How to influence patient oral hygiene behavior effectively.

Considerable resources are expended in dealing with dental disease easily prevented with better oral hygiene. The study hypothesis was that an evidence-based intervention, framed with psychological theory, would improve patients' oral hygiene behavior. The impact of trial methodology on trial outcomes was also explored by the conducting of two independent trials, one randomized by patient and one by dentist. The study included 87 dental practices and 778 patients (Patient RCT = 37 dentists/300 patients; Cluster RCT = 50 dentists/478 patients). Controlled for baseline differences, pooled results showed that patients who experienced the intervention had better behavioral (timing, duration, method), cognitive (confidence, planning), and clinical (plaque, gingival bleeding) outcomes. However, clinical outcomes were significantly better only in the Cluster RCT, suggesting that the impact of trial design on results needs to be further explored.

Slow-release fluoride devices for the control of dental decay.

BACKGROUND: Slow-release fluoride devices have been investigated as a potentially cost-effective method of reducing dental caries in those with high risk of disease. OBJECTIVES: To evaluate the effectiveness of different types of slow-release fluoride devices on preventing, arresting, or reversing the progression of carious lesions on all surface types of deciduous and permanent teeth. SEARCH STRATEGY: We searched (up until February 2005) multiple electronic databases (Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, EMBASE), bibliographic references of identified randomised controlled trials (RCTs), textbooks, review articles, and meta-analyses. Letters were sent to authors of identified RCTs asking for clarifications and unpublished or ongoing research. Relevant journals were handsearched for more recent reports than those obtained from databases. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials (RCTs) comparing slow-release fluoride devices with an alternative fluoride treatment, placebo, or no intervention in all age groups. The main outcomes measures sought were changes in numbers of decayed, missing, and filled teeth or surfaces (DMFT/DMFS in permanent teeth or dmft/dmfs in primary teeth) and progression of carious lesions through enamel and into dentine. DATA COLLECTION AND ANALYSIS: Abstracts of all reports identified were considered independently by two review authors and full reports obtained of any potentially relevant articles to allow further assessment for relevance and validity. Data extraction and quality assessment were conducted independently by two and three review authors respectively, with arbitration by the fourth. Where uncertainty existed, authors were contacted for additional information. MAIN RESULTS: Only one trial involving 174 children fully met the criteria for inclusion in this review. Although 132 children were still included in the trial at the 2-year completion point, examination and statistical analysis was performed on only the 63 children who had retained the beads. Thirty-one of these were in the intervention group and 32 in the control group. Amongst these 63 children, caries increment was reported to be statistically significantly lower in the intervention group than in the placebo group (mean difference: -0.72 DMFT, 95% confidence interval -1.23 to -0.21 and -1.52 DMFS, 95% confidence interval -2.68 to -0.36) AUTHORS' CONCLUSIONS: There is some evidence of a caries-inhibiting effect of slow-release fluoride glass beads. This evidence is regarded as weak and unreliable because the results were from participants selected on the basis of bead retention rather than an intention-to-treat analysis.

Purification and Characterization of Human Serum and Secretory IgA1 and IgA2 Using Jacalin.

Human immunoglobulin A (IgA) is found in serum and secretions in several different forms (1), Serum IgA is produced by the bone marrow and is pre-dominately monomeric (M ( r )= 160 kDa). Most of the IgA in secretions (sIgA) is polymeric, predominantly dimeric, comprising two monomer subunits linked together by intersubunit disulfide bonds and a cysteine-rich polypeptide termed J-chain (M ( r )= 16 kDa). Polymeric IgA in secretions, but not in serum, contains an additional heavily glycosylated protein called secretory component (SC) (M ( r )= 70 kDa).

Cytofluorometric analysis of anti-lymphocyte antibodies in AIDS.

Anti-lymphocyte antibodies (ALA) have been detected in the plasma of 53.8% of HIV-positive patients tested (CD4/CD8 ratios: mean 0.265; range 0.01 to 0.5) using analytical continuous-flow cytofluorometry. IgG from the AIDS plasma was seen to bind to normal PBL in 53.8% of cases (14/26). In double labelling experiments CD4 + lymphocytes, CD8 + lymphocytes, and B lymphocytes were all bound by the ALA, but monocytes were not bound. Pre-adsorption of the diluted AIDS plasma onto an excess of mouse spleen cells did not remove lymphocyte binding activity. No evidence was found for preferential binding to phytohaemagglutinin-stimulated lymphocytes. ALA could not be detected in the plasma of normal subjects, patients with acute renal failure undergoing renal dialysis, or patients with high levels of circulating immune complexes.

A catalytically active high-Mr form of human cathepsin B from sputum.

A cysteine proteinase from purulent sputum was partially purified by a method involving affinity chromatography on Sepharose-aminohexanoylphenylalanylglycinaldehyde semicarbazone. It was immunologically related to lysosomal cathepsin B from human liver and was similar in many, but not all, other aspects. It was catalytically active, as demonstrated by active-site-directed radioiodination, and hydrolysed three cathepsin B substrates, two with Km values similar to those of lysosomal cathepsin B. In addition, the rates of inactivation of the sputum and lysosomal forms of the enzyme by L-3-carboxy-2,3-transepoxypropionyl-leucylamido(4-guanidino) butane (Compound E-64) were very similar. However, the sputum enzyme differed from lysosomal cathepsin B in the following respects. Inhibition by chicken cystatin was much weaker for sputum cathepsin B than for the lysosomal enzyme. Sputum cathepsin B had greater stability at pH 7.5 and a higher apparent Mr, even after deglycosylation, than lysosomal cathepsin B. We conclude that the form of cathepsin B found in sputum is probably a truncated form of human procathepsin B, with some differences in properties that could be of physiological importance.