Non-nutritive sucking habits and their effects on the occlusion in the deciduous dentition in children.

AIM: The study evaluated the presence of non-nutritive sucking habits and and their effects on the occlusion in the deciduos dentition in Spanish children. MATERIALS AND METHODS: Study design: Cross-sectional survey. A clinical examination was performed by an experienced examiner in 275 children aged 3 to 6 years and the collected data included the presence of anterior open bite (vertical dimension), unilateral or bilateral posterior crossbite (transverse dimensions), midline deviation and sagittal relationships between incisors, molars and canines. In addition, the parents of each child completed a questionnaire about oral habits. Data analysis included descriptive statistics (frequency distribution). Statistical significance for the association between the non-nutritive sucking habits and development of malocclusion was determined using Chi-square and Fisher's exact tests. Multiple logistic regression analysis was used in order to adjust the results for confounding effects of non-nutritive habits before assessing statistical significance. RESULTS: Non-nutritive sucking habit was observed in 224 children (81.5%) and malocclusions were present in 152 children (55.2%). There were significant relationships between pacifier sucking habit and transverse dimension alteration (OR= 3.29, CI: 0.97- 11.17, p=0.044), midline deviation (OR= 3.00, CI: 1.22-7.38, p=0.013). Children with a history of finger sucking (or thumb sucking) had an increased risk of malocclusion 4.25 times higher (CI: 0.92-19.58, p=0.044) and there was a significant relationship between finger sucking and vertical relationship (OR= 8.25, CI: 2.50-27.25, p=0.001). Children with non- nutritive sucking habits had an increased risk of malocclusion 2.55 higher compared to those without non-nutritive sucking habits (p=0.004). CONCLUSION There was an impact of non-nutritive sucking habit and development of malocclusions in this sample of children.

Effect of audiovisual distraction on children's behaviour, anxiety and pain in the dental setting.

AIM: To evaluate whether the parental perception of the patient's anxiety, children's anxiety, pain, behaviour and heart rate of paediatric patients improves when an audiovisual technique is used as a distraction method during dental treatment. MATERIALS AND METHODS: This non-randomised crossover trial was performed with 34 patients aged 6-8 years, who required a minimum of two treatment visits for restorative therapy. During the last visit, the patient was shown a cartoon film. RESULTS: There was a significant improvement in the global behaviour when children were shown a cartoon film (P < 0.001). A significant increase in heart rate was recorded in both visits (P = 0.0001) when the anaesthetic was injected. A 97% of the sample would like to continue seeing their chosen film during subsequent visits. No statistically significant differences were found (P > 0.05) between the visits in terms of parental perception of the patient's anxiety, or the patient's self-reported anxiety, pain and heart rate. CONCLUSIONS: The use of the audiovisual material used as a method of distraction produces a global improvement in patient behaviour, but not in parental perception of the patient's anxiety, self-reported anxiety, pain or heart rate according to the measurement scales used. This material is also highly accepted by paediatric patients.

Dentistry and self-medication: a current challenge.

The classical definition of self-medication is "the taking of drugs, herbs or home remedies on one's own initiative, or on the advice of another person, without consulting a doctor". Used as a solution to the wide range of complaints and minor health problems which may appear over a lifetime, it can be the result of an individual choice or by the influence of a family who is well informed about which techniques and drugs are safe and useful. This paper reviews the concept of self-medication, placing particular emphasis on the common self-medication errors within dentistry and their negative consequences in terms of systemic disease. Used in a responsible way self-medication is desirable because, as an independent search for a drug treatment, it can complement the work of health professionals. Furthermore, it represents a self affirming, independent attitude on the part of patients. Information, therapeutic advice and education are argued to be the basic elements underlying responsible self-medication.

[Evaluation of quality and function of stainless steel crowns for primary molars]. / Evaluación de calidad y funcionalidad de las coronas de acero inoxidable en molares primarios.

A study of 30 stainless steel crowns placed on primary molars by students od Stomatology was performed. The following criteria were taken into consideration: occlusion, proximal contact, marginal extension, marginal adaptation and absence of cement. In spite of the numerous errors in the five criteria studied, only three crowns were considered unacceptable and not clinically functional.

[Ectopic eruption: presentation of a case with 90 percent rotation of an upper primary second molar]. / Erupción ectópica: presentación de un caso con 90 por 100 de rotación en un segundo molar primario superior.

Ectopic eruption of the first permanent molar is a plaguing problem in pedriatric dentistry. This paper reviews the characteristics of ectopic eruption and in the last part reports a case with a 90% rotation of a second primary maxillary molar.

[Presence of parents during dental treatment of children: a very controversial topic]. / La presencia de los padres durante el tratamiento dental de los niños: un tema realmente controvertido.

The convenience of the presence of the parents in the dental operatory during the treatment of their children has always been controversial. This paper presents a study performed through a questionnaire regarding the topic.

Durable complete remissions after 2'-deoxycoformycin treatment in patients with hairy cell leukemia resistant to interferon alpha.

The efficacy of interferon alpha in treatment of hairy cell leukemia is well established. Our experience with low doses of 2'-deoxycoformycin, a competitive inhibitor of adenosine deaminase, showed that it was also effective against hairy cell leukemia in 10 of 11 patients studied whose disease was resistant to interferon alpha. Ten patients entered complete remission after five to 12 doses of 2'-deoxycoformycin (4 mg/m2 every other week), and one patient did not respond. No relapses were observed after median follow-up of 18.5 months; unmaintained complete remissions lasted from more than 10 to more than 30 months. The study demonstrated that 2'-deoxycoformycin induces a high rate of durable, unmaintained complete remissions in patients with hairy cell leukemia resistant to interferon alpha.

Biologic response modifiers in cancer therapy: a review.

Biologic response modifiers have expanded the therapeutic horizon of medical oncology. These agents, procedures, and interventions are likely to become an established fourth modality of cancer therapy in the near future. This is a succinct review of the most prominent areas of clinical research and the results obtained, including cytokines (interferons, interleukins), growth factors, monoclonal antibodies, adoptive immunotherapy, and tumor vaccines.

Role of interferons in the therapy of metastatic renal cell carcinoma.

The prognosis of metastatic renal cell carcinoma continues to be dismal because of the lack of effective systemic therapies. To date, existing chemotherapy and hormonal therapy have produced disappointing results. However, alpha interferon and other biologic response modifiers have recently shown evidence of modest but consistent activity. This review summarizes results obtained with alpha interferon alone or in combination in the treatment of advanced renal carcinoma. It is hoped that future development of this field of cancer therapy may result in further improvements in the clinical management of these patients.

Recombinant interferon gamma in hairy cell leukemia, multiple myeloma, and Waldenstrom's macroglobulinemia.

Fifteen patients with multiple myeloma, five with hairy cell leukemia, and five with Waldenstrom's macroglobulinemia were treated with recombinant interferon gamma (rINF-gamma) to determine the antitumor activity of this agent. The rIFN-gamma was administered by daily intramuscular injection at doses ranging from 0.125 to 0.5 mg/m2. No responses were observed in patients with multiple myeloma, although in one patient the disease has remained stable for over 16 months. Minimal improvement in some hematologic indexes were observed in three of five patients with hairy cell leukemia. One partial remission and one minor response were documented in two of the five patients with Waldenstrom's macroglobulinemia. In five patients, an increase in normal serum immunoglobulins was observed. These results suggest that there is only minimal activity of rIFN-gamma as a single agent in neoplasms of B-cell origin.

Phase I study of recombinant methionyl human consensus interferon (r-metHuIFN-Con1).

Consensus interferon (r-metHuIFN-Con1) is the product of a gene constructed to code for the most frequent amino acid residues known to occur in subspecies of alpha interferons. Twenty-one patients with advanced malignancy entered this phase I trial with dosing levels of 3, 7.5, 15, 30, and 45 mcg/m2/day given intramuscularly on days 1-5 and 8-10 of each 28-day cycle. The initial dose was randomly given by intravenous, intramuscular, or subcutaneous injection to facilitate pharmacokinetic studies. Vomiting and diarrhea were dose-limiting at 45 mcg/m2/day, preventing completion of therapy. Malaise, flu-like symptoms, nausea, and headache were frequent but tolerable at a dose of 30 mcg/m2/day. Patients were able to escalate to 45 mg/m2/day, suggesting tachyphlaxis to these toxicities. The initial distribution phase (T1/2 alpha) was 4.9-9.0 minutes with a T1/2 beta of 34-415 minutes in three patients for whom sequential values could be determined. r-MetHuIFN-Con1 was absorbed after both subcutaneous and intramuscular administration. 2'5'-Synthetase levels increased following treatment, although no consistent pattern was noted. One partial response was seen in a patient with gastrointestinal carcinoma. The recommended phase II starting dose of r-metHuIFN-Con1 is 30 mg/m2/day using this schedule by any of these routes of administration.

Recombinant interferon alpha and gamma in combination as treatment for metastatic renal cell carcinoma.

Fifty-three patients with metastatic-renal cell carcinoma received treatment with combinations of recombinant alpha (rIFN-alpha-2a) and gamma (rIFN-gamma) interferons on three different treatment schedules. On treatment schedule A, 13 patients received i.m. rIFN-alpha-2a and rIFN-gamma simultaneously at a 1:1 ratio by dose units (2 X 10(6) U/m2), equivalent to a 1:10 ratio by protein weight. Results included severe constitutional symptoms in 62% of the patients and no partial remissions (PR) or complete remissions among 10 evaluable patients. On treatment schedule B, 25 patients received an i.m. injection of rIFN-alpha-2a and rIFN-gamma simultaneously at a 1:1 ratio by protein weight (2 X 10(6) U/m2 and 2 X 10(5) U/m2, respectively). This schedule was well tolerated, allowing a 25-50% increment in over 75% of the patients. Four patients (16%) achieved PR. On treatment schedule C, 15 patients received alternating weekly therapy: first rIFN-gamma (5 X 10(6) U/m2 daily for 7 days) followed by rIFN-alpha-2a (10 X 10(6) U/m2 daily for 7 days). One of 13 evaluable patients in treatment schedule C achieved an 80% tumor reduction and was rendered free of disease after the primary tumor was resected. Toxicity was similar in nature to that of rIFN-alpha-2a or rIFN-gamma separately. The toxicity of treatment schedule A suggested additive toxic effects. No distinct synergistic antitumor effect was observed.

Interferon therapy for metastatic renal cell carcinoma.

We have used multiple interferon protocols to treat 274 patients who had metastatic renal cell carcinoma. Leukocyte (alpha) interferon in 50 patients produced 3 complete responses (CR) and 10 partial responses (PR), a 26% response rate that was nearly matched among the next 89 patients treated with recombinant alpha interferon (2 CR, 17 PR, 21%). Other types and combinations of interferon, even when coupled with cytotoxic chemotherapy or other biologic agents, did not produce better results. Interferon has definite activity against renal cell carcinoma, but clinical experience has not yet defined the optimal type, dose, and treatment schedule.

Mid-term observations on the efficacy of alpha-interferon in hairy cell leukemia and status of the interferon system of patients in remission.

We summarize our experience using alpha-interferon (IFN-alpha) in the treatment of 93 patients with hairy cell leukemia. Both partially purified interferon and recombinant IFN-alpha produced over 85% response rate. Equal efficacy at 12 months of treatment was found for both types of IFN-alpha. However, continuation of treatment up to 24 months with partially purified IFN-alpha resulted in an increased number of complete remissions. An increase in the number of bone marrow's hairy cells occurred in 70-80% of the patients in whom a treatment was discontinued. Only 20% of the patients required reinitiation of treatment, and in all, reinduction of remission was readily obtained. Toxicity to IFN-alpha in patients with hairy cell leukemia was minimal. IFN-alpha production by patients in remission was studied. Only those patients in complete remission showed adequate IFN-alpha production. The role of endogenous IFN-alpha in the induction and sustenance of remission in hairy cell leukemia is discussed.

Phase II studies of recombinant human interferon gamma in metastatic renal cell carcinoma.

Thirty-three patients with metastatic renal cell carcinoma were treated with recombinant human interferon gamma (rIFN gamma) in two sequential, nonrandomized phase II studies. Fifteen patients received rIFN gamma by daily i.m. injection in doses ranging from 0.25 to 1.0 mg/m2, and 18 patients received it by daily continuous i.v. infusion in doses ranging from 0.01 to 0.05 mg/m2. Partial remissions were achieved by one of 14 (7%) evaluable patients in the i.m. study and in one of 16 in the i.v. study (6%). The incidence of clinical toxicity was similar for both studies. Toxicity was severe in patients receiving rIFN gamma by the i.m. route at 1.0 mg/m2 and by the i.v. route at 0.05 mg/m2. Toxicity includes constitutional symptoms (fatigue, anorexia, weight loss), leukopenia, abnormalities in liver function tests, and hypertriglyceridemia. At the doses and schedules used, rIFN gamma had minimal therapeutic activity as a single agent in metastatic renal cell carcinoma.