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Resorbable plate fixation in pediatric craniofacial surgery
112 New Antiepileptic Med 102:147,1997
CURRENT LITERATURE Drugs.
Sirven JI, Liporace JD. Postgrad
The traditional antiepileptic drugs have been associated with a number of adverse systemic and cognitive effects. Approval of several new antiepileptic drugs since 1993 has implications for primary health care workers who treat epileptic patients. In this article, the authors examine five new drugs: felbamate, fosphenytoin, gabapentin, lamotrigine, and topiramate. Each of these drugs is unique and chemically different from the others. Felbamate is effective in treating both partial and generalized seizures alone or in combination with other drugs. Dosage is increased gradually, but has side effects that include aplastic anemia in 1 out of every 2,000 to 5,000 patients. It is therefore relegated to a role as a second-line medication. Fosphenytoin is a major advance in the control of status epilepticus, replacing benzodiazapines and intravenous phenytoin as the common therapy. The drug is given intravenously or intramuscularly and takes about 8 to 15 minutes to act. The initial dose is 15 to 20 mg/kg and takes 7 minutes to infuse, at a rate of 150 mg/min. Gabapentin is useful for all types of seizures and is also being used to control chronic pain syndromes (eg, trigeminal neuralgia, migraines, etc) It has no significant drug interactions. Lamotrigine is FDA approved only for add-on therapy for partial seizures. Side effects include headache, double vision, drowsiness, nausea, and a rash. Topiramate appears useful in treating partial seizures. It also is considered an add-on medication. Adverse effects includes sleepiness, confusion, diZZmeSS.-ROGER E. ALEWVDER Reprint requests to Dr Sirven: Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University Hospital, 111 S 1 Ith St, Suite #4150 Gibbon Building, Philadelphia, PA 19107.
Stepwise multivariate regression analysis revealed three factors to be of statistical significance with regard to smoking cessation. Previous heavy alcohol abuse as opposed to light or moderate consumption was a negative predictor of smoking cessation. Combined therapy versus single modality treatment (surgery or radiation alone) was associated with higher quit rates. Total laryngectomy when compared to other surgical procedures proved favorable towards smoking cessation. It is for these reasons that the authors recommend frequent short duration counseling beginning at the time of tumor diagnosis as the best practical approach for this difticult problem.-J. BROKLOFF Reprint 980146,
requests to Dr DiNardo: Richmond, VA, 23298.
Medical
College
of Virginia,
Box
Resorbable Plate Fixation in Pediatric Craniofacial Surgery. Eppley BL, Sadove AM, Havlik RJ. Plast Reconstr surg lOO:l, 1997 The authors showed the use and effectiveness of resorbable plate fixation in pediatric craniofacial surgery. They used 912 resorbable fixation plates in 100 patients ages 4 to 15 months. These patients underwent surgery to correct either frontal, sagittal, or occipital bone deformities. The lactosorb plates, which are composed of polyglycolic and polylactic acids, were supplied by Walter Lorenz. The authors took radiographs immediately postoperatively, 6 months, and 1 year. They reported no complications from implantation. Only four patients had to have screws removed due to palpability or secondary reconstructive surgery. The author concluded the resorbable plates to be effective and safe for use in pediatric craniofacial surget-y.-R. HOLLOWAY
Virucidal Activity of an Oral Fluid Human Immunodeficiency Virus-l Antibody Preservative. Bestwick RR, Fitchen JH. Am J Med 102:26,1997 (suppl4A)
Reprint requests to Dr Eppley: Division of Plastic Surgery, James Whitcomb Riley Hospital for Children, 702 Barnhill Dr, Room 3540, Indianapolis, IN 46202-5200.
Oral fluid samples have been shown to provide accurate results when used to test for antibody to the human immunodeficiency virus-l (HIV-l). The effective use .of this medium is contingent on the stabilization of immunoglobins in the sample through the use of preservatives. The preservative contained in the oral surgery testing system (Ora Sure HIV-l oral specimen collecting device, Epitope, Beaverton, OR) preserved oral fluid samples from infected individuals, yet, the samples were non-infectious. This preservative at minimum produced a 5-log reduction in infectious HIV-1 titre when incubated with an equal volume of concentrated HIV for either 15 or 60 minutes.-R.H. HAUG
Varicella-Zoster Virus Infection. Postgrad Med 102:187,1997
Reprint requests to Dr Bestwick: Beaverton, OR 97008-7108.
Epitope,
8505 SW Creekside
Place,
Factors Affecting Smoking Cessation in Patients with Head and Neck Cancer. Vander Ark W, DiNardo LJ. Laryngoscope 107:888, 1997 This study examines the smoking habits of head and neck cancer patients treated at a tertiary care cancer center. Eighty-seven patients over a 2-year period were evaluated by interview for demographic factors, level of exposure, tumor stage and location, treatment modalities, concomitant alcohol use, and cessation methods. Overall 69% of the patients quit smoking by the end of the study period. The majority of the patients who quit did so shortly after cancer diagnosis.
Brody MB, Moyer D.
Varicella-zoster virus accounts for approximately 3.5 million cases per year in its primary form (chickenpox) and an additional 300,000 cases of herpes zoster in its reactivated form. With the US licensing of a vaccine in 1995, investigators are anticipating a decline in the number of pediatric chickenpox cases in the future, accompanied by a subsequent reduction of disease in susceptible adults. In the short-term, primary care doctors will encounter wild-type and vaccine-induced chickenpox in suceptible immunocompetent patients or immunocompromised adults. Most chickenpox infections occur in patients under 15 years of age, but adults have a 15-fold increase in mortality. The. virus is transmitted through exposure to infectious airborne droplets with nearly face-to-face contact usually required, although it can be transmitted through contaminated ventilation systems. The period of infectivity extends from 2 days before the appearance of a rash through resolution of the skin lesions. The incubation period is approximately 10 to 21 days. After the primary infection, the virus remains latent in the dorsal spinal ganglia. The mechanisms leading to its reactivation as herpes zoster remain poorly understood. The clinical presentation of zoster is a unilateral vesicular eruption, usually involving the thoracolumbar dermatomes, accompanied by acute neuritis. Human immunodeficiency virus infection is a well-recognized predisposing factor.
CURRENT LITERATURE Drugs.
Sirven JI, Liporace JD. Postgrad
The traditional antiepileptic drugs have been associated with a number of adverse systemic and cognitive effects. Approval of several new antiepileptic drugs since 1993 has implications for primary health care workers who treat epileptic patients. In this article, the authors examine five new drugs: felbamate, fosphenytoin, gabapentin, lamotrigine, and topiramate. Each of these drugs is unique and chemically different from the others. Felbamate is effective in treating both partial and generalized seizures alone or in combination with other drugs. Dosage is increased gradually, but has side effects that include aplastic anemia in 1 out of every 2,000 to 5,000 patients. It is therefore relegated to a role as a second-line medication. Fosphenytoin is a major advance in the control of status epilepticus, replacing benzodiazapines and intravenous phenytoin as the common therapy. The drug is given intravenously or intramuscularly and takes about 8 to 15 minutes to act. The initial dose is 15 to 20 mg/kg and takes 7 minutes to infuse, at a rate of 150 mg/min. Gabapentin is useful for all types of seizures and is also being used to control chronic pain syndromes (eg, trigeminal neuralgia, migraines, etc) It has no significant drug interactions. Lamotrigine is FDA approved only for add-on therapy for partial seizures. Side effects include headache, double vision, drowsiness, nausea, and a rash. Topiramate appears useful in treating partial seizures. It also is considered an add-on medication. Adverse effects includes sleepiness, confusion, diZZmeSS.-ROGER E. ALEWVDER Reprint requests to Dr Sirven: Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University Hospital, 111 S 1 Ith St, Suite #4150 Gibbon Building, Philadelphia, PA 19107.
Stepwise multivariate regression analysis revealed three factors to be of statistical significance with regard to smoking cessation. Previous heavy alcohol abuse as opposed to light or moderate consumption was a negative predictor of smoking cessation. Combined therapy versus single modality treatment (surgery or radiation alone) was associated with higher quit rates. Total laryngectomy when compared to other surgical procedures proved favorable towards smoking cessation. It is for these reasons that the authors recommend frequent short duration counseling beginning at the time of tumor diagnosis as the best practical approach for this difticult problem.-J. BROKLOFF Reprint 980146,
requests to Dr DiNardo: Richmond, VA, 23298.
Medical
College
of Virginia,
Box
Resorbable Plate Fixation in Pediatric Craniofacial Surgery. Eppley BL, Sadove AM, Havlik RJ. Plast Reconstr surg lOO:l, 1997 The authors showed the use and effectiveness of resorbable plate fixation in pediatric craniofacial surgery. They used 912 resorbable fixation plates in 100 patients ages 4 to 15 months. These patients underwent surgery to correct either frontal, sagittal, or occipital bone deformities. The lactosorb plates, which are composed of polyglycolic and polylactic acids, were supplied by Walter Lorenz. The authors took radiographs immediately postoperatively, 6 months, and 1 year. They reported no complications from implantation. Only four patients had to have screws removed due to palpability or secondary reconstructive surgery. The author concluded the resorbable plates to be effective and safe for use in pediatric craniofacial surget-y.-R. HOLLOWAY
Virucidal Activity of an Oral Fluid Human Immunodeficiency Virus-l Antibody Preservative. Bestwick RR, Fitchen JH. Am J Med 102:26,1997 (suppl4A)
Reprint requests to Dr Eppley: Division of Plastic Surgery, James Whitcomb Riley Hospital for Children, 702 Barnhill Dr, Room 3540, Indianapolis, IN 46202-5200.
Oral fluid samples have been shown to provide accurate results when used to test for antibody to the human immunodeficiency virus-l (HIV-l). The effective use .of this medium is contingent on the stabilization of immunoglobins in the sample through the use of preservatives. The preservative contained in the oral surgery testing system (Ora Sure HIV-l oral specimen collecting device, Epitope, Beaverton, OR) preserved oral fluid samples from infected individuals, yet, the samples were non-infectious. This preservative at minimum produced a 5-log reduction in infectious HIV-1 titre when incubated with an equal volume of concentrated HIV for either 15 or 60 minutes.-R.H. HAUG
Varicella-Zoster Virus Infection. Postgrad Med 102:187,1997
Reprint requests to Dr Bestwick: Beaverton, OR 97008-7108.
Epitope,
8505 SW Creekside
Place,
Factors Affecting Smoking Cessation in Patients with Head and Neck Cancer. Vander Ark W, DiNardo LJ. Laryngoscope 107:888, 1997 This study examines the smoking habits of head and neck cancer patients treated at a tertiary care cancer center. Eighty-seven patients over a 2-year period were evaluated by interview for demographic factors, level of exposure, tumor stage and location, treatment modalities, concomitant alcohol use, and cessation methods. Overall 69% of the patients quit smoking by the end of the study period. The majority of the patients who quit did so shortly after cancer diagnosis.
Brody MB, Moyer D.
Varicella-zoster virus accounts for approximately 3.5 million cases per year in its primary form (chickenpox) and an additional 300,000 cases of herpes zoster in its reactivated form. With the US licensing of a vaccine in 1995, investigators are anticipating a decline in the number of pediatric chickenpox cases in the future, accompanied by a subsequent reduction of disease in susceptible adults. In the short-term, primary care doctors will encounter wild-type and vaccine-induced chickenpox in suceptible immunocompetent patients or immunocompromised adults. Most chickenpox infections occur in patients under 15 years of age, but adults have a 15-fold increase in mortality. The. virus is transmitted through exposure to infectious airborne droplets with nearly face-to-face contact usually required, although it can be transmitted through contaminated ventilation systems. The period of infectivity extends from 2 days before the appearance of a rash through resolution of the skin lesions. The incubation period is approximately 10 to 21 days. After the primary infection, the virus remains latent in the dorsal spinal ganglia. The mechanisms leading to its reactivation as herpes zoster remain poorly understood. The clinical presentation of zoster is a unilateral vesicular eruption, usually involving the thoracolumbar dermatomes, accompanied by acute neuritis. Human immunodeficiency virus infection is a well-recognized predisposing factor.