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Low public awareness of oral cancer and delays in symptomatic patients presenting to health services have been identified as contributing factors to poor survival rates. In order to promote diagnosis and treatment of oral cancer at an earlier stage, public awareness campaigns have been recommended, encouraging those with signs and symptoms to attend primary care services at an earlier stage. This article provides an overview of the evidence of effectiveness of interventions aimed at raising cancer awareness and explores the use of mass media for health behaviour change. The use of awareness campaigns to promote earlier diagnosis of oral cancer is also explored from both a patient and health professional perspective. The findings of the overview suggest that while awareness raising campaigns can increase knowledge of the disease and attendance at health services in the short-term, those at lesser risk often respond, and evidence of longer-term impact is very limited. The translation of knowledge into behaviour change is likely to require a more comprehensive, longer-term, multi-faceted approach, acknowledging the social determinants of health and health behaviour theory. More work is required to understand what needs to be included in campaigns to make them effective. Availability and access to appropriately trained and informed primary care personnel is important, particularly for high-risk groups. This is relevant for: supporting those with signs and symptoms to attend services; promoting opportunistic screening; enabling referral of patients to secondary care in a timely manner; and for provision of advice on the major risk factors associated with oral cancer.

Neurodegeneration associated with brain iron accumulation (NBIA) comprises a heterogeneous group of disorders in which disruption of cellular mechanisms leads to accumulation of iron in the basal ganglia. This group includes patients with recently discovered mutations in the PLA2G6gene encoding a calcium-independent phospholipase A2 enzyme that catalyzes the hydrolysis of glycerophospholipids. Previously, children with PLA2G6mutations have been diagnosed with several different disorders and we wished to better define the phenotype of PLA2G6- associated neurodegeneration.

An appliance model was used in this study to determine the predominant cultivable microflora involved in early dental plaque formation on human enamel surfaces. Twelve enamel slabs were mounted on either side of an intraoral appliance, and the device was worn for periods of 48 h under (1) 'normal' conditions, and (2) with extraoral sucrose applications, nine times daily. Plaque samples were removed from the surface of different slabs at various time-periods, and the bacterial composition determined, with the 4036 isolates being expressed both as percentage and absolute counts. Streptococcus species dominated the plaque microflora at all sampling times, with S.oralis and S.sanguis predominating. A significant increase in total bacterial counts per mm2 enamel occurred from 2 to 48 h, and although sucrose had little effect on the percentage counts of organisms, most genera and species were present in significantly higher numbers per mm2 enamel in sites exposed to sucrose.This study demonstrates the importance of expressing results as absolute as well as proportional counts. Furthermore the appliance appears to offer some advantages over previously used models since (1) the use of multiple slabs allows longitudinal studies to be performed and (2) two experimental conditions can be investigated simultaneously, one on each side of the mouth.

Structure−activity relationships of a lead hydroxamic acid inhibitor of recombinant human stromelysin were systematically defined by taking advantage of a concise synthesis that allowed diverse functionality to be explored at each position in a template. An ex vivo rat model and an in vivo rabbit model of stromelysin-induced cartilage degradation were used to further optimize these analogs for oral activity and duration of action. The culmination of these modifications resulted in CGS 27023A, a potent, orally active stromelysin inhibitor that blocks the erosion of cartilage matrix.

The Poswillo Report, published in 1990, made recommendations regarding general anaesthesia (GA), sedation and resuscitation in dentistry. The aims of the present study were to examine the level of provision of GA and sedation by general dental practitioners (GDPs) a few years after the publication of the report, and to estimate the degree of compliance of GDPs with a number of its principal recommendations. In May 1994, a questionnaire was sent to 268 GDPs in two Scottish Health Boards, and a response rate of 80% was achieved. Thirteen per cent of respondents had treated GA cases during 1993-94 while 18% indicated that they had stopped providing a GA service since the immediate pre-Poswillo years. However, 91% had referred some patients elsewhere for treatment under GA. There was very little evidence of a replacement of GA by sedative techniques. The percentages of respondents using inhalation or intravenous sedation during the previous year were 9% and 27%, respectively. Almost all of the respondents reported that they had been trained in cardiopulmonary resuscitation and 60% stated that resuscitation exercises were practised at least once a year. While over 80% of the practitioners indicated that their dental surgeries stocked the emergency drugs recommended in the Poswillo Report, 12% expressed concern regarding the length and content of the drug list

During the past decade the development of primary care medical services has been based on the medico-social model of health care delivery and this has resulted in the creation of the primary care team. These changes have so far not involved the general dental services. It was therefore decided to test the potential for coordination and integration of general dental practice in the primary care services. This started by examining a general medical and a general dental practice, occupying the same site, but functioning separately. Around 24% of patients were common to both practices. The initial data collected from a pilot study have been analysed and assessed in relation to patient attendance, record systems, staff cooperation, screening programmes, health promotion, patient referrals and staff education. The potential of this model for improving patient care and targeting the pre-school, middle-aged and elderly is described. It is concluded that coordinated primary care dental and medical services is an important area for further health services and educational research

Objective: To develop and evaluate a model of integrated primary dental and medical care.Design: 3-year prospective study.Setting: A general dental practice and a general medical practice occupying the same building in Glasgow.Intervention: Regular staff meetings, joint use of patient records systems and information derived from patient questionnaires. Dentistry was included in established screening programmes such as child health surveillance and care of elderly. Staff were encouraged to participate in joint work practices and joint consultations were carried out.Main outcome measures: Patient registration, avoidance of discrepancies in information, reduction of secondary referrals, joint work practices.Results: The number of registered joint patients attending both medical and dental practices increased by 90%. The joint use of patient record systems avoided discrepancies in patient information which would have affected the quality of patient care. Including dentistry in child health surveillance and care of elderly screening programmes resulted in an increase in 0–5 year olds registering with dentists from 36% to 68% (P < 0.001) and with > 75 year olds from 47% to 71% (P < 0.001). Joint consultations reduced the need for secondary referrals.Conclusions: This model of health care demonstrated the potential for coordination and integration of functions between the dental team and the primary care team. Integrated primary dental and medical care requires attitudinal change in health care professionals and requires greater emphasis in education and training of health care professionals in the future

Pairs of extracted premolar teeth were prepared with MOD cavities reducing the lingual cusp at its base to one of five widths: 1.25-2.25 mm. One of each pair was then restored with one of five adhesive restorative techniques and the weakened cusp of both teeth fractured by a force applied to the cusp at an angle of 30 degrees to the long axis of the tooth. At all cusp widths a layered restorative technique in which the cavities were filled to the enamel-dentine junction with glass-ionomer cement and the enamel replaced by composite, reinforced the weakened cusp more than the other restorative materials tested. This combination of materials to reinforce weakened cusps is worth considering as a cost effective alternative to removing the cusp entirely and making a crown or protecting the cusp with a cuspal coverage gold inlay

Summary Six virus isolates recovered from clinical material and producing in inoculated infant mice histopathological changes resembling those produced by coxsackie B viruses were investigated. On the basis of cross neutralization tests all six isolates were found to be antigenically interrelated but distinct from all existing enteroviruses, including Public Health Laboratory (PHL) prototype coxsackie B 1 strain. All six isolates, however, were neutralized by the WHO reference antiserum to coxsackie B 1, Conn-5 strain, although the antisera to these isolates failed to neutralize Conn-5 strain. Conventional and kinetic neutralization tests revealed a considerable degree of antigenic heterogeneity among these isolates as well as antigenic difference between the two prototype strains, PHL and Conn-5. In the light of current definition, these six isolates, because of their narrower antigenic spectrum, as compared to prototype Conn-5 strain, cannot be considered as prime strains of coxsackie B 1 virus. The present study emphasizes the need for reexamination of present definition of “prime” and “prototype” strains. The findings also indicate the importance of using the enterovirus strains with the broadest antigenic spectrum in identification work.

Without Abstract:

Summary From a collection of viruses isolated over a period of years from clinical material and not identifiable by routine procedures, three were selected for this investigation. All three isolates were recovered in 1958 from cases of aseptic meningitis. Cross neutralization tests revealed that they were antigenically indistinguishable. One of these, 275/58, isolated from the cerebrospinal fluid of a 3 year old child, was chosen for detailed study. The general characteristics of this virus were found to be compatible with those of enteroviruses as specified by the Committee on Enteroviruses. Human origin of this virus was established by neutralization tests with patient's serum, pooled human gamma globulin and human sera submitted during enterovirus seasons from cases suspected to have virus infections. The 275/58 virus was not neutralized either by intersecting pools or individual antisera prepared against all known enteroviruses, nor by WHO enterovirus reference antisera. Conversely, antiserum to 275/58 virus failed to neutralize poliovirus types 1–3, echovirus types 1-33, Coxsackie virus B 1B 6 and Coxsackie virus A 9. The virus was found to be non-pathogenic for infant mice.

Without Abstract:

ALTHOUGH cadmium chloride has been in use at least since 1868 as a precipitant for lecithin, no completely satisfactory method for the removal of cadmium chloride from the complex formed in this manner has been devised. Strecker1used hydrogen sulphide to precipitate the cadmium. Bergell2, in 1900, made use of ammonium carbonate, and Levene and Simms3, in 1921, introduced the procedure in recent common use, namely, treatment of a chloroform solution of lecithin – cadmium chloride with dry ammonia – methanol solution, both procedures resulting in the precipitation of a cadmium ammonium chloride complex. All these methods, in addition to resulting in poor yields, expose the easily oxidizable and labile lecithin to undesirably harsh treatment, with the result that, however pure the lecithin – cadmium chloride complex may have been, the lecithin finally isolated is once more somewhat impure.

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