A randomized trial of the effectiveness of an ultrasonic denture hygiene intervention program among community dwelling elders

Purpose

This study aimed to assess the effectiveness of ultrasonic denture hygiene interventions in improving denture cleanliness among elderly individuals.

Materials and methods

Sixty-six participants who had received upper metal framework removable partial dentures within the past 5 years were randomly allocated into three denture hygiene intervention groups: group 1 (mechanical cleaning with a toothbrush and ultrasonic cleaning with cetylpyridinium chloride), group 2 (mechanical cleaning with a toothbrush and ultrasonic cleaning with distilled water), and control (mechanical cleaning with a toothbrush only). Denture cleanliness was assessed at baseline and 1-month using: i) Denture Cleanliness Index (DCI) scores; ii) plaque coverage percentage; and (iii) microbiological samples for bacterial and yeast detection. Differences between groups were assessed with one-way analysis of variance and Chi-squared tests.

Results

Mean DCI scores and mean percentages of plaque coverage area were significantly reduced in group 1 and group 2, compared to the control group for both cobalt chromium (CoCr) and acrylic fitting surfaces (p<0.001). No significant differences were found between groups 1 and 2 with regard to the prevalence and viable counts of yeasts or total microbial viable counts. No significant differences in the investigated clinical and microbiological parameters were observed between CoCr and acrylic surfaces following the intervention period.

Conclusion

The ultrasonic cleaner was significantly more effective than mechanical cleaning in the reduction of biofilm coverage on metal framework removable partial dentures over a 1-month intervention period. Nevertheless, the adjunctive use of cetylpyridinium chloride with ultrasonic cleaning did not yield additional benefits.

Intermittent catheterization: Clinical practice guidelines from Association Française d'Urologie (AFU), Groupe de Neuro-urologie de Langue Française (GENULF), Société Française de Médecine Physique et de Réadaptation (SOFMER) and Société Interdisciplinaire Francophone d'UroDynamique et de Pelvi-Périnéologie (SIFUD-PP)

INTRODUCTION

Our objective was to provide guidelines covering all aspects of intermittent catheterisation (intermittent self-catheterisation and third-party intermittent catheterisation).

MATERIALS AND METHODS

A systematic review of the literature based on Pubmed, Embase, Google scholar was initiated in December 2014 and updated in April 2019. Given the lack of robust data and the numerous unresolved controversial issues, guidelines were established based on the formal consensus of experts from steering, scoring and review panels.

RESULTS

This allowed the formulation of 78 guidelines, extending from guidelines on indications for intermittent catheterisation, modalities for training and implementation, choice of equipment, management of bacteriuria and urinary tract infections, to the implementation of intermittent catheterisation in paediatric, geriatric populations, benign prostatic hyperplasia patients and continent urinary diversion patients with a cutaneous reservoir as well as other complications. These guidelines are pertinent to both intermittent self-catheterisation and third-party intermittent catheterisation.

CONCLUSION

These are the first comprehensive guidelines specifically aimed at intermittent catheterisation and extend to all aspects of intermittent catheterisation. They assist in the clinical decision-making process, specifically in relation to indications and modalities of intermittent catheterisation options. These guidelines are intended for urologists, gynaecologists, geriatricians, paediatricians, neurologists, physical and rehabilitation physicians, general practitioners and other health professionals including nurses, carers….

Implementation strategies in emergency management of children: a scoping review protocol

BACKGROUND

Behavior change is not simple, and the introduction of guidelines or protocols does not mean that they will be followed. As such, implementation strategies are vital for the uptake and sustainability of changes in medical protocols. Medical or mental emergencies may be life-threatening, especially in children due to their unique physiological needs. In emergency departments (EDs), where timely decisions are often made, practice change requires thoughtful considerations regarding the best approaches to implementation. As there are many studies reporting on a wide variety of implementation strategies in the emergency management of children in EDs, we aim to identify and map the characteristics of these studies.

METHODS

We will conduct a scoping review to identify various implementation strategies in the emergency management of children using the Arksey and O'Malley framework. We will search MEDLINE (Ovid), Embase (Ovid), Cochrane Central (Wiley), and CINAHL (Ebsco), from inception to May 29, 2019, for implementation studies among the pediatric population (≤ 21 years) in a pediatric emergency setting. Two pairs of reviewers will independently select studies for inclusion and extract the data. We will perform a descriptive, narrative analysis of the characteristics of the identified implementation strategies.

DISCUSSION

We will present specific characteristics and outcome measures of all included studies in a tabular form. The results of this review are expected to help identify and characterize successful implementation strategies in the emergency management of children in EDs.

SYSTEMATIC REVIEW REGISTRATION

Open Science Framework https://osf.io/h6jv2.

Oxytocin administration selectively improves olfactory detection thresholds for lyral in patients with schizophrenia

BACKGROUND

Olfaction plays an important role in mammalian social behavior. Olfactory deficits are common in schizophrenia and correlate with negative symptoms and low social drive. Despite their prominence and possible clinical relevance, little is understood about the pathological mechanisms underlying olfactory deficits in schizophrenia and there are currently no effective treatments for these deficits. The prosocial neuropeptide oxytocin may affect the olfactory system when administered intranasally to humans and there is growing interest in its therapeutic potential in schizophrenia.

METHODS

To examine this model, we administered 40IU of oxytocin and placebo intranasally to 31 patients with a schizophrenia spectrum illness and 34 age-matched healthy control participants in a randomized, double-blind, placebo-controlled, cross-over study. On each test day, participants completed an olfactory detection threshold test for two different odors: (1) lyral, a synthetic fragrance compound for which patients with schizophrenia have specific olfactory detection threshold deficits, possibly related to decreased cyclic adenosine 3',5'-monophosphate (cAMP) signaling; and (2) anise, a compound for which olfactory detection thresholds change with menstrual cycle phase in women.

RESULTS

On the placebo test day, patients with schizophrenia did not significantly differ from healthy controls in detection of either odor. We found that oxytocin administration significantly and selectively improved olfactory detection thresholds for lyral but not for anise in patients with schizophrenia. In contrast, oxytocin had no effect on detection of either odor in healthy controls.

DISCUSSION

Our data indicate that oxytocin administration may ameliorate olfactory deficits in schizophrenia and suggest the effects of intranasal oxytocin may extend to influencing the olfactory system. Given that oxytocin has been found to increase cAMP signaling in vitro a possible mechanism for these effects is discussed.

Oxytocin administration enhances controlled social cognition in patients with schizophrenia

BACKGROUND

Individuals with schizophrenia have functionally significant deficits in automatic and controlled social cognition, but no currently available pharmacologic treatments reduce these deficits. The neuropeptide oxytocin has multiple prosocial effects when administered intranasally in humans and there is growing interest in its therapeutic potential in schizophrenia.

METHODS

We administered 40 IU of oxytocin and saline placebo intranasally to 29 male subjects with schizophrenia and 31 age-matched, healthy controls in a randomized, double-blind, placebo-controlled, cross-over study. Social cognition was assessed with The Awareness of Social Inference Test (TASIT) and the Reading the Mind in the Eyes Test (RMET). We examined the effects of oxytocin administration on automatic social cognition (the ability to rapidly interpret and understand emotional cues from the voice, face, and body); controlled social cognition (the ability to comprehend indirectly expressed emotions, thoughts, and intentions through complex deliberations over longer time periods); and a control task (the ability to comprehend truthful dialog and perform general task procedures) in individuals with and without schizophrenia using mixed factorial analysis of variance models.

RESULTS

Patients with schizophrenia showed significant impairments in automatic and controlled social cognition compared to healthy controls, and administration of oxytocin significantly improved their controlled, but not automatic, social cognition, F(1, 58)=8.75; p=0.004. Conversely, oxytocin administration had limited effects on social cognition in healthy participants. Patients and controls performed equally well and there were no effects of oxytocin administration on the control task.

DISCUSSION

Intact social cognitive abilities are associated with better functional outcomes in individuals with schizophrenia. Our data highlight the potentially complex effects of oxytocin on some but not all aspects of social cognition, and support the exploration of intranasal oxytocin as a potential adjunct treatment to improve controlled social cognition in schizophrenia.

Molecular adsorption onto metallic quantum wires

We have studied the adsorption of mercaptopropionic acid, 2,2'-bipyridine, and dopamine onto electrochemically fabricated Cu nanowires. The nanowires are atomically thin with conductance quantized near integer multiples of 2e(2)/h. Upon molecular adsorption, the quantized conductance decreases to a fractional value, due to the scattering of the conduction electrons by the adsorbates. The decrease is as high as 50% for the thinnest nanowires whose conductance is at the lowest quantum step, and smaller for thicker nanowires with conductance at higher quantum steps. The adsorbate-induced conductance changes depend on the binding strengths of the molecules to the nanowires, which are in the order of mercaptopropionic acid, 2,2'-bipyridine, and dopamine, from strongest to weakest. The sensitive dependence of the quantized conductance on molecular adsorption may be used for molecular detection.