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Background: Because postlicensure surveillance determined that a previous rotavirus vaccine, RotaShield, caused intussusception in 1 of every 10,000 recipients, we assessed the association of the new monovalent rotavirus vaccine (RV1) with intussusception after routine immunization of infants in Mexico and Brazil., Methods: We used case-series and case-control methods to assess the association between RV1 and intussusception. Infants with intussusception were identified through active surveillance at 69 hospitals (16 in Mexico and 53 in Brazil), and age-matched infants from the same neighborhood were enrolled as controls. Vaccination dates were verified by a review of vaccination cards or clinic records., Results: We enrolled 615 case patients (285 in Mexico and 330 in Brazil) and 2050 controls. An increased risk of intussusception 1 to 7 days after the first dose of RV1 was identified among infants in Mexico with the use of both the case-series method (incidence ratio, 5.3; 95% confidence interval [CI], 3.0 to 9.3) and the case-control method (odds ratio, 5.8; 95% CI, 2.6 to 13.0). No significant risk was found after the first dose among infants in Brazil, but an increased risk, albeit smaller than that seen after the first dose in Mexico--an increase by a factor of 1.9 to 2.6 - was seen 1 to 7 days after the second dose. A combined annual excess of 96 cases of intussusception in Mexico (approximately 1 per 51,000 infants) and in Brazil (approximately 1 per 68,000 infants) and of 5 deaths due to intussusception was attributable to RV1. However, RV1 prevented approximately 80,000 hospitalizations and 1300 deaths from diarrhea each year in these two countries., Conclusions: RV1 was associated with a short-term risk of intussusception in approximately 1 of every 51,000 to 68,000 vaccinated infants. The absolute number of deaths and hospitalizations averted because of vaccination far exceeded the number of intussusception cases that may have been associated with vaccination. (Funded in part by the GAVI Alliance and the U.S. Department of Health and Human Services.).

The clinical failure of coronal restorations can compromise the healthy periapical status of endodontically treated teeth. The purpose of the present ex vivo study was to assess the effectiveness of the cervical barrier in preventing bacterial microleakage in the eventual loss of the coronal restoration. Following removal of the smear layer and obturation to the cementoenamel junction using gutta-percha, 70 single-rooted mandibular premolars were randomly divided into five different groups: Group 1 received no additional treatment; Groups 2 and 3 had 2 mm and 3 mm of the obturation removed, respectively, followed by placement of a cervical barrier that was the same thickness as the obturation. In Group 4 (positive control), the root canals were filled only with gutta-percha, while in Group 5 (negative control), the root canals were completely impermeabilized following obturation. The filled root canals were incorporated into a split-chamber model system using Enterococcus faecalis as a microbial marker. The apices were suspended in the lower chambers. Leakage was determined daily for 60 days and evaluated for turbidity. According to Fisher's exact test, the cervical barrier in Groups 2 and 3 prevented the microleakage of E. faecalis into the root canals when compared with Groups 1 and 4. This result was similar to that for the completely sealed samples in Group 5 (p = 0.001).

The purpose of this in vitro study was to evaluate the antimicrobial effect of photodynamic therapy on Streptococcus mutans (A TCC 25175) suspensions, using a red laser for one minute in combination with toluidine blue O (TBO) or methylene blue (MB). Both photosensitizers were used in three concentrations (25, 10 and 5 mg/L). The activity ofphotosensitizers and laser irradiation were tested separately on the bacteria, as well as the irradiation of this light source in the presence of the TBO or MB. These groups were compared to a control group, in which the microorganism did not receive any treatment. The activity of both TBO and MB or laser irradiation, alone, were not able to reduce the number of S. mutans. In the groups of lethal photosensitization, a bacterial reduction of 70% for TBO and 73% for MB was observed when these photosensitizers were used at 25 mg/L and a reduction of 48% was observed for MB at 5mg/L. In other concentrations there were no significant differences in comparison to the control group. Both the TBO and the MB at 25 mg/L associated with a red laser had an excellent potential for use in PDT in lethal sensitization of S. mutans.

Objectives: The present study aims to investigate (1) what is the influence of illness labels (flu, asthma and angina pectoris) upon the level of agreement with the prescription of generic medicines, and (2) the influence of socio-demographic factors on lay beliefs about generic medicines, in general, and for different illness labels., Method: This was a cross-sectional design in which the participants were Portuguese, men and women, aged over 18 years old, and recruited from the general population (non-patients). The participants completed an anonymous self-administered questionnaire which included measures of lay beliefs about generic medicines in general (GMS), level of agreement with the prescription of a generic medicines for different illnesses, and socio-demographic factors., Main Outcome Measure: Level of agreement with the use of generic medicines for flu, asthma and angina pectoris. Results Participants seemed to have well-defined beliefs about generics concerning their efficacy and similarity with brand medicines. Beliefs about the efficacy of generic medicines were significantly different according to the three age groups (18-25 years, mean = 3.84 (0.56); 26-37 years, mean = 3.80 (0.61); >38 years, mean = 3.72 (0.66); F = 4.4; P = 0.01), and level of education attained (9 years, mean = 3.60 (0.69); 12 years, mean = 3.78 (0.57); graduate, mean = 3.93 (0.54); F = 32.2; P = 0.000). Although participants have a moderate level of agreement with the prescription of generic medicines for the three different illnesses, their agreement significantly decreased when the illness was perceived as more serious. The lay beliefs about generics seemed to moderate the level of agreement with the prescription of a generic medicine., Conclusions: Lay beliefs about generic medicines may influence the level of agreement with the prescription of a generic medicine in a general population sample. These results raise important questions concerning the need to consider illness perceptions of lay people and their relationship with perceptions of treatment for different conditions.

We present the case of a scuba diver who experienced acute ear pain during ascent from a dive. CT imaging was performed because of severe unrelenting headache. Blood and gas was identified within the epidural space of the middle fossa and over the petrous bone, as well as hemorrhage within the adjacent temporal lobe. To the best of our knowledge, this is the first case of CT-documented barotrauma affecting the brain as a result of middle-ear gas rupturing through the tegmen tympani.

Ataxia-telangiectasia (A-T) is a human autosomal recessive disease caused by mutations in the gene encoding ataxia-telangiectasia mutated (ATM). A-T is characterized by progressive cerebellar degeneration, variable immunodeficiency, and a high incidence of leukemia and lymphoma. Recurrent sino-pulmonary infections secondary to immunodeficiency and hematopoietic malignancies are major causes of morbidity and mortality in A-T patients. In mice, an introduced mutation in Atm leads to a phenotype that recapitulates many of the symptoms of A-T, including immune system abnormalities and susceptibility to malignancy. Here we show that the replacement of the bone marrow compartment in Atm knockout mice (Atm(-/-)) using a clinically relevant, nonmyeloablative host-conditioning regimen can be used to overcome the immune deficiencies and prevent the malignancies observed in these mice. Therefore, bone marrow transplantation may prove to be of therapeutic benefit in A-T patients.