here immunological attempts to diagnose schistosomal myelopathy. ELISA performed on the cerebrospinal fluid (CSF) was the most successful, detecting 12/12 cases tested prior to or within one month of treatment. This is based on a "normal" value established on neurological patients without myelopathy. Only 13/149 non-schistosomal myelopathy patients from an endemic area gave positive results in this test. Oligoclonal bands were detected in the CSF of 5/9 schistosomal myelopathy patients and 11/18 cases of myelopathy of other known causes, but in 0/7 cases of myelopathy where the cause was not established. Western blotting was unable to distinguish between myelopathy due to schistosomiasis and other causes. It is recommended that the ELISA be performed on CSF and the results be compared with a "normal" level for neurological patients. In our laboratory this system gives a high sensitivity and a negative result can be confidently used to exclude schistosomal myelopathy.

Structure and ideology of shelters for battered women.

Recent literature concerning battered women's shelters includes untested suggestions that shelters can be categorized by their ideological differences and that their ideologies predict their organizational structures. However, widely accepted principles of organizational theory predict that older shelters would have a different structure than newer shelters. Some of the presumed consequences of organizational age conflict with the structural characteristics presumably demanded by certain shelter ideologies. In the present study both ideology and organizational age were studied as predictors of shelter organization's structure. A nationwide survey of 111 shelters provided the data. Feminist versus other ideologies were associated with a distinctive pattern of priorities for the shelters. However, organizational age was found to be more important than ideology in predicting structural variables.

Diagnosis of neurocysticercosis by enzyme-linked immunosorbent assay.

The detection of neurocysticercosis by enzyme-linked immunosorbent assay, the criterion used for determining seropositivity and the method of interpreting results are discussed. Serum and cerebrospinal fluid (CSF) samples from each of 212 patients were analysed. The results showed that in some patients positive antibody titres may be found in only one specimen. If both specimens are analysed 87% of neurocysticercosis patients can be detected serologically. However, if only CSF is tested, the detection rate falls to 67%. It is recommended that clinicians submit both serum and CSF samples for analysis.

Practice plans offer hospitals a share of the profits.

Part A hospital-based physician costs, under the DRG payment system, can reduce a hospital's profitability. One strategy that can possibly turn this situation around is the development of a practice plan by the hospital. This plan can ensure hospital-based physicians a guaranteed level of income and possibly more, and also allow hospitals to share in the revenues generated by the plan.

Salivary composition and calculus formation in patients undergoing hemodialysis.

The purpose of this report is to provide further information regarding oral changes in patients with chronic renal disease who are undergoing hemodialysis. Quantitative changes in salivary flow rate and alterations in the composition of stimulated and unstimulated sliva were studied along with the rate of formation of supragingival calculus. Results revealed a lower salivary flow rate and increased salivary urea concentration in the dialysis group. Dialysis patients also formed more heavy calculus.

Tetracyclines: double blind clinical study to evaluate the effectiveness in periodontal surgery.

Twenty consecutive hospital patients who were to have periodontal surgery were assigned to one of two groups in a double blind clinical study. Ten were placed on tetracycline 250 mg, 6 times per day for 5 days. The other ten were given an identical appearing placebo 6 times per day for 5 days. The capsules were placed in a brown envelope so that neither the patient nor the periodontist knew which medication was being administered. The patients were randomly assigned to one of the two groups and were evaluated subjectively and objectively on the 3rd day and the 7th day. Statistically there were no differences between the two groups. In both groups there was some inflammation on the 3rd day but on the 7th day, it had subsided. Tetracycline is not recommended for routine prophylactic use in periodontal surgery.