Changes in the dental arches and dentition between 25 and 45 years of age

The purpose of this longitudinal investigation was to study changes in the dental arches and dentition that occur in midadulthood in an untreated, normal sample. The subjects had Class I molar and canine relationships with less than 4.0 mm of overjet and less than 50% overbite. None had undergone previous orthodontic treatment. Evaluations and measurements were made from dental casts and periapical radiographic surveys of 15 females and 15 males from approximately 25 years to 46 years. The findings indicate that over the span of the study, significant changes occur in the maxillary and mandibular dental arches and dentition in both males and females, including a clinically significant increase in tooth size-arch length (circumference) discrepancy. These changes should be considered part of the normal maturational process and should be taken into consideration when planning treatment and retention options for adolescent and adult patients.     

The effect of regular exercise on women receiving danazol for treatment of endometriosis

OBJECTIVE: To determine the effects of regular exercise on women receiving danazol for the treatment of endometriosis. METHODS: Thirty-nine patients were randomized to a danazol-only or a danazol/exercise regimen in a prospective clinical trial carried out at tertiary care institutions. Patients in the danazol/exercise group were instructed to exercise four times per week, for 40 min per session, at an intensity of 20 metabolic units. Side effect profiles, pelvic symptoms, aerobic fitness, strength and hormone levels were compared for all subjects. The number of side effects of danazol was analyzed by the method of generalized estimating equations. RESULTS: The number of side effects reported during a 4-week period was 1.09-2.17 times greater for the danazol-only than for the danazol/exercise group. All patients had improvement of symptoms during treatment. The danazol/exercise group had significantly lower testosterone levels during treatment. The time to recurrence of endometriosis was not different between groups. CONCLUSIONS: Exercise during danazol therapy reduces the number of androgenic side effects. Relief of pain and time to recurrence are unaffected.     

Effect of parasympathetic denervation of liver and pancreas on glucose kinetics in man

The study aim was to investigate the role of the parasympathetic nervous system in the control of glucose tolerance in man. Glucose kinetics were determined during an oral glucose tolerance test (OGTT) in six subjects with truncal vagotomies and six control subjects. Basal plasma glucose levels in the two groups were equal; however, 20 to 40 minutes after the OGTT, glucose was higher in vagotomized compared with control subjects (P < .02). There were no differences in insulin levels between the subjects. Glucagon decreased after the OGTT in the controls, whereas in the vagotomized subjects it increased transiently and did not decrease beyond basal levels. There was no difference in basal hepatic glucose production, but suppression was greater in controls in the first 10 minutes (P < .01). Gut-derived glucose appearance increased faster and to a higher level (56.0 +/- 8 v 29.7 +/- 2.9 mumol/kg/min, P < .02) in vagotomized subjects. There were no differences in the metabolic clearance rate of glucose between the two groups. It is concluded that parasympathetic innervation of the pancreas is essential for suppression of glucagon secretion during hyperglycemia. However, abnormal glucose tolerance in vagotomized subjects is primarily due to rapid gut glucose absorption, with the denervated parasympathetic system playing only a minor role.     

Paclitaxel with mitoxantrone, fluorouracil, and high-dose leucovorin in the treatment of metastatic breast cancer: a phase II trial

PURPOSE: Paclitaxel is a highly active single agent in the treatment of breast cancer. However, its optimal incorporation into combination regimens awaits definition. In this phase II study, we added paclitaxel, administered by 1-hour infusion, to a previously described combination regimen that included mitoxantrone, fluorouracil (5-FU), and high-dose leucovorin (NFL). PATIENTS AND METHODS: Forty-six patients with metastatic breast cancer received the following regimen as first- or second-line treatment: paclitaxel 135 mg/m2 by 1-hour intravenous (i.v.) infusion on day 1, mitoxantrone 10 mg/m2 by i.v. bolus on day 1, 5-FU 350 mg2/m by i.v. bolus on days 1, 2, and 3, and leucovorin 300 mg i.v. over 30 to 60 minutes immediately preceding 5-FU on days 1, 2, and 3. Courses were administered at 3-week intervals for a total of eight courses in responding patients. RESULTS: Twenty-three of 45 assessable patients (51%) had major responses. Previous chemotherapy, and in particular previous treatment with doxorubicin, did not affect response rate. The median response duration was 7.5 months. Myelosuppression was moderately severe, with 76% of courses resulting in grade 3 or 4 leukopenia. Hospitalization for treatment of fever during neutropenia was required in 13% of courses, and two patients died as a result of sepsis. Two patients developed severe congestive heart failure after a large cumulative anthracycline dose. CONCLUSION: This combination regimen was active as first- or second-line therapy for metastatic breast cancer, although its activity compared with other combination regimens or with paclitaxel alone is unclear. Myelosuppression was more severe than anticipated based on previous results with the NFL regimen or with paclitaxel administered at this dose and schedule as a single agent. The infrequent development of cardiotoxicity in these patients suggests that the paclitaxel/mitoxantrone combination may not share the problems previously reported with the paclitaxel/doxorubicin combination.