Powered toothbrushes: indications for patient use and recommendations for dental professionals

Data on the size and number of placental glutathione S-transferase-positive (PGST+) foci were collected from a two-stage hepatocarcinogenesis model in female Sprague-Dawley rats. the study consisted of multiple 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-exposed dose groups including both diethylnitrosomine (DEN)-initiated and uninitiated animals. Groups were observed after 15 or 31 weeks of TCDD exposure. The parameters in the first half of a two-stage mathematical model of carcinogenesis were estimated from these data. If the model is valid, the results suggest that TCDD stimulates the production of PGST+ foci and promotes the growth of PGST+ foci. This finding suggests a complicated mechanism for TCDD-induced production of Hepatic foci that we refer to as activation, labeling TCDD as an activator. The analysis also indicates that there is an interaction between DEN and TCDD which results in dose-related formation of initiated cells throughout the study period. Best-fitting curves (using maximum likelihood methods) for TCDD-induced activation and promotion reached saturation levels at low doses of TCDD. In summary, the model fit the data well, but leads to an interpretation of the data which either questions the validity of the model or implies that our understanding of the effects of TCDD and DEN is incomplete.     

Social support: some pragmatic implications for health care professionals

BACKGROUND: Depression affects a significant proportion of the expanding elderly population in the UK. Reports of a poorer prognosis for older than for younger adult patients have been challenged by recent papers. METHOD: The casenotes of 56 adults (mean age 47.8 years) and 54 elderly (mean age 72.9 years) patients with primary depression were assessed one year after receiving hospital treatment. Outcome measures were compared with earlier reported findings and factors possibly influencing outcome were explored. RESULTS: The pattern of outcome in both age groups was broadly similar, thus: adults v. elderly: recovered 44.6% v. 44.4%; relapsed and recovered 23.2% v. 24%; residual symptoms 19.6% v. 13% and chronic depression 7.1% v. 5.5%. In the adults there were two natural deaths and one suicide. In the elderly there were two cases of dementia and five natural deaths, which was double the expected death rate. Predictors of poor outcome were melancholic depression in adults and longer duration of illness at intake and an increasing number of previous episodes of affective disorder in the elderly. CONCLUSION: The outcome of treated depressive illnesses appears similar in elderly and adult patients. Associated physical ill health did not adversely affect outcome in the elderly group.     

Office-based training in tobacco cessation for dental professionals

During a 90-minute, on-site training session, a dentist/tobacco-cessation educator trained 293 dental professionals from 57 offices. The authors report statistically significant increases between the pre-training and follow-up surveys for 12 tobacco-cessation activities and the amount of time spent on such activities (P < .001). Using participants' estimates-taken at three months after the training-the authors calculated that an average of two patients per office had stopped using tobacco, two had stopped and relapsed, and eight patients were considering stopping tobacco usage.     

Learning from multiple perspectives: global implications for speech-language and hearing professionals

By immunofluorescence microscopic observation, monoclonal and polyclonal antibodies against a synthetic actin C-terminal peptide were found to stain too colloguial, ambiguous punctuate structures distributed throughout the cytoplasm of 3Y1 cells, independently of actin stress fibers. Antibody against rab5, a small GTP binding protein of the sorting endosome, and anti-actin antibody co-stained these punctuate structures. On the other hand, transferrin receptor, a well characterized maker of the sorting and recycling endosomes, colocalized with actin on the vesicular structures at the cell peripheral region but not at the perinuclear area where the recycling endosome localized. These observations suggest that actin molecules localize on the sorting endosomes. Tropomyosin, F-actin binding protein, also colocalized with actin on the sorting endosomes. From these results, we proposed that actin-filaments with tropomyosin constitute the membrane skeleton on the sorting endosome surface. This article is the first report to show that actin-filaments localize on the intact endosomes.     

Searching for information on the World Wide Web--a guide for dental health professionals: Part 1

Mastering the retrieval of valid information from the Internet can be challenging, especially for busy professionals with little time for learning the necessary techniques. This article provides a conceptual framework for browsing and searching for clinically relevant, valid information on the Web. Part 1 provides an overview of the Web that includes information on access methods, general characteristics, and the main user interface (a browser). Concerns about information validity are also discussed. Part 2 will describe several common methods for searching the Web, including how to visit a web site directly, visit a directory site, and conduct a search via a search-engine site.     

Fatal Staphylococcus aureus infective endocarditis: the dental implications

Rates of infant mortality and prematurity or low birthweight serve as indirect measures of the health of a nation. This paper presents current population data documenting the still serious problem of perinatal outcome in the USA as well as in other economically developed countries. International comparisons suggest that nations which have the greatest inequality of income and social opportunity also have the most adverse perinatal, child and adult health outcomes. Furthermore, the data assert that these effects are independent of average national wealth or gross national economic productivity. Health status differs by social class and race, even among the most affluent sectors of the population. All social classes, even the wealthiest, suffer the health consequences of social inequalities. An explanatory socio-psychological theory of causality is proposed.     

"The myth of mental illness:" continuing controversies and their implications for mental health professionals

Since the publication of "The Myth of Mental Illness" in 1960, there has been an ongoing debate about Thomas Szasz's ideas concerning mental illness. In this paper, Szasz's views are summarized, as are the views of Szasz's critics. Specifically, the following areas are addressed: Szasz's definition of disease, his notions regarding the unconscious and rationality, his beliefs regarding culpability, his proposed differences between psychiatry and other branches of medicine, the uses of the term "mental illness," and the possibility of implicating physical lesions in some mental illnesses. With this discussion as a backdrop, the importance of these issues to mental health practitioners is addressed.     

Earlier dental maturation: fact or fiction?

The objective of this investigation was to determine if there is a difference in dental age of maturation between adolescents treated in the 1970s and those treated in the 1990s. Records of 150 Caucasian patients, 8.5 to 14.5 years old and treated in a private orthodontic office between 1972 and 1974, were randomly selected; records of another 150 patients of the same race and age range but treated between 1992 and 1994 were also collected. The percentage of calcification of the mandibular canines was rated according to methods used by Demirjian, who divided tooth development into eight segments, A to H. Using stage G to compare the 1970 and 1990 patient samples, we demonstrated dental age reductions of 1.21 years for males and 1.52 years for females, and a combined reduction of 1.40 years.     

Dental fear with and without blood-injection fear: implications for dental health and clinical practice

BACKGROUND: It has been suggested that the sympathetic nervous system might play an important role in the development of coronary artery spasm. However, no cardiac imaging modality has been able to demonstrate abnormal sympathetic innervation in patients with coronary artery spasm. The purpose of this study was to assess the presence and location of abnormal sympathetic innervation using iodine 123-metaiodobenzylguanidine (123I-MIBG) single photon emission computed tomography (SPECT) and to evaluate the clinical efficacy of 123I-MIBG SPECT as a noninvasive screening test in patients with coronary artery spasm. METHODS AND RESULTS: Coronary arteriography and a provocative test with intravenous administration of ergonovine maleate were performed in 26 patients (20 men, 6 women, mean age 48.2+/-12.0 years, range 20 to 67 years) who were suspected of having a coronary artery spasm. The subjects were divided into 2 groups: group 1 (n = 18) comprised subjects with a positive provocative test result, and group 2 (n = 8) comprised subjects with negative provocative test results. Ten healthy subjects served as controls. No abnormal MIBG uptake was observed in the control subjects. Abnormal sympathetic nervous innervation using 123I-MIBG SPECT was observed either as a reduced uptake or a defective pattern in the perfused areas in 13 of the 18 regions supplied by vessels of ergonovine-induced vasospasm. Normal sympathetic innervation, as evidenced by normal 123I-MIBG uptake, was noted in all of the 60 segments of normal vessel territories. Reduced uptake of 123I-MIBG was not detected in the perfused areas of 5 vasospasm-induced vessels (perfusion territory of left anterior descending coronary artery [LAD] and the right coronary artery [RCA] in 2 and 3 patients, respectively). The sensitivity and specificity of 123I-MIBG for detection of coronary artery spasm were 72.2% (95% confidence interval [CI] 55% to 89%) and 100%, respectively. The positive predictive and negative predictive values were 100% and 92.3% (95% CI 91% to 93%), respectively. CONCLUSION: 123I-MIBG SPECT is a feasible method to evaluate noninvasively and localize the territories of coronary arteries with spasm. Invasive diagnostic coronary arteriography with ergonovine provocation test may be unnecessary for diagnosis of coronary artery spasm in patients with typical resting pain, negative exercise test or normal thallium perfusion scan results, but showing abnormalities in 123I-MIBG SPECT.     

Breastfeeding: a course for health professionals

Breastfeeding advocates say that breastfeeding is health promotion in its purest form. Its considerable health benefits to the infant and the mother are well documented. Recent research has identified breastfeeding as a key factor in the prevention of sudden infant death syndrome and increased cognitive functioning. As a method of feeding, breastfeeding offers immediate economic advantages to the parents and long-term economic savings to society. One author reports that the exclusive breastfeeding of infants for four months could save the Province of Ontario at least $862,000 a year just by reducing the need for the treatment of otitis media. Another researcher calculated the cost of treating 150 bottle-fed babies hospitalized for gastroenteritis at $450,000 Canadian, while reminding us that "hospitalization for gastroenteritis is almost unknown for exclusively breast-fed infants." With all these known benefits, why is breastfeeding not more prevalent among Canadian mothers?     

Mexico: a challenge for nutrition professionals

Human ovarian surface epithelial (HOSE) cells transfected with the E6 and E7 oncogenes of the human papilloma virus (PV) do not express measurable telomerase activity. Relative to untransfected control cells, HOSE-PV cells have an extended in vitro lifespan characterized by a very high frequency of telomeric associations (TAs) of chromosomes. In order to study the role of telomere shortening in the formation of TAs, we studied the telomere length in 120 dicentric chromosomes in HOSE-PV cells by using quantitative fluorescence in situ hybridization. Forty percent of the dicentric chromosomes had no fluorescence signal at the junction site, and in the remainder the fluorescence at the junction was less than at corresponding unjoined ends. These observations support a critical role of telomere shortening in the development of TAs and the subsequent genetic instability observed in a majority of tumor cells.     

Clinical informatics and the dental curriculum. A review of the impact of informatics in dental care, its implications for dental education

Important advances have been made in the field of supraventricular and ventricular tachycardias. Catheter ablation procedures are potentially curative in many patients suffering of supraventricular tachycardias. The technique uses radiofrequency current. This form of energy is already very familiar to surgeons. Expected benefits as well as potential complications have to be discussed with the patient prior to the ablation procedure. The automatic internal defibrillator has been commercially available since the end of the eighties. It delivers electrical therapy in case of ventricular malignant arrhythmias, for instance ventricular fibrillation. The sudden death rate is markedly reduced in implanted patients. The long term prognosis however remains critically dependent of the left ventricular function and possible progressive heart failure. Reimbursement depends on pre-implant agreement by the Social Security. At the present time, no reimbursement is provided for prophylactic indications. These two techniques facilitates the treatment of patients previously described as "resistant cases".     

Postdivorce family therapy: Suggestions for professionals.

Reviews the literature describing the stress experienced by family members (the ex-spouse, mother–child, and father–child relationships) in the postdivorce transition. Findings indicate that the postdivorce transition period may be abbreviated and/or more successfully negotiated by professional interventions designed to (1) increase ex-spouse cooperation and support in both parents' continuing participation in raising their children, (2) improve the quality and effectiveness of parent–child communication, and (3) train both mothers and fathers in behavioral management techniques useful in their single-parent roles. Suggestions are made for postdivorce family therapy oriented toward helping both ex-spouses continue meaningful involvement with their children. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Internet for healthcare professionals

The Internet is a useful clinical tool for information and communication. Resources that are available on the Internet include the Medline index, full-text articles, patient handouts, discussion lists, continuing education, medical and pharmaceutical texts, and case studies. This article summarizes the different types of resources available and teaches the basic skills for using the Internet to find medical information. Otolaryngology sites are listed and described.     

Training professionals for rehabilitation teams

Transformed treatment philosophies, egalitarian roles, crossover competencies, and engagement of consumers and families are essentials in training.     

Mental health professionals versus non-mental-health professionals: Childhood trauma and adult functioning.

Research on childhood family environments of mental health professionals suggests that therapists are often raised in dysfunctional families and experience significant psychological distress in adult life. This study examined the prevalence of childhood trauma, family dysfunction, and current psychological distress among female mental health professionals (N?=?340) and compared it with the prevalence among women working in other professions (N?=?2,623). Psychotherapists reported higher rates of physical abuse, sexual molestation, parental alcoholism, psychiatric hospitalization of a parent, death of a family member, and greater family dysfunction in their families of origin than did other professionals. As adults, psychotherapists experienced less anxiety, depression, dissociation, sleep disturbance, and impairment in interpersonal relationships than did women in professions other than mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)