Tobacco use habits of naval personnel during Desert Storm.

This study examined availability and usage of tobacco products, and their potential impact on the oral health of naval personnel deployed to Desert Storm. Of 4,200 surveys mailed to a randomly selected sample, 45.6% were returned (N = 1,915). The respondents included 55.9% who reported a present or former smoking habit, 34.1% who identified themselves as current smokers (SM), and 23.8% who were smokeless tobacco (ST) users. Tobacco products were easily and inexpensively accessible through ship stores, exchange, or military support organizations (USO). While in the Persian Gulf, 7.0% started SM and 9.3% started ST, resulting in an overall 4.7 and 6.1% increase in SM and ST, respectively. Of those who were already tobacco users, 29.2% reported more SM use and 19.0% used ST more often. Stress (35.1%) and boredom (21.4%) were the most frequently cited reasons to start or increase use. Although 30.5% of respondents reported military personnel have encouraged them to quit, 77.2% reported that anti-smoking efforts have been unsuccessful in influencing them to quit. Since the tobacco usage rate is higher in the military than in the civilian sector, greater emphasis on preventive efforts in warranted to promote health and wellness.

Pheochromocytoma in multiple endocrine neoplasia type 2: European study. The Euromen Study Group.

OBJECTIVES: Pheochromocytoma (pheo) is the second component of the multiple endocrine neoplasia type 2 (MEN 2) syndrome. Clinical expression is sometimes poor, and chronology between medullary thyroid carcinoma (MTC) and pheo is not well evaluated. Therefore, a retrospective study was done in eight European countries in order to precise the main characteristics of pheo in MEN 2. SUBJECTS: Data from 300 MEN 2 patients with pheo (274 MEN 2 A and 26 MEN 2 B) were obtained from cases registered by the EuroMen study group, and collected by a medical standardized questionnaire. These cases occurred between 1969 and 1992. RESULTS: Mean age at diagnosis of pheo was 39.5 years (range 14-68 years) in MEN 2A and 32.4 years (range 15-41 years) in MEN 2B patients. Pheo occurred first in 25.1% of the cases (2-15 years before diagnosis of MTC) and after MTC in 40.2% (2-11 years). In other cases (34.7%), MTC and pheo were diagnosed at the same time. Involvement was bilateral in 67.8% of cases. Malignancy was only 4%. Thirty-nine deaths occurred in these 300 patients, 64.1% were linked in pheo, 23.1% to MTC and 12.8% to other causes. Surgery was unilateral in 39.7% of the cases and bilateral adrenalectomy was the first procedure in 48.4%. A bilateral adrenalectomy in two steps had to be done in 11.9% of cases. In conclusion, these results justify systematic and prolonged biochemical screening of pheo during follow-up of MTC and address some questions about the best mode of surgery.

Comparison of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on oral health in institutionalized, mentally handicapped adults: one-year results.

The purpose of this study was to compare the efficacy of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on plaque accumulation and gingivitis in mentally handicapped adults over a one-year period. Twenty-seven institutionalized mentally handicapped adults participated. Gingival index (GI), plaque index (PI), and probing depths (PD) were recorded and an ultrasonic scaling was performed (Baseline 1). GI, PI, and PD were again recorded after 2 weeks (Baseline 2). Patients were then assigned to either the chlorhexidine or essential oil mouthrinse group. The patients rinsed twice daily under supervision with their assigned mouthrinse while maintaining their attempts at daily brushing. GI and PI were recorded at monthly intervals for 12 months, while the PD was recorded only at Baseline 1 and 2 and at 12 months. A paired t-test was used to compare differences between the parameters at Baseline 1 and Baseline 2. A 2-factor repeated measure ANOVA was performed on each parameter after the Baseline 2 evaluation. A statistically significant decrease in the probing depth occurred as a result of ultrasonic scaling; however, no significant changes in the PI or GI occurred. Both mouthrinses produced a significant improvement in the GI after one month. Despite the improvement, the GI was still indicative of disease. Over the 12 months no further significant improvement in the GI occurred. A statistically significant improvement in the PI occurred in the chlorhexidine group at month 1, but returned to Baseline 2 levels over the 12 months. No improvement in the PI occurred in the essential oil group. The probing depths remained the same over the 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Relative proportions of pathogen-related oral spirochetes (PROS) and Treponema denticola in supragingival and subgingival plaque from patients with periodontitis.

The purpose of this study was to use monoclonal antibodies to enumerate spirochetes in dental plaque, including the newly recognized pathogen-related oral spirochete (PROS) and specific serovars of Treponema denticola. Plaque was collected from control subjects with no apparent periodontal disease and from sites of moderate to severe chronic periodontitis in patients with inflammatory periodontal disease. Individual monoclonal antibodies were used to determine whether spirochetes were present and then a double-staining protocol was employed to count total spirochetes and specific treponemes in individual microscopic fields. Results indicate that spirochetes are more common at diseased sites and in subgingival plaque than at healthy sites or in supragingival plaque. Together PROS and T. denticola comprised the majority of all spirochetes in all samples and PROS and T. denticola serovars "B" and D were most numerous in plaque from patients with periodontitis. PROS were the majority of all spirochetes in supragingival plaque (76.2% +/- 23.8%) and subgingival plaque (60.9% +/- 19.1%) from periodontitis patients, significantly larger than the percentage of T. denticola serovar "B" (P less than .001 for both supragingival and subgingival plaque) and serovar D (P less than .01 for supragingival and P less than .001 for subgingival plaque). These observations indicate that PROS are the predominant spirochete in plaque from sites of patients with periodontitis, but other analytical approaches are necessary to determine if PROS or T. denticola are pathogenic.

Effectiveness of four sterilizing procedures on prophylaxis cups.

Though manufactured as a single use, disposable item, prophylaxis (prophy) cups are often cleaned, sterilized or disinfected, and re-used. The purpose of this study was to determine whether 1) sterilization of prophy cups is achieved during routine procedures 2) debris is completely removed after cleaning. Three types of prophy cups (250 of each type) were evaluated. Prophy cups were contaminated with a pumice slurry containing B. stearothermophilus spore. After contamination, cups were distributed equally between ultrasonic or manual cleaning, then further distributed to one of four sterilization procedures: ETO, chemiclave, autoclave, and glutaraldehyde (GLU) immersion (6 3/4 hours). Five cups served as control and were not subjected to sterilization. Additionally, 15 prophy cups were contaminated and immersed in GLU for 10 minutes. Results indicate sterilization may be achieved by all sterilization methods tested. However, recommended disinfection immersion time of 10 minutes for GLU was not effective in achieving adequate disinfection of prophy cups. Photomicrographs indicate debris remains trapped in prophy cups after manual or ultrasonic cleaning. Prophy cup sterilization may be achieved through standard routine sterilization procedures, but remaining debris is likely due to porosity of rubber and configuration of the cups. Time management, cost effectiveness, and sound clinical judgment suggest single use.

The effects of antiformin-citric acid chemical curettage on the microbial flora of the periodontal pocket.

This study investigated the hypothesis that antiformin-citric acid chemical curettage combined with scaling and root planing (SRP/AF) would significantly reduce pathogenic bacteria of the periodontal pocket when compared to scaling and root planing alone (SRP). Ten patients with moderate periodontitis participated. Four pockets per patient, one in each posterior sextant, were chosen. Pocket depths, attachment levels, and gingival index (GI) were measured. Bacterial samples were examined under dark-field microscope for: (1) spirochetes, (2) motile rods, and (3) all others. A randomized four-sextant treatment design was used. One sextant received no treatment, a second received SRP, and the two remaining sextants received identical treatments of SRP/AF. Of these two sextants, one was sampled at baseline and 12 weeks only in order to serve as an additional control. The remaining sextants were sampled at 1, 4, 8, and 12 weeks. Both SRP and SRP/AF significantly reduced the percentage of spirochetes and motile rods. A significant reduction in GI and pocket depths was also noted. Attachment level showed no significant change. Results of both treatment groups showed no significant differences among any of the parameters. A comparison of the two SRP/AF groups indicated no significant difference among clinical or bacterial parameters due to sampling.