Oral health effects, brushing habits and management of methamphetamine users for the general dental practitioner.

BACKGROUND: Methamphetamine is a synthetic drug commonly abused in South Africa and is highly addictive. Users have a higher prevalence of dental caries compared to non-users and the classical caries pattern found in methamphetamine users is termed 'meth mouth'. The increased consumption of soft drinks and the absence of saliva are the main risk factors for 'meth mouth'. AIM: To determine the oral health status of individuals using methamphetamine. METHOD: A cross-sectional study was conducted on a convenience sample of 308 self-reported methamphetamine users at 22 specialised substance addiction treatment centres in the Western Cape, South Africa. RESULTS: There was a significant difference in tooth brushing frequency when using methamphetamine (p = 0.0000022; χ(2) = 23.84; OR = 3.25). The mean decayed, missing and filled teeth score was ten and there was an association between the mean number of decayed teeth and the duration of drug addiction (p = 0.0071; χ(2) = 12.07). Users who were using methamphetamine for less than four years had fewer missing teeth compared to those who were using methamphetamine for more than four years. CONCLUSIONS: When methamphetamine abuse is detected, the dentist can play a key role in early management of drug addiction by referring the patient to specialised substance addiction treatment centres. In addition, by restoring the dental appearance, users may regain their self-esteem and improve their oral health quality of life.

Efficacy and tolerability of a new estradiol delivering matrix patch (Estraderm MX) in postmenopausal women.

OBJECTIVE: To examine the efficacy and tolerability of a new matrix patch delivering estradiol (E2 Matrix) at doses of 0.05 and 0.10 mg per day (Estraderm MX 50, 100) in the treatment of moderate to severe postmenopausal symptoms. METHODS: A total of 254 postmenopausal women were randomized to receive treatment with E2 Matrix 0.10 mg (N = 86), E2 Matrix 0.05 mg (N = 82), or placebo (N = 86) in a double-blind, double-dummy fashion for a period of 12 weeks continuously. Patches were applied twice weekly to the buttocks with each patient wearing two patches at all times. The primary efficacy criterion was the difference from baseline of the mean number of moderate to severe hot flushes per 24 h during the last 2 weeks of treatment. Other efficacy variables included reduction in hot flushes at 4 and 8 weeks, reduction in daytime flushing and night sweats, and Kupperman Index at 4, 8, and 12 weeks. RESULTS: E2 Matrix 0.10 and 0.05 mg were both significantly superior to placebo in reducing hot flushes per 24 h after 4, 8, and 12 weeks of treatment (P < 0.001). Also, for all other efficacy parameters studied, both dosage strengths of E2 Matrix were statistically significantly superior to placebo at all time points (P < 0.001). Local tolerability was good in both groups. A slight increase in estrogen related adverse effects (breast tenderness, leukorrhoea) was seen with the 0.10 mg patch. Adhesion of patches and compliance were good. Overall systemic tolerability was good in both treated groups. However, a 4.8% overall incidence of endometrial hyperplasia was observed in patients with an intact uterus. CONCLUSIONS: This new matrix patch offers an effective and well tolerated dosage form for delivery of 0.05 and 0.1 mg estradiol per day. It may be particularly suitable for those women who experience local sensitivity to alcohol-containing systems. In light of the observed hyperplasia after treatment in five patients, estrogen therapy should as yet be supplemented monthly with a progestogen in women with an intact uterus.

Intracranial teratoma with multiple fetuses: pre- and post-natal appearance.

An intracranial teratoma in which six distinct dysmorphic fetuses were included was studied at autopsy. Karyotopic studies showed a normal chromosomal number in the child and the same karyotype in the three tumoral parts were examined. This is the second tumor of this type reported.

Serum levels of ritodrine during oral maintenance therapy.

In order to elucidate some aspects of the efficacy of orally administered ritodrine, serum concentrations of ritodrine were determined during intravenous and oral therapy. Ritodrine serum concentrations during steady-state intravenous therapy (200 micrograms/min) ranged from 91.0 to 123.0 ng/ml. Serum concentrations during maintenance therapy with 120 mg ritodrine per os fluctuate between 3.2 and 30.5 ng/ml, depending on the moment of tablet intake. During oral maintenance therapy a striking correlation was found between the maternal heart rate and the serum concentration of ritodrine. The findings suggest that efficacy of orally administered ritodrine is doubtful on pharmacological grounds.

Predictive value of uterine contractility and the serum levels of progesterone and oestrogens with regard to preterm labour.

A longitudinal investigation regarding the serum concentrations of oestradiol, oestriol and progesterone in relation to uterine activity has been performed in 80 healthy primigravid women during the course of pregnancy up to the 37th week of pregnancy. The frequency of uterine contractions was quantitatively objectivated by means of external toco-dynamometry; simultaneously the uterine activity has been recorded by the pregnant women qualitatively. It appears that there is a gradual increase of all the three mentioned hormones during the course of pregnancy. However, there is a large interindividual spread. There exists no relation between the hormonal serum levels and uterine activity (quantitatively as well as qualitatively recorded). Between these two latter there is a poor relation. It is impossible to predict the occurrence of preterm birth based on hormonal serum changes. This holds for the progesterone-oestradiol ratio.