Rush order containment of critical drugs in ICUs

The recent SARS CoV-02 pandemic has put enormous pressure on intensive care staff, making it imperative to relieve them of repetitive tasks with little added value such as drug replenishment. We propose a decision support system based on a hybrid policy to manage the inventory of critical drugs with low and intermittent demand at an Intensive Care Unit (ICU). Demand forecasting is at the heart of any inventory policy. We claim that in the ICU setting drug demand patterns must be therapy based. Heterogeneous data have been collected during an on site study, and information have been extracted to provide a faithful abstract representation of the ward as a system, as well as the potential evolutions of ICU patients clinical conditions. Together with medical guidelines, this provides the foundation of a therapy based demand forecasting tool. This study integrates schedule optimization and demand forecasting, and exploits simulation for evaluation purpose in the long run. At the beginning of every period, drug orders are optimally scheduled with respect to forecast demand. Then, scheduled orders are deployed day by day and confronted with the real demand in a simulated environment. Potential stock outs trigger rush orders to restore safety stocks. The comparison between the proposed policy and a standard policy mimicking current practice in an ICU ward shows that information on therapy patterns can be successfully incorporated into drug replenishment processes to reduce the number of rush orders, a primary goal in designing an efficient system.

Postoperative infections and tetracycline prophylaxis in periodontal surgery: a retrospective study

The aims of this retrospective study were to assess the incidence of infection after periodontal surgery, in relation to the type of surgical procedure, and the effectiveness of prophylactic tetracycline administration. Nineteen (4.4%) of 445 surgical procedures in patients who were given no tetracycline resulted in signs of infection, while two (3.8%) in patients who were treated with tetracycline resulted in signs of infection. There was no statistically significant difference between these incidences, suggesting that there is no reason for routine tetracycline prophylaxis in periodontal surgery. There was no statistically significant difference in the incidence of infection whether or not bone (ostectomy or osteoplasty) or tooth extraction was involved in the surgical procedure.

[Needles in dental practice. Clinical evaluation and experiments on deformation and siliconization]

The authors have considered: a) the rate of the deformation of three different needles (Groups B, V, R) when used in different clinical conditions; b) the modification of the surface silicon of the needles after in vivo and in vitro stress. The results have shown a good behaviour of all the groups when employed through the mucous membrane, but a progressively increased deformation after contacts with an osseous surface, significantly higher for groups B and V than group R. No difference in the surface silicon, both among the groups and in relation to the technique of utilization.

[Chlorhexidine in periodontal therapy]

Chlorhexidine a cationic antiseptic active against a wide spectrum of bacteria is widely and successfully used in the treatment of periodontal disease in the home and the outpatients' clinic. A review of the literature forms the basis for an assessment of the advantages and disadvantages of the various supra and subgingival application techniques with details of the limitations and risk/benefit ratio implicit in the various clinical situations.

[Effect of laser light on polymerization of composite materials]

The purpose of this study is to verify the advantages of light Laser Argon Technique on composite resin polymerization. These results have been compared to the normal halogen light technique, used in daily practice the only advantage of Laser Argon Technique is the faster polymerization, compared to the normally employed technique, due to the brightness and monocromaticy of the laser bean.

Antihypertensive effects of a novel peripheral vasodilator, Ro 12-4713

The effects of Ro 12-4713, a vasodilator, on blood pressure and heart rate, were tested in 13 ambulant patients with mild to severe hypertension. The patients received Ro 12-4713 in total oral doses ranging from 1.5 to 4 mg/kg over a 3-5 day period. Standard laboratory tests were done 24 h before and after the study. Standing and supine blood pressure and heart rate were determined before, and every hour for 6-8 h after drug administration. ECGs were recorded before, during and at the end of each study day. Ro 12-4713 reduced the pretreatment standing and supine-blood pressure from 213 +/- 34/126 +/- 21 mmHg and 218 +/- 31/130 +/- 20 mmHg to 156 +/- 33/85 +/- 9 mmHg and 158 +/- 25/88 +/- 11 mmHg at the end of Day 5. Heart rate was only transiently increased in patients with pretreatment values of less than 90 beats/min. Although abnormal ECGs tended towards normalization, there were 2 cases of T-wave inversion (the patients remained asymptomatic). Raised BUN levels tended to decrease towards normal. Side effects reported spontaneously by patients (headaches, palpitations, dizziness, nausea and one case of water retention) appeared to be transient in nature. Ro 12-4713 appeared to be a very potent and long lasting antihypertensive agent, whose inherent side effects were only transient in nature.