OBJECTIVES. The purpose of the study was to determine the clinical and economic impact of alternative contraceptive methods. METHODS. Direct medical costs (method use, side effects, and unintended pregnancies) associated with 15 contraceptive methods were modeled from the perspectives of a private payer and a publicly funded program. Cost data were drawn from a national claims database and MediCal. The main outcome measures included 1-year and 5-year costs and number of pregnancies avoided compared with use of no contraceptive method. RESULTS. All 15 contraceptives were more effective and less costly than no method. Over 5 years, the copper-T IUD, vasectomy, the contraceptive implant, and the injectable contraceptive were the most cost-effective, saving $14,122, $13,899, $13,813, and $13,373, respectively, and preventing approximately the same number of pregnancies (4.2) per person. Because of their high failure rates, barrier methods, spermicides, withdrawal, and periodic abstinence were costly but still saved from $8933 to $12,239 over 5 years. Oral contraceptives fell between these groups, costing $1784 over 5 years, saving $12,879, and preventing 4.1 pregnancies. CONCLUSIONS. Contraceptives save health care resources by preventing unintended pregnancies. Up-front acquisition costs are inaccurate predictors of the total economic costs of competing contraceptive methods.

The present study has demonstrated that urea is present in gingival crevicular fluid and its concentration is usually several times higher than that of blood serum or saliva. This supports the hypothesis that the high pH seen in gingival crevices arises from urea. The concentration of crevicular urea was inversely related to the severity of gingival inflammation and increased markedly following periodontal surgery. It was concluded that clinically healthy or slightly inflamed gingivae have a mechanism for concentrating urea in crevicular fluid and that this mechanism is destroyed during inflammation but reconstituted following periodontal surgery.

No abstract

No abstract

In a study on 120 subjects (60 males and 60 females) between the ages of 12 and 69 years, it was found that the relationship between gingival inflammation and crevicular fluid flow was not affected by age or sex. Because of their relationship to gingival disease, the effect of age aad sex on crevicular pH, urea content, and concentration and crevice depth were also examined. Whereas, aging had no significant effect, sex may have had a slight effect since males exhibited slightly deeper pockets and a higher crevicular pH at most levels of inflammation. However, tMs may be due to poorer home care in males. ITie results have confirmed the inflammation-crevicular fluid relationship in a large number of adults of both sexes and add support for the use of crevicular fluid flow measurements as an objective technique for monitoring gingival inflammation.