Oral hygiene and oral flora evaluation in psychiatric patients in nursing homes in Turkey.

CONTEXT: The World Health Organization has stated that psychiatric patients are a group of people who have oral and dental illnesses. AIMS: The aims of this study were to document the oral hygiene of individuals with chronic psychiatric illness, to determine the extraoral and intraoral findings, to detect the dominant microorganisms in oral flora, and to inform clinicians of these findings. SETTINGS AND DESIGN: The study included 100 patients (69 men and 31 women) with different psychiatric illnesses living in a nursing home. They were 19-96 years old (median, 48 years). SUBJECTS AND METHODS: The participants completed a questionnaire about patients' oral health. They underwent extraoral and intraoral examinations. Two swab samples were obtained from the oral mucosa of these patients. Gram preparations were analyzed for leukocytes, bacteria, and yeast. STATISTICAL ANALYSIS USED: Chi-square test and z-test were used. RESULTS: All patients (100%) had the necessary equipment for oral hygiene; however, many (43%) patients had poor oral hygiene. There was a high prevalence of xerostomia (56%) and fissured tongue (61.4%) (among other tongue anomalies). The most commonly isolated microorganisms were coagulase-negative Staphylococcus0 (35.9%), Streptococcus spp. (30.3%), nondiphtheroid Bacilli (16.9%), Staphylococcus aureus (2.3%), Candida spp. (11.8%), and Gram-negative Bacilli (2.8%). CONCLUSIONS: The oral hygiene of most patients was insufficient. The presence of Gram-negative Bacilli growth in the oral flora can be explained by poor hand hygiene. These findings suggest that it is useful to educate individuals about oral hygiene and hand hygiene and to inform the staff and families about this issue.

Evaluation and comparison of the antimicrobial efficacy of teicoplanin- and clindamycin-coated titanium implants: an experimental study.

We studied the effects of coating titanium implants with teicoplanin and clindamycin in 30 New Zealand White rabbits which were randomly assigned to three groups. The intramedullary canal of the left tibia of each rabbit was inoculated with 500 colony forming units of Staphylococcus aureus. Teicoplanin-coated implants were implanted into rabbits in group 1, clindamycin-coated implants into rabbits in group 2, and uncoated implants into those in group 3. All the rabbits were killed one week later. The implants were removed and cultured together with pieces of tibial bone and wound swabs. The rate of colonisation of the organisms in the three groups was compared. Organisms were cultured from no rabbits in group 1, one in group 2 but from all in group 3. There was no significant difference between groups 1 and 2 (p = 1.000). There were significant differences between groups 1 and 3 and groups 2 and 3 (p < 0.001). Significant protection against bacterial colonisation and infection was found with teicoplanin- and clindamycin-coated implants in this experimental model.

The effects of human amniotic membrane and periosteal autograft on tendon healing: experimental study in rabbits.

In this study, the effects of periosteal autograft and human amniotic membrane on tendon healing were compared. Forty-two New Zealand rabbits were divided into three groups. Flexor digitorum fibularis tendons were cut and repaired with a modified Kessler technique and circumferential sutures in all groups. Tendon repair alone was carried out in group 1, tendon repair and application of human amniotic membrane was done in group 2 and tendon repair and application of periosteal autograft was done in group 3. Biomechanical and histopathological examinations were done 2 and 6 weeks postoperatively. Biomechanical examination showed that group 3 was the strongest at weeks 2 and 6. Adhesion, inflammation and new bone formation showed no difference between groups at week 2. However, adhesion formation was found to be less in groups 2 and 3 than group 1 at week 6. The application of periosteal autograft might be useful in repair of tendon injuries.

Management of tibial fractures with Orthofix axial external skeletal fixator in 15 dogs.

In the present study, the applicability of fixator, surgical time, time to weightbearing, the healing time and complications of tibial fractures in dogs after fixation with Orthofix axial external skeletal fixator were evaluated. The study was performed on 15 cases which were presented to the Clinics of Small Animal Surgery. After the determination of the fracture type, fracture location, appropriate screw diameter and the location of the first screw on the fragment according to preoperative radiographs, the dogs were placed under general anaesthesia and the fixator was applied with cranio-medial approach to the tibia. Clinical and radiological examinations were continued until the removal of the external skeletal fixators at three different times (at approx. days 45, 60 and 75) according to the clinical and radiological fracture healing. The treatment results were determined by the Modified Hannover Veterinary Medicine Faculty Small Animal Fracture Evaluation Scale. The results were excellent in eight cases (53.3%), good in four cases (26.7%), fair in one case (6.7%) and poor in two cases (13.3%). Based on this study, the use of external skeletal fixation with Orthofix axial external skeletal fixator can be recommended for dogs with tibial fractures as long as careful pin tract management is performed. Further investigation is needed to determine the use of Orthofix axial external skeletal fixator for the management of other long bone fractures.