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Biomedical subjects

W Wade

Publications and source records attributed to W Wade.

25 records · Page 2Linked to original sources

Spinal fractures complicating ankylosing spondylitis.

Individuals with ankylosing spondylitis (AS) are at increased risk for developing fractures of the spine, especially in the cervical region. This tendency is related to the ossification of spinal ligaments and osteopenic changes in the spinal vertebrae. We reviewed our clinical experience of SCI occurring due to AS, and the literature regarding the natural history of these fractures. A significant number of individuals are not aware of their increased risk for spinal fracture and sustain spinal fractures without realizing it. Difficulties in diagnosis and inappropriate management of spinal fractures in these individuals have often resulted in severe neurologic sequelae and a mortality rate approximately twice that observed with similar fractures in a normal spine. The need for better patient education emphasizing the significance of even minor trauma, and a thorough evaluation of AS patients with a history of trauma is stressed.

Cervical Vertebrae↗

The mechanism of action of chlorhexidine. A study of plaque growth on enamel inserts in vivo.

Controversy exists concerning the mode of action of chlorhexidine in plaque inhibition. This study attempted to determine whether an oral reservoir of chlorhexidine was necessary for plaque inhibition. Plaque growth on enamel under the influence of topically applied or rinsed chlorhexidine was closely monitored by clinical scoring, bacterial culturing and scanning electron microscopy. Thus, 3 subjects wore removable acrylic appliances containing enamel inserts. In the first regimen, inserts on one side of the appliances were exposed to 0.2% chlorhexidine and on the other, water for 1 min twice a day for 14 days. In the second regimen, subjects rinsed with 0.2% chlorhexidine for 1 min twice a day for 14 days with the appliances in situ. Results demonstrated that plaque growth assessed by the 3 study methods was very small on chlorhexidine-treated inserts by comparison with water-treated specimens. Importantly, inserts treated with chlorhexidine topically or by rinsing could not be distinguished by any method of evaluation. It is concluded that chlorhexidine achieves plaque inhibition as a result of an immediate bactericidal action during the time of application and a prolonged bacteriostatic action as a result of adsorption to the pellicle coated enamel surface. Consistent with other clinical studies, it is apparent that a progressively desorbing oral reservoir of antiseptic is not the mechanism by which chlorhexidine achieves plaque inhibition on teeth.

Administration, Topical↗

Use of antimicrobial containing acrylic strips in the treatment of chronic periodontal disease. A three month follow-up study.

Local antimicrobial therapy has been considered for use in the treatment of chronic periodontal disease. This study evaluated chlorhexidine, metronidazole, and tetracycline delivered into periodontal pockets in an acrylic resin vehicle and compared the results with root planed and untreated sites over a three-month follow-up period. One site per patient where pocketing greater than or equal to 6 mm associated with a single rooted tooth was randomly allocated to one of the five possible regimens. Baseline and follow-up measurements included probing depth, loss of attachment, bleeding on probing, crevicular fluid flow, and dark-field microscopy of a subgingival plaque sample. Intratreatment evaluations revealed no significant changes in any parameter for untreated sites. Significant improvements in many parameters occurred with all four therapies although the magnitude and duration were greater in metronidazole and root planing groups. The more important intertreatment comparisons indicated that most treatments produced significant benefits compared with the control group; however, again these were greater with metronidazole and root planing. Furthermore, significantly greater effects were noted for metronidazole and root planing compared with tetracycline and more particularly chlorhexidine. It is concluded that some locally delivered antimicrobials alone may be useful in the treatment of chronic periodontal disease. However, at this time local antimicrobial therapy should be considered as adjunctive to conventional debridement techniques.

Adult↗