Hippocampal volume change relates to clinical outcome in childhood-onset schizophrenia.

BACKGROUND: Fixed hippocampal volume reductions and shape abnormalities are established findings in schizophrenia, but the relationship between hippocampal volume change and clinical outcome has been relatively unexplored in schizophrenia and other psychotic disorders. In light of recent findings correlating hippocampal volume change and clinical outcome in first-episode psychotic adults, we hypothesized that fewer decreases in hippocampal volume would be associated with better functional outcome and fewer psychotic symptoms in our rare and chronically ill population of childhood-onset schizophrenia (COS) patients. METHOD: We prospectively obtained 114 structural brain magnetic resonance images (MRIs) from 27 COS subjects, each with three or more scans between the ages of 10 and 30 years. Change in hippocampal volume, measured by fit slope and percentage change, was regressed against clinical ratings (Children's Global Assessment Scale, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms) at last scan (controlling for sex, time between scans and total intracranial volume). RESULTS: Fewer negative symptoms were associated with less hippocampal volume decrease (fit slope: p = 0.0003, and percentage change: p = 0.005) while positive symptoms were not related to hippocampal change. There was also a relationship between improved clinical global functioning and maintained hippocampal volumes (fit slope: p = 0.025, and percentage change: p = 0.043). CONCLUSIONS: These results suggest that abnormal hippocampal development in schizophrenia can be linked to global functioning and negative symptoms. The hippocampus can be considered a potential treatment target for future therapies.

Antihypertensive action of bendroflumethiazide: increased prostacyclin production?

A within-patient randomized, double-blind, crossover study was performed to investigate mechanisms of action of bendroflumethiazide in mild essential hypertension. Significant reductions in lying, standing, and postexercise blood pressure were seen after both 3 days and 10 wk treatment with bendroflumethiazide 10 mg daily. Plasma levels of 6-oxo-PGF1 alpha, the chemical hydrolysis product of prostacyclin, were increased by both 3 days and 10 wk therapy with bendroflumethiazide. This raises the possibility that thiazides may reduce peripheral resistance by increasing prostacyclin biosynthesis.

A comparison of perceived and actual dental needs of a select group of children in Texas.

Dental caries (DMFS) evaluations were made for 150 children in Grades 2 to 7. Three months later, a trained interviewer questioned 120 children from 100 families to determine atitudes toward oral hygiene and dental health on the part of (a) the child, (b) the parent, along with (c) the child's perception of the parent's attitude, and (d) the parent's perception of the child's attitude. Evaluation of the perceived attitudes toward oral hygiene revealed a statistically significant correlation between the child's attitude and the degree of dental health as well as between the attitudes of child and parent. Conclusions were: (1) parents were not accurate in their perception of the dental health habits of their children, (2) children were not performing acceptable routine oral hygiene procedures, (3) children accurately perceived the attitudes of their parents toward dental health, and (4) children's actual dental health behavior as manifested by dental health status was related to the attitudes of their parents.

Teachers as models in programs for school dental health; an evaluation of "The Toothkeeper".

An evaluation of the effectiveness of the Toothkeeper program was performed in Houston to determine if participation in the program by elementary school children would result in their having cleaner teeth and better gingival health than seen in similar children not in the program. Assessments for plaque and gingivitis were made at the beginning, at the completion of the formal 16-week program, and again after a second 16-week period. In this particular setting, the Toothkeeper was found to be ineffective. Possible reasons for the ineffectiveness of the program are discussed and several suggestions for modifying the program are offered.

Oral hygiene for dental implant patients.

Effective home care cleaning techniques are described for patients with dental implants. Specific methods are described for the fixed prosthesis, the fixed detachable prosthesis and the removable prosthesis. While dental caries is no longer a problem, peri-implant gingivitis and peri-implant osteitis are concerns for patients who have dental implants. Techniques and the tools available enable dental implant patients to keep their dental implants plaque-free and consequently, free of peri-implant infection. This report will discuss home care for the fixed detachable prosthesis, the removable prosthesis, and the fixed prosthesis.

Data base management systems extend computer use.

A data base management system (DBMS) is a tool that can help the healthcare industry manage more information efficiently. This tool has the capability to store and retrieve data without the need for several programs or files. The DBMS is a sophisticated yet "user friendly" program that does not require any extensive computer training. In the age of microcomputers, the DBMS provides more power, eliminates seemingly unnecessary and repetitive work with data input, and falls within the budget range of most healthcare institutions.