Anticalculus effect of a dentifrice containing 0.5% zinc citrate trihydrate.

A doubleblind 3-month anticalculus clinical study was conducted to determine the magnitude of the antitartar effect to be derived from use of a 0.5% zinc citrate dentifrice. From a population of 1600 subjects exhibiting calculus, 1210 subjects (age 18 and over) were selected and received a dental prophylaxis. The subjects were initially stratified on the basis of calculus score, age, and sex, then allocated randomly to a 3-month usage period of one of two treatment groups. These were a dentifrice containing 0.5% zinc citrate or a control dentifrice without zinc citrate. Calculus was assessed using the Volpe-Manhold Index. Oral soft tissue status was assessed throughout the course of the study. At the conclusion of the study 964 subjects had completed the trial: 486 using the zinc citrate dentifrice and 478 using the control. The results showed that the mean calculus scores in the group using the dentifrice containing zinc citrate were 13.7% lower than those of the group using the control dentifrice. This finding was statistically significant (P less than 0.05). No adverse effects related to the use of either dentifrice were observed.

[Secular acceleration and the electrocardiography in childhood and adolescence]. / Säkulare Akzeleration und Elektrokardiogramm im Kindes- und Jugendalter.

As a consequence of advanced growth episondes and an increase in the final height of adolescents, resulting in changes in the cardiovascular system, an "acceleration" of electrocardiographic parameters and special morphological features of the ECG can be observed. The trend towards a closer relation between ECG parameters and body height than age, as seen in our probands as well as in the literature, reflects the influence of acceleration on the electrocardiogram.

[The laser nephelometric determination of C-reactive protein]. / Untersuchungen zur lasernephelometrischen Bestimmung des C-reaktiven Proteins.

A method for the laser nephelometric determination of C-reactive protein (CRP) is described, using easily available reagents. The upper limits of the reference ranges were determined for newborns and adults. They are 12 mg/l and 27 mg/l, respectively. A comparison with the radial immunodiffusion, which is a widespread method in the clinical laboratory, showed significantly different (higher) values for the laser nephelometry as well as a higher reliability in detecting only slightly raised concentrations. The capillary test proved to be not suitable for the quantification of CRP, but is sufficiently reliable for the detection of sera with pathologically elevated CRP-concentrations.

Effects of three antibiotics on theophylline kinetics.

Nine healthy subjects received single doses of intravenous aminophylline (5 mg/kg) on four occasions separated by at least 1 wk. One trial was a control; the other three were performed during administration of therapeutic doses (250 mg every 6 hr) of tetracycline, erythromycin, and cephalexin. Theophylline concentrations in multiple plasma samples drawn during 24 hr after each dose were determined by high-pressure liquid chromatography. Mean kinetic variables for theophylline during control, tetracycline, erythromycin, and cephalexin trials, respectively, were: volume of distribution, 0.57, 0.61, 0.63, and 0.62 l/kg; elimination half-life (t1/2), 7.9, 9.2, 10.3, and 8.6 hr; total clearance, 0.90, 0.84, 0.78, and 0.89 ml/min/kg. In no case did differences between treatment conditions approach significance. Thus there is no consistent evidence of a kinetic interaction between theophylline and three commonly prescribed antibiotics.

Clinical toxocity of theophylline in relation to cigarette smoking. A report from the Boston Collaborative Drug Surveillance Program.

Adverse reactions to derivatives of theophylline were studied among 2,766 medical inpatients. The primary diagnosis at discharge was cardiac disease in 23 percent, chronic obstructive pulmonary disease in 22 percent, asthma in 13 percent, pulmonary infection in 10 percent, and other disorders in 3 percent of the patients. Eight hundred seven of the patients were current cigarette smokers, and 1,209 denied smoking. Adverse effects of administration of theophylline were reported in 298 patients (10.8 percent). Gastrointestinal disturbances, reported in 7.8 percent of the recipients, were the most common adverse effects. Others were cardiovascular disturbances (1.2 percent), effects on the central nervous system (0.9 percent), and miscellaneous adverse reactions (0.9 percent). A higher frequency of adverse reactions was associated with higher doses of theophylline; however, cigarette smoking was negatively correlated with the frequency of adverse reactions. Adverse effects were experienced by 13 percent of the nonsmokers, by 11 percent of those who smoked up to 20 cigarettes daily, and by 7 percent of those who smoked more heavily. This association was most apparent among young patients with normal renal function and was least evident among the elderly.

Adverse reactions to practolol in hospitalized patients: a report from the Boston Collaborative Drug Surveillance Program.

Adverse reactions to practolol were studied in 198 prospectively monitored hospitalized medical patients. The mean age of the practolol recipients was 57 years; angina and cardiac arrhythmias were the most common indications for therapy. Adverse reactions were attributed to practolol in 20 patients (10%). Fifteen of these twenty reactions involved impairment of cardiac function (bradyarrhythmias, heart block, congestive heart failure, hypotension), and in three instances the reaction was considered life-threatening. Three additional patients had cutaneous reactions attributed to the drug. Adverse reactions to practolol were not dose-related, but toxicity appeared to be more frequent among patients concurrently receiving quinidine. The frequency of cardiovascular complications of propranolol in a similar series of patients was nearly identical. However, no skin reactions were attributed to propranolol. The findings suggest that practolol and propranolol produce unwanted cardiovascular effects with nearly equal frequency among hospitalized patients. Cutaneous reactions to practolol are evident even during short-term use.

Clinical use and toxicity of intravenous lidocaine. A report from the Boston Collaborative Drug Surveillance Program.

The clinical use and toxicity of intravenous lidocaine were surveyed in 750 hospitalized medical patients who received the drug for the treatment of cardiac arrhythmias. The majority of these patients were older than 60 years and most had diagnoses of cardiovascular disease. Lidocaine therapy was started within 48 hours of admission in 77 per cent of cases. Adverse reactions to lidocaine were reported in 6.3 per cent of patients, but only one in four reactions was considered life-threatening. Central nervous system disturbances and cardiovascular complications were the most common untoward effects. All but two adverse reactions occurred within the first 5 days of treatment. Adverse reactions were more common in elderly individuals, in those who died, and in those with long hospitalizations. Diagnoses of acute myocardial infarction or congestive heart failure, and low body weight were also associated with a higher frequency of unwanted effects. Serious adverse reactions to intravenous lidocaine were relatively uncommon. Patients with serious underlying disease or with diminished hepatic clearance of lidocaine appear to be predisposed to adverse effects from this drug.

Compatibility of penicillin and ascorbic acid injection.

The stability of Potassium Penicillin G, USP, when mixed with Ascorbic Acid Injection, USP, in 5% Dextrose Injection, USP, was studied. The change in concentration over an eight-hour period of potassium penicillin G in the admixture was determined by the hydroxylamine colorimetric assay method and the microbiological assay method. The stability of penicillin was not adversely affected by the presence of sodium ascorbate. Reports of incompatibilities between penicillin and ascorbic acid are a function of pH rather than a characteristic of the ascorbate ion. Articles reporting studies involving ascorbic acid should specify whether the work refers to the use of ascorbic acid or Ascorbic Acid Injection, USP. Confusion in the literature could be reduced by changing the official title from Ascorbic Acid Injection to Sodium Ascorbate Injection.

Clinical toxicity of reserpine in hospitalized patients: a report from the Boston Collaborative Drug Surveillance Program.

Adverse reactions to reserpine were studied in 231 hospitalized medical patients who received the drug. Reserpine was administered specifically for hypertension in 91.3 percent of patients; 35.5 per cent of patients received the drug by intramuscular (IM) injection. The IM route of administration was associated with higher mean daily doses (1.28 +/- 0.14 mg/day) than was oral administration (0.37 +/- 0.02 mg/day). Adverse reactions to reserpine were reported in 26 patients (11.3 per cent), but only three of these reactions were considered life-threatening and no deaths were attributed to the drug. Central nervous system (CNS) disturbances, reported in 12 patients, were the most common unwanted effects. Gastrointestinal disturbances were reported in six patients, and hypotension in six. Toxicity occurred more frequently in those who received IM, and therefore high-dose, reserpine. Adverse reactions also were more common in patients who had not received rauwolfia derivatives prior to admission; however, this group of patients also received IM reserpine more frequently. Finally, reserpine toxicity, in particular central nervous system (CNS) disturbances, was reported more frequently in patients also receiving barbiturates, suggesting additive CNS effects.