Staff development through ward-group consultation.
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Hospitals, Psychiatric↗
Biomedical subjects
D T Brown
Publications and source records attributed to D T Brown.
Drugs affecting clearance of middle ear secretions: a perspective for the management of otitis media with effusion.
Otitis media with effusion (OME) is characterized by the production and accumulation in the middle ear of mucus secretions, whose physicochemical properties are an important feature in the etiology and treatment of the disease. Many types of pharmaceutical agents, including anti-inflammatory agents, antihistamines, antibiotics, and mucolytics, have been used in attempts to improve the clinical status of patients with OME. This study critically reviews the literature from the point of view of possible changes induced by these agents in the physicochemical properties of the secretions and hence their clearance from the middle ear. In vitro studies on mucociliary clearance of respiratory (tracheobronchial) secretions and middle ear effusions are cited as the basis for analyzing the important parameters expected to govern middle ear clearance and to determine the rationale for use (or nonuse) of various classes of drugs. It is expected that this analysis will prove useful in the design of properly controlled trials of such agents.
Animals↗
Graduate training in school psychology.
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Curriculum↗
Carbocysteine.
Carbocysteine is prescribed for conditions characterized by the accumulation of excessive mucus. Although often described as a mucolytic, its function is probably that of mucoregulation, which results in physical changes in accumulated secretions that are favorable in terms of clearance. The chemistry, pharmacology, pharmacokinetics, clinical applications, and toxicology of carbocysteine are reviewed.
Carbocysteine↗
Dentin exposure and decay incidence when removable partial denture rest seats are prepared in tooth structure.
Prosthodontists surveyed preferred inverted V-shaped canine cingulum ledge rest seats located at the junction of the middle and cervical thirds of the lingual surface. Most respondents indicated that they preferred a ledge depth of at least 1.0 mm and indicated that their preparations usually did not extend into dentin. When the respondents evaluated various ledge depths, the mean depth of those judged adequate was 0.74 mm, which was less than the respondent and textbook recommendations. Premolar occlusal rest seats judged adequate generally met textbook size guidelines. The mean clinical incidence of dentin exposure with cingulum ledges and occlusal rest seats was 61%, close to the 55% exposure rate found on extracted teeth. Dentin Detector Gel effectively identified clinical dentin exposure but tooth sensitivity was not a good indicator of dentin exposure. Seventy-one of the 107 rest seats studied for incidence of caries and decalcification had exposed dentin but only two of the 71 had lesions. Ten of the 107 had small enamel fractures, primarily occurring on cingulum ledges.
Attitude of Health Personnel↗
The effect of fentanyl, meperidine and diamorphine on nerve conduction in vitro.
The effect of fentanyl, meperidine and diamorphine on A- and C-fiber conduction in an in vitro rabbit vagus nerve preparation was examined. The nerves were maintained at 37 degrees C with an oxygenated electrolyte solution. The effect of the commercial preparation of fentanyl (Sublimaze) and isotonic solutions of fentanyl, meperidine and diamorphine were observed. Sublimaze had a neurotoxic effect related to its hypotonicity. In isotonic solutions, fentanyl and meperidine, but not diamorphine, blocked nerve conduction and both showed marked frequency-dependent blocking actions in C-fibers. Naloxone (Narcan) did not prevent the effect of fentanyl. Both fentanyl and meperidine potentiated the block produced by a low concentration of bupivacaine (0.005 mM, 0.00016%), the effect of meperidine being seen at clinically relevant concentrations. Fentanyl was slightly more potent than meperidine in its effect on nerve conduction, but its greater opioid potency would not allow its use as a local anesthetic. The local anesthetic effect of meperidine may be more useful clinically.
Animals↗
The effect of finish line form and luting agent on the breaking strength of Dicor crowns.
Molar teeth were prepared to a standardized cylindric form using a lathe. Dicor crowns were luted on these preparations using zinc phosphate, glass-ionomer, and resin cements. The crowns were thermocycled and subjected to fracture loading to compare the effect of the different luting agents on fracture strength. Five finishing lines were used to determine if resin cement and associated bonding procedures could counteract the negative effect certain finish lines produce on all-ceramic crowns. When resin cement was used in conjunction with restoration and tooth precementation bonding treatments, the crowns were significantly stronger than when glass-ionomer or zinc phosphate cements were used. No difference in strength was found between the five finish lines when the crowns were cemented with resin and associated bonding procedures.
Analysis of Variance↗