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Aim: To investigate the prevalence of gingivitis and periodontitis, and the oral hygiene status of adults with cystic fibrosis (CF) in the Republic of Ireland. Materials and Methods: A case–control study in the form of a clinical examination of 92 adults with a diagnosis of CF was carried out in the adult CF unit in Cork University Hospital. A 40‐item questionnaire was used to capture socio‐demographic variables and medical and dental information. Two calibrated examiners carried out a periodontal assessment on participants, using the WHO‐recommended CPI‐modified index, and oral hygiene status was measured using the Greene–Vermillion index. The results were compared with a population‐based control group of similar socio‐demographic profile. Results: Oral hygiene levels (plaque and calculus) were significantly worse in people with CF, with a median plaque index of 0.83 (interquartile range [IQR] 0.333–1.542) in the CF group compared with 0.5 (IQR 0.167–0.667) in the non‐CF group. Calculus index in the CF group was 0.33 (IQR 0.17–0.83) compared with 0.33 (IQR 0.125–0.33) in the non‐CF group. However, periodontal disease levels were significantly lower in the CF group. Gingivitis (bleeding on probing ≥ 10% sites) was seen in 67.4% of the CF group, compared with 83.7% of the non‐CF group, OR 0.365 (95% confidence interval [CI] 0.181–0.736), relative risk (RR) 0.779 (95% CI 0.655–0.928). Mild periodontitis (periodontal probing depth [PPD] < 5 mm) was seen in 15.2% of the CF group, compared with 31.5% of the non‐CF group, OR 0.390 (CI 0.190–0.800), RR 0.483 (95% CI 0.273–0.852). Severe periodontitis (PPD ≥ 6 mm) was seen in 0% of the CF group, compared with 9.8% of the non‐CF group. There was a tendency, albeit non‐significant, towards reduced periodontitis in PWCF who regularly took antibiotics, particularly azithromycin. Conclusions: In this study, adults with CF had poor oral hygiene practices, with high levels of plaque and calculus. Despite this finding, adults with CF had lower levels of clinical gingivitis and periodontitis than seen in a non‐CF control group. Further study is required to examine the causes of this phenomenon. [ABSTRACT FROM AUTHOR]

Background: Solid organ transplant provides a lifeline for people with end stage organ failure. Each year the number of individuals in receipt of a solid organ transplant is increasing. Prevention of post‐transplant sepsis and infection are critical for transplant success. The oral cavity contains more than 700 different species of bacteria and is a potential reservoir for disease causing pathogens. Prior to undergoing solid organ transplant, individuals must receive a certification of dental health from a dental practitioner. There are currently no guidelines or protocols for dental practitioners to follow when certifying a patient as dentally fit. This allows for a wide variation of the term 'dentally fit'. This survey was conducted as part of a larger study assessing the oral health of adults with cystic fibrosis ongoing in Cork University Dental School and Hospital. The aim of the study was to ascertain current practices and attitudes of dental practitioners regarding the provision of dental treatment pre and post solid organ transplantation. Methods: An anonymous cross sectional survey of dental practitioners in Ireland was conducted. Results: The data collected showed a wide variation in the provision of treatment for patient undergoing or in receipt of a solid organ transplant. Conclusion: It demonstrates a need for further research to be conducted to ascertain the full impact solid organ transplant has on oral health, so that guidelines can be developed to aid both dental and medical professionals in the treatment of this vulnerable cohort. [ABSTRACT FROM AUTHOR]

The use of Oral Nutritional Supplements (ONS) is widespread among patients with long- and short-term medical conditions. Although ONS serve an important purpose in the management of malnutrition, their effect on the oral hard and soft tissues is not well understood. The aim of this article is to conduct an analysis of the available literature relating to ONS and their impact on the oral environment. This study was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines adapted by Liberati. The PICO question is as follows: Population: Individuals (both children and adults) Intervention: Use of Oral Nutritional Supplements Comparison: Individuals not taking Oral Nutritional Supplements Outcome: Increased risk of oral disease (specifically dental caries, periodontal disease or candida)The research question was “Are people who take ONS at higher risk of oral diseases than the general population?” Eligibility criteria The results obtained from the literature search were filtered, according to these inclusion and exclusion criteria: Inclusion criteria • Individuals were prescribed Oral Nutritional Supplements • All studies were included, including, case– control, cohort, cross-sectional or case studies. • Studies were included if they directly compared the association between ONS and oral health i.e. Effect of ONS on the oral environment had to be one of the aims of the study • Studies on human subjects or in vitro experiments • Published in English language • Studies from 1960 to the present day Individuals were prescribed Oral Nutritional SupplementsAll studies were included, including, case– control, cohort, cross-sectional or case studies.Studies were included if they directly compared the association between ONS and oral health i.e. Effect of ONS on the oral environment had to be one of the aims of the studyStudies on human subjects or in vitro experimentsPublished in English languageStudies from 1960 to the present day Exclusion criteria • Studies not in English • Review articles and case series were excluded • Studies including the use of other nutritional supplements such as vitamin or herbal supplements were not included. • Other supplemental feeding methods such as enteral or parenteral feeding were not examined Studies not in EnglishReview articles and case series were excludedStudies including the use of other nutritional supplements such as vitamin or herbal supplements were not included.Other supplemental feeding methods such as enteral or parenteral feeding were not examined4 databases were searched: Medline (via Ebsco), Embase, Web of Science Core Collection, Google Scholar. Risk of bias was assessed using the ROBINS-I tool. A total of 58 records were identified through databases and searching bibliographies. 50 publications were excluded from the review, based on study title and abstract. The full text of eight articles were assessed for eligibility. No article answered the primary aim of the systematic review. Three articles discussed the secondary aim of the systematic review and these were included in the qualitative systematic review.The main outcome of the first study showed that the ONS had higher cariogenic potential than milk due to it’s higher acidogenicity. However, there was no statistical difference in dentine demineralisation and no significant difference in viable micro-organisms present. The main outcome of the second study showed that Escherichia coli, Staphylococcus aureus and C. albicans all grew at room temperature in the dairy-based ONS collected, and that C. albicans also grew in the juice which was milk protein-free and lipid-free. The third study showed that ONS were “potentially cariogenic” on enamel. Two studies were deemed as being at “low” of bias, however another study was deemed to be at “serious” level of bias. All studies stressed the possibility of dental disease caused by oral nutritional supplements, however there is not enough research available to imply causation. Due to the high sugar content of these supplements, and the known dental implications of this, it would be beneficial to carry out more research into this area. [ABSTRACT FROM AUTHOR]

Irish Republican women in Britain formed a vital network which provided their counterparts in Ireland with weapons, intelligence, and shelter for when they travelled across the Irish Sea. Far from being auxiliary, these women were an essential part of republican operations and blurred the boundaries between the "male" IRA and the "female" Cumann na mBan. Yet strikingly, few historians have examined this network of female republican activism, despite the availability of digitised sources such as the Military Service Pension Collection. This article seeks to remedy this oversight by using this collection to examine the role of republican women in Britain, highlighting the overlapping nature of men and women's activities, while also drawing attention to the unique circumstances of acting in a clandestine organisation within the country of the enemy. [ABSTRACT FROM AUTHOR]

Introduction: Prostatic ductal adenocarcinoma (DCa) is an aggressive variant. The purpose of this study was to determine if T2 signal intensity (SI) differs from conventional adenocarcinoma (CCa). Materials and methods: A retrospective study of patients who underwent preoperative MRI and prostatectomy between 2009 and 2012 was performed. T2 SI ratios (SIR) for tumour (T) to obturator internus muscle (M) and normal peripheral zone (PZ) were compared. Two radiologists evaluated the central gland/PZ to detect tumours and compared diagnostic accuracy. Results: T2 SIR for DCa were 3.60 (T/M), 0.66 (T/PZ); 2.68 (T/M), 0.47 (T/PZ) for Gleason 9; 2.50 (T/M), 0.47 (T/PZ) for Gleason 7/8 and 3.95 (T/M), 0.73 (T/PZ) for Gleason 6 tumours. There was a difference in T2 T/M and T/PZ SIR between DCa and Gleason 9 ( p = 0.003, p = 0.004) and Gleason 7/8 ( p = 0.006, p = 0.002), but no difference in SIR between DCa and Gleason 6 tumours. The sensitivity for tumour detection was 0-27 % for DCa, 64-82 % for Gleason 9, 44-88 % for Gleason 7-8 and 0-20 % for Gleason 6. There was a difference in the sensitivity of detecting Gleason 9 and 7/8 tumours when compared to DCa ( p = 0.004, p = 0.001). Conclusions: DCa resembles Gleason score 6 tumour at T2-weighted MRI, which underestimates tumour grade and renders the tumour occult. Key Points: • Prostatic ductal adenocarcinoma is aggressive, resembling endometrial carcinoma at histopathology. • Prostatic ductal adenocarcinoma resembles Gleason score 6 tumour at T2-weighted MRI. • MRI grading may underestimate ductal adenocarcinoma based on increased T2 signal. [ABSTRACT FROM AUTHOR]

This clinical practice guideline recommends that providers routinely evaluate any patient presenting with complaints that may represent acute aortic syndrome (AAS) to establish a pretest risk of disease that can then be used to guide diagnostic decisions. Note: AAS = acute aortic syndrome, ECG = electrocardiogram, CT = computed tomography, STEMI = ST-elevation myocardial infarction. Intermediate pretest probability I The committee suggests using a strategy starting with D-dimer testing for excluding AAS in a population with an intermediate pretest probability (prevalence 0.5%-5%), followed by ECG-gated CT in patients with a positive D-dimer test. The coordination panel in conjunction with the patient representatives placed higher value on reducing missed diagnosis for AAS without a substantial increase in radiation exposure to the patient if the diagnosis could be obtained using alternate methods with less radiation exposure. [Extracted from the article]