Attitudes of carers and the elderly occupants of residential homes to antimicrobial chewing gum as an aid to oral health.

OBJECTIVE: The aim of this study was to investigate the attitudes of elderly residents to using an antimicrobial chewing gum as an aid to oral health, and the opinion of their carers on such a procedure. DESIGN: A cross-sectional, multi-centre survey using a structured interview/questionnaire conducted with elderly residents and their carers. SETTING: In January 1998, 9 residential/nursing homes were chosen at random from all the homes in West Hertfordshire, 207 residents were asked to chew two pieces of gum twice daily for 7 days. SUBJECTS: The participants, 148 women and 59 men, were aged between 53-100 years (mean age 82.23 +/- 9.62 years). 47 carers, all female, were involved in distributing and collecting the gum. RESULTS: 122 residents (58.9%) were edentulous and 85 (41%) of the participants were partially dentate. Of those with teeth 23 (27%) had 21 teeth or more. 73 (35.2%) residents found that chewing the gum was difficult with 37 (17.9%) of this group being unable to chew (P < 0.0001 for those residents with no teeth/dentures or dentures unopposed by teeth or other dentures). 32 (18.6%) subjects disliked the flavour of the gum. Of the 170 residents who chewed the gum 99 (57.2%) found it reduced oral dryness and 78 (45.1%) reported it made their mouth feel healthy. 34 (53.6%) of the dentate and 47 (40.9%) of the edentate residents wished to keep using the gum (P < 0.05). 35 (74.5%) of the carers found it easy to distribute the gum and 29 (61.7%) thought that chewing gum was an acceptable method of maintaining oral health for residents. CONCLUSION: The antimicrobial gum investigated in this study was acceptable to many elderly occupants and their carers, significantly improving perceived oral health and oral dryness of residents.

Rust resistance in Triticum cylindricum Ces. (4x, CCDD) and its transfer into durum and hexaploid wheats.

In order to counteract the effects of the mutant genes in races of leaf rust (Puccinia recondita f.sp. tritici Rob. ex Desm.) and stem rust (P. graminis f.sp. tritici Eriks. &Henn.) in wheat, exploration of new resistance genes in wheat relatives is necessary. Three accessions of Triticum cylindricum Ces. (4x, CCDD), Acy1, Acy9, and Acy11, were tested with 10 races each of leaf rust and stem rust. They were resistant to all races tested. Viable F1 plants were produced from the crosses of the T. cylindricum accessions as males with susceptible MP and Chinese Spring ph1b hexaploid wheats (T. aestivum, 6x, AABBDD), but not with susceptible Kubanka durum wheat (T. turgidum var. durum, 4x, AABB), even with embryo rescue. In these crosses the D genome of hexaploid wheat may play a critical role in eliminating the barriers for species isolation during hybrid seed development. The T. cylindricum rust resistance was expressed in the F1 hybrids with hexaploid wheat. However, only the cross MP/Acy1 was successfully backcrossed to another susceptible hexaploid wheat, LMPG-6. In the BC2F2 of the cross MP/Acy1//LMPG-6/3/MP, monosomic or disomic addition lines with resistance to either leaf rust race 15 (infection types (IT) 1=, 1, or 1+; addition line 1) or stem rust race 15B-1 (IT 1 or 1+; addition line 2) were selected. Rust tests and examination of chromosome pairing of the F1 hybrids and the progeny of the disomic addition lines confirmed that the genes for rust resistance were located on the added T. cylindricum C-genome chromosomes rather than on the D-genome chromosomes. The T. cylindricum chromosome in addition line 2 was determined to be chromosome 4C through the detection of RFLPs among the genomes using a set of homoeologous group-specific wheat cDNA probes. Addition line 1 was resistant to the 10 races of leaf rust and addition line 2 was resistant to the 10 races of stem rust, as was the T. cylindricum parent. The added C-genome chromosomes occasionally paired with hexaploid wheat chromosomes. Translocation lines with rust resistance (2n = 21 II) may be obtained in the self-pollinated progeny of the addition lines through spontaneous recombination of the C-genome chromosomes and wheat chromosomes. Such translocation lines with resistance against a wide spectrum of rust races should be potentially valuable in breeding wheat for rust resistance.

Genetic studies of leaf and stem rust resistance in six accessions of Triticum turgidum var. dicoccoides.

Six accessions of Triticum turgidum var. dicoccoides L. (4x, AABB) of diverse origin were tested with 10 races of leaf rust (Puccinia recondita f.sp. tritici Rob. ex Desm.) and 10 races of stem rust (P. graminis f.sp. tritici Eriks. &Henn.). Their infection type patterns were all different from those of lines carrying the Lr or Sr genes on the A or B genome chromosomes with the same races. The unique reaction patterns are probably controlled by genes for leaf rust or stem rust resistance that have not been previously identified. The six dicoccoides accessions were crossed with leaf rust susceptible RL6089 durum wheat and stem rust susceptible 'Kubanka' durum wheat to determine the inheritance of resistance. They were also crossed in diallel to see whether they carried common genes. Seedlings of F1, F2, and BC1F2 generations from the crosses of the dicoccoides accessions with RL6089 were tested with leaf rust race 15 and those from the crosses with 'Kubanka' were tested with stem rust race 15B-1. The F2 populations from the diallel crosses were tested with both races. The data from the crosses with the susceptible durum wheats showed that resistance to leaf rust race 15 and stem rust race 15B-1 in each of the six dicoccoides accessions is conferred by a single dominant or partially dominant gene. In the diallel crosses, the dominance of resistance appeared to be affected by different genetic backgrounds. With one exception, the accessions carry different resistance genes: CI7181 and PI 197483 carry a common gene for resistance to leaf rust race 15. Thus, wild emmer wheat has considerable genetic diversity for rust resistance and is a promising source of new rust resistance genes for cultivated wheats.

Transfer of leaf rust and stem rust resistance genes from Triticum triaristatum to durum and bread wheats and their molecular cytogenetic localization.

Six accessions of Triticum triaristatum (Willd) Godr. &Gren. (syn. Aegilops triaristata) (6x, UUMMUnUn), having good resistance to both leaf rust (Puccinia recondita f.sp. tritici Rob. ex Desm) races and stem rust (P. graminis f.sp. tritici Eriks. &Henn.) races, were successfully crossed with both susceptible durum wheats (T. turgidum var. durum L., 2n = 28, AABB) and bread wheats (T. aestivum, 2n = 42, AABBDD). In some crosses, embryo rescue was necessary. The T. triaristatum resistance was expressed in all F1 hybrids. Backcrossing of the F1 hybrids to their wheat parents to produce BC1F1 plants was more difficult (seed set 0-7.14%) than to produce F1 hybrids (seed set 12.50-78.33%). The low female fertility of the F1 hybrids was due to low chromosome pairing. Only gametes with complete or nearly complete genomes from the F1 hybrids were viable. In BC2F4 populations from the cross MP/Ata2//2*MP, monosomic or disomic addition lines (2n = 21 II + 1 I or 22 II) with resistance to leaf rust race 15 (IT 1) were selected. In BC2F2 populations from the crosses CS/Ata4//2*MP and MP/Ata4//2*MP, monosomic or disomic addition lines with resistance to either leaf rust race 15 or stem rust race 15B-1 (both IT 1) were selected. Rust tests and cytology on the progeny of the disomic addition lines confirmed that the genes for rust resistance were located on the added T. triaristatum chromosomes. The homoeologous groups of the T. triaristatum chromosomes in the addition lines from the crosses MP/Ata2//2*MP, CS/Ata4//2*MP, and MP/Ata4//2*MP were determined to be 5, 2, and 7, respectively, through the detecting of RFLPs among genomes using a set of homoeologous group specific wheat cDNA probes. The addition lines with resistance to leaf rust race 15 from the crosses MP/Ata2//2*MP and CS/Ata4//2*MP were resistant to another nine races of leaf rust and the addition line with resistance to stem rust race 15B-1 from the cross MP/Ata4//2*MP was resistant to another nine races of stem rust as were their T. triaristatum parents. Since such genes provide resistance against a wide spectrum of rust races they should be very valuable in wheat breeding for rust resistance.

The mechanism and inheritance of adult plant leaf rust resistance in 12 wheat lines.

Twelve lines of wheat (Triticum aestivum L.) were developed that had susceptible infection types to leaf rust (Puccinia recondita Rob. ex Desm. f.sp. tritici) race UN 15 in the seedling stage but were resistant in the adult plant stage in the field. The lines were developed from four crosses, each involving four parents (eight in total) that had originally been selected for adult plant or field resistance to stem rust (Puccinia graminis Pers. f.sp. tritici Eriks, and Henn.). The objectives of the present study were to determine the mechanism of resistance to leaf rust and its inheritance in the 12 lines. The 12 lines were grown in an artificially inoculated field nursery in Saskatoon, coefficients of infection (CI) were determined at four dates, and the areas under the disease progress curve (AUDPC) were calculated. Four representative lines were grown in a growth chamber to measure the latent period and pustule size at the two-leaf and flag-leaf stages. Eight lines were crossed and backcrossed to a susceptible check and the parents, F1, F2, F3, and BC1F2 generations were grown in a field nursery. The 12 lines showed wide ranges in CI and AUDPC but all were significantly more resistant than the susceptible check. The four lines studied in the growth chamber had longer latent periods and smaller pustules than the susceptible check at both stages. The differences tended to be greater at the flag-leaf stage. The inheritance studied showed that resistance was recessive or partially recessive and was controlled by two or more genes in each line of the eight lines. In three of the eight lines, Lr34 may be one of the genes and in the other five both Lr13 and Lr34 could be present. However, additional genes are clearly involved. A single gene by itself had only a small effect, but in two and three gene combinations the effects appeared to be greater. This type of resistance appears to occur frequently and may be durable because its complex inheritance may make it more difficult for the rust fungus to overcome. It should be used in breeding wheat for areas where leaf rust is a major problem.

The effects of level of 2,4-D and time in culture on regeneration rate and chromosome numbers of regenerants from calli of the hybrid Triticum aestivum cv. Chinese Spring ph1b x Thinopyrum ponticum (2n = 10x = 70).

Thinopyrum ponticum (Podp.) Barkworth &D. R. Dewey (2n = 10x = 70) has excellent resistance for both leaf and stem rusts. Long-term callus cultures were established from the immature embryos of a hybrid between Triticum aestivum L. (2n = 6x = 42) x Th. ponticum. They were maintained in culture for over 2 years and continued to grow and have organogenetic capacity. With increasing time on a maintenance medium, the plant regeneration rates of the hybrid calli decreased when transferred to regeneration media containing 0.1, 0.2, or 0.5 mg/L 2,4-D, but the rate of decrease was much higher at 0.5 mg/L than at either 0.1 or 0.2 mg/L 2,4-D. After 3 months of subculture, the highest plant regeneration rate was obtained on the medium containing 0.5 mg/L 2,4-D (1.11 plantlets/callus), while on the 24th month of subculture the highest plant regeneration rate was obtained on the medium containing 0.1 mg/L 2,4-D (0.20 plantlets/callus). Thus, it was shown that as the calli aged it was important to reduce the level of 2,4-D in the regeneration medium. Over 2 years, a total of 667 regenerants were successfully transferred and grown to maturity. Chromosome numbers in root-tip cells were determined for 539 regenerants and ranged from 36 to 70. Telocentric chromosomes were frequent. A fertile plant was found among the regenerants after 15 months of subculture. It had 56 chromosomes with 2.15 (1-6) univalents, 22.76 (17-26) closed bivalents, 3.55 (1-9) open bivalents, and 0.41 (0-3) trivalents and was highly resistant to stem rust race 15B-1. Callus culture of wide hybrids can be used to introgress characters from alien species into wheat.

Molecular detection of Lophopyrum chromatin in wheat-Lophopyrum recombinants and their use in the physical mapping of chromosome 7D.

In situ hybridisation and restriction fragment length polymorphism (RFLP) analysis were used to determine the relative location of the translocation breakpoint and the size of the integrated chromatin segment in hexaploid wheat-Lophopyrum translocation stocks. Three 7el2-7D recombinant stocks were Robertsonian translocations, 7DS.7el. The remaining recombinant stock (KS10-2) was 7elS.7el-7DL and contained only the distal one-half of the long arm of 7D. The recombinant stock with 7el1 (K11695) could be designated 7DS.7DL-7el where approximately the distal one-half of 7DL was replaced. RFLP analysis indicated that on the 7DL RFLP map the breakpoints for K11695 and KS10-2 are in different locations and that the two recombinants contain an overlapping region (a common region) of the Lophopyrum chromosome 7 in which Lr19, a leaf-rust resistant gene, is located. RFLP analysis also indicated that RFLP markers which mapped to within 1.5 cm of the centromere of chromosome 7D are located in the distal half of the long arm.

A placebo-controlled trial of nadolol in the treatment of neuroleptic-induced akathisia.

BACKGROUND: Although propranolol has been documented to be useful in treatment of neuroleptic-induced akathisia, preliminary anecdotal reports on the efficacy of nadolol in treatment of this condition are contradictory. METHOD: To evaluate the efficacy of nadolol in treatment of this condition, a double-blind, placebo-controlled trial was conducted in 20 psychiatric inpatients. Patients with akathisia of at least moderate severity were randomly assigned to receive nadolol 40 to 80 mg/day or placebo. Patients were rated daily for 4 days, then every other day for 15 days by means of the Extrapyramidal Symptom Rating Scale. RESULTS: No significant differences were found between or within groups in subjective restlessness scores. In objective akathisia scores, there were no significant differences between groups; however, beginning at Day 9, both groups showed significant improvement compared with Day 1. There was no difference between groups in number of responders. CONCLUSIONS: The authors' data do not support the efficacy of nadolol in the treatment of neuroleptic-induced akathisia and do not provide support for a peripheral site of action for beta-blockers in treatment of this condition.

Impact of an organ donor and tissue donor advocacy program on community hospitals.

A crucial shortage of organ donors exists in the United States. The majority of donor referrals come from large (greater than 500) beds) hospitals and trauma centers. To determine whether a significant number of donors who are not being recognized or referred also existed in medium-sized (300 beds) community hospitals, a Donor Advocacy Program was instituted at Francis Scott Key Medical Center in May 1987. This team developed policies and procedures to identify potential donors and conducted educational programs for physicians and nurses. A designated "Donor Advocate" made daily rounds on the inpatient units to maintain donor awareness and facilitate potential donations. After the first year, the program was evaluated. In comparison to the average of the previous three years, donor referrals increased by approximately 400 per cent and tissue donations increased over 500 per cent. Four organs were retrieved from two donors. It is concluded that an increase in referrals and tissue donations can be achieved at community hospitals through a structured donor awareness program. Recommendations are made to further examine the age group most often eligible for organ and tissue donations in community hospitals and target educational efforts accordingly. Commitment of hospital administration is vital to a positive outcome in such a program.

Substance abuse patterns reveal contrasting personal traits.

The Eysenck Personality Questionnaire (EPQ) responses of 202 male and 95 female substance users taken during 21 months at a public-sector hospital facility were studied. Collectively, inpatients were more impulsive (high P), introverted (low E), and anxious (high N) than same-sexed normals on the main EPQ scales (p less than .001). The alcohol, cocaine, opioid, and polysubstance users and a residual mixed group differed on all EPQ scales (ps less than .05). Cocaine users were the most impulsive, with alcohol and opioid users least so. The polysubstance and residual mixed groups were the most extroverted, with opioid users least. The alcohol and residual mixed groups were the most anxious, and cocaine users least so. Alcohol users earned the highest "lie" (L) scores, with opioid users lowest. When the residual mixed group was excluded from analyses the results were little changed.

Reactivity of anti-asialo GM1 serum with tumoricidal and non-tumoricidal mouse macrophages.

All peritoneal macrophage (pM phi) populations studied exhibited some binding of the anti-asGM1 serum as assessed by flow cytometry. The levels of reactivity varied quantitatively among populations, depending on the combination of eliciting and activating agents employed prior to the harvest of pM phi. Resident pM phi contained a very small percentage (4%) of cells that were strongly asGM1+. Any treatment of these cells that induced them to become stimulated or activated increased the percentage of highly asGM1+ cells. Treatments that enhanced anti-asGM1 binding including eliciting pM phi with proteose peptone (16% asGM1+) or Brewer's thioglycollate medium (66% asGM1+), treatment with the activating biological response modifiers (BRMs) MVE-2 (12% asGM1+) and P acnes (18% asGM1+), or treatment with both peptone + MVE-2 (37% asGM1+) or peptone + poly IC/LC (33%). Increased expression of anti-asGM1 was accompanied by some increase in the reactivity of the various pM phi populations to treatment with anti-asGM1 serum. This conclusion was based on the reduced viabilities of cells treated with both an eliciting agent and an activating agent prior to in vitro treatment with anti-asGM1 + C, as well as by reductions in cytolytic activity of pM phi elicited with peptone and activated by MVE-2, following anti-asGM1 treatment in vitro or administration in vivo. Conversely, the cytolytic activity of resident pM phi activated in vivo by MVE-2 or heat-killed P acnes, agents that induced relatively small increases in the percentage of asGM1+ cells, was resistant to the effects of in vivo and/or in vitro treatment with doses of anti-asGM1 serum that inhibit NK activity. These results indicate that stimulation of pM phi by eliciting or activating agents can increase the level of expression of asGM1. This increased expression of asGM1 may be a useful marker for some aspects of macrophage heterogeneity, but increased expression is not necessarily directly related to expression of tumoricidal activity. In fact, the results of this study demonstrate that anti-asGM1 serum can be used for specific depletion of NK activity in vivo in normal mice and in mice treated with at least some BRMs. However, the results also demonstrate that the use of eliciting agents, particularly thioglycollate, or eliciting agents in conjunction with activating agents can cause pM phi to become reactive with anti-asGM1 serum.

Enhanced mutagenesis parallels enhanced reactivation of herpes virus in a human cell line.

U.v. irradiation of human NB-E cells results in enhanced mutagenesis and enhanced reactivation of u.v.-irradiated H-1 virus grown in those cells ( Cornelis et al., 1982). This paper reports a similar study using herpes simplex virus (HSV) in NB-E cells. The mutation frequency of HSV (resistance of virus plaque formation to 40 micrograms/ml iododeoxycytidine ) increased approximately linearly with exposure of the virus to u.v. radiation. HSV grown in unirradiated cells gave a slope of 1.8 X 10(-5)m2/J, with 3.2 X 10(-5)m2/J for HSV grown in cells irradiated (3 J/m2) 24 h before infection. There was no evidence for mutagenesis of unirradiated virus by irradiated cells, as seen with H-1 virus. Enhanced reactivation of irradiated HSV in parallel cultures increased virus survival, manifested as a change in slope of the final component of the two-component survival curve from a D0 of 27 J/m2 in unirradiated cells to 45 J/m2 in irradiated cells. Thus, enhanced mutagenesis and enhanced reactivation occurred for irradiated HSV in NB-E cells. The difference in the enhanced mutagenesis of HSV (dependent on damaged DNA sites) and of H-1 virus (primarily independent of damaged DNA sites) is discussed in terms of differences in DNA polymerases.

Decision for alcohol detoxication: a method to standardize patient evaluation.

We have presented a tested method of evaluation of the patient with acute alcohol intoxication and/or abstinence syndromes, which we recognize needs further modification and refinement. However, we wish to encourage continued development and standardization of an evaluation instrument that ultimately can become widely accepted. This should reduce the current confusion concerning the diagnosis, extent, and severity of the acute phase of alcohol dependence. If this can be accomplished, the questions (and the controversy) of drug vs non-drug and medical vs nonmedical treatment become moot; rather, a continuum of care will exist which is based on meaningful use and interdisciplinary communication of symptom severity as a foundation for rational treatment approaches.

The subacute phase of alcoholism.

Aggressive intervention in the medical and psychosocial problems of the subacute phase of alcoholism allows the physician to assume a holistic approach to the alcohol-addicted individual and provides a basis for eventual arrest of the chronic disease. A variety of metabolic abnormalities and physiologic disorders require attention. Management of psychologic problems requires the use of rational authority, early psychotherapy, judicious short-term psychopharmacology and use of available community resources.