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Dentist’s frequently encounter patients who are medically, physically or mentally compromised. One such medical condition is ‘hydrocephalus’. Hydrocephalus is basically a neurological disorder caused by excessive intracranial pressure due to abnormal accumulation of cerebrospinal fluid within the ventricles or subarachnoid space of brain and raised intracranial pressure. Ventriculo-Peritoneal Shunt (VPS) is the most commonly used treatment though ventriculo-atrial shunt is also another treatment option. To maintain the intracranial pressure within normal range, the patients are kept on medications which make them more prone for dental malformations and caries. Because of the poor oral hygiene, these patients require a regular dental care. This report discusses the dental management process employed for a five years old patient having hydrocephalus.

Background: Avulsion is the most commonly occurring traumatic dental injury due to increased violence, road traffic accidents and partaking of children in contact sports and disregard to wear injury prevention devices. Replantation is the treatment of choice which is a very technique sensitive procedure and success depends on multiple factors. Aim: To evaluate knowledge status about the management guidelines of avulsed tooth among the general dental practitioners of Agra-Mathura region. Methodology: A questionnaire based cross-sectional survey was conducted among 184 general dental practitioners of Agra-Mathura region who were divided on the basis of educational qualification and practising experience. Statistical analysis was done. Chi square test was used for inter and intra group comparison. Results: There was presence of low knowledge level among the general dental practitioners. Significant difference was seen in the knowledge level among dentists based on educational qualification and practising experience in terms of handling of tooth after avulsion, socket preparation, splinting time period. Conclusion: Highly educated and more experience dentists had comparatively better knowledge still they lack information at multiple points. Current study indicates there is need to improve and update knowledge of dental practitioners on the management of avulsed tooth.

Objective: The aim of this study was to evaluate the remineralization of incipient lesions with CPP-ACP and its comparison with the effect of fluoride on the same. Study Design: A total of 225 teeth with incipient lesions in 108 children within the age group of 6-14 yrs. were divided into five groups by block randomization. Enamel biopsy was done for incipient lesions. Calcium and phosphate were analyzed using auto analyzer, fluoride was assessed using Orion analyzer. Results: Results showed that CPP-ACP enhances the remineralization process and that CPP-ACP has comparable effect as fluoridated dentifrice, as difference was not statistically significant (p>0.05), using ANOVA, Tukey’s test. Conclusion: CPP-ACP is effective remineralizing agent. A beneficial dose response effect is seen with the application of casein phosphopeptides. In addition, there is a synergistic effect of CPP-ACP with fluoride.

There remains a perpetual fear of aspiration or swallowing of stainless steel or cast crown during trial or adaptation. This is more if the patient is a child or handicapped. This article presents a simple and innovative technique to tag stainless steel/cast crown using materials easily available in our clinic.

External cervical resorption has been reported to occur when bleaching of root filled teeth is done with 30% " H2O2 alone or mixed with sodium perborate. H2O2 leakage through dentinal tubules has been speculated as one of the reasons for the resorption. External cervical root resorption has not been reported with the bleaching agent sodium perborate mixed with bidistilled water. Purpose of this study was to comparatively evaluate the H2O2 leakage from three bleaching agents i.e., sodiumperborate mixed with 30% H2O2 or bidistilled water or 30% H2O2 alone.21 human freshly extracted premolars were taken and root canal treatment was completed. Pulp chambers were prepared to receive bleaching agents. The teeth were divided into experimental and control groups. Experimental group was again divided into subgroups: A, B, C according to bleaching agents used. Results showed that maximum H2O2 leakage occur red from 30% H2O2 while minimum from sodium perhorate mixed wilh bidistilled water.

Background/objectives: Candida spp. has been detected in the mouths with extensive carious lesions in adults as well as children with variable frequency in different geographical areas. In this study we evaluated the prevalence of candida spp. in the oral cavity of children of central India with and without dental caries.Method and materials: Children (3-12 years) were examined for decayed, missing and filled teeth (deft/DMFT) scores. Children (n-25) having ≤3 score made control group while those (n-25) having score ≥4 made experimental group. Mycological examination was conducted on the collected saliva sample of selected children. Oral yeast colonization was assessed by culturing Candida albicans on suitable broth. Collected data was then statistically analyzed.Results: The CFU/plate of candida in experimental group was statistically higher than in control group children. Spearman's rank correlation (rs = 0.643) showed linear relationship of CFU/plate with deft/DMFT scores.Conclusion: This study showed the active role of C. albicans in dental caries in children of 3-12 years of age group in Indore city of central India.

Patients who have thyroid disease present a treatment challenge to the dentist. Awareness of the condition and current stage of treatment is important in understanding the possible modifications needed for dental treatment. The main complications associated with hyperthyroidism are cardiac comorbidity, others are diabetes mellitus and asthma. Consultation with physicians/ endocrinologist is warranted if any sign or symptom is noted on examination. Dental treatment modifications may be necessary for dental patients who are under medical management and follow- up for a thyroid condition.

Oral manifestations in paediatric HIV infection are diverse and show differences in clinical presentation and severity from that of adults. Very little data exist for oral lesions in paediatric population in India. We aimed to evaluate the oral manifestations of Paediatric HIV seropositive patients undergoing highly active antiretroviral therapy (HAART). The cross sectional study was conducted on forty four HIV positive children in the age group of 8-14 years undergoing HAART at NGO centres in Salem district were included in the study. Children were examined for oral lesions and diagnosed in accordance with European council Clearinghouse-World Health Organization. Patients were classified with respect to their immune status based on CD4 count. The common oral manifestations associated with HIV were found to be reduced with the introduction of HAART.

Introduction: Although pulpal necrosis can be associated with orthodontically treated ectopic maxillary canine, the literature is scarce on this topic. Objective: This retrospective study aimed to investigate if ectopic maxillary canines were more predisposed to lack of sensitivity due to orthodontic treatment. Materials and Methods: The sample was comprised of 20 patients (13 females and 7 males) with a mean age of 21.7 years. Forty maxillary canines were divided into two groups: ectopic (n=26) and non-ectopic (n=14). The post-treatment pulpal assessment included thermal, electrical, and percussion tests. Initial panoramic radiographs were used to assess the axial angulation of the ectopic canines and their linear distance to the occlusal plane. A clinical examination and a questionnaire were used to collect data on 14 background variables capable of influencing on pulp status. Results: There was no influence from axial angulation (p=0.0661) and linear distance (p=0.4840), nevertheless rather from duration of traction (p=0.0437). The mixed-effects logistic regression showed no statistically significant difference between ectopic and non-ectopic canines with regard to pulpal sensitivity (p=0.0744). From a clinical standpoint, 12 teeth (46.15%) presented with lack of sensitivity in the ectopic group whereas only two (14.29%) had the same outcome in the control group. Of the 14 background variables, only four would be worth pursuing further research: initial location, presence of gingival recession, bracket slot size, and history of spontaneous pain. Conclusion: Although further studies are still necessary, lack of pulpal sensitivity can be a side effect when treating ectopic maxillary canines.

Purpose: Denture cleansing tablets have been used effectively against stains and Candida when soaked for longer time yet complete sterilization against broad range of bacteria is questionable. Microwave sterilization has been shown effective against bacteria and fungus both but not against stains. Our study aims to comparatively evaluate the efficacy of microwave irradiation and denture cleanser on the disinfection and destaining of stained denture.Materials and Methods: Ninety-nine acrylic sheets were stained with Acacia catechu and lime and sterilized in UV chamber. Three samples served as negative control and remaining 96 samples were divided in groups A, B, C and D according to contaminating microorganism; three bacteria and one fungus. According to time of irradiation, groups were subdivided into subgroups-1 (2 min), 2(4 min), 3(6 min) and 4 (denture cleanser for 8 h). Microwave irradiation was done either in presence of water or denture cleansing solution. Following procedure samples were scored for staining and then inoculated for 24 h. Then after broth were checked for OD. One sample from each subgroup was inoculated for cfu count.Results: Effective disinfection for all stained samples achieved with microwave for 6 min in presence of water or denture cleansing solution. Denture cleanser for 8 h was more effective for Candida albicans. 100% stain removal was found with irradiation for 6 min in presence of denture cleanser.Conclusion: 6 min microwave irradiation in presence of denture cleansing solution could achieve complete sterilization even for spore and membrane forming bacteria. Simultaneously it completely destained all the samples.

Objective: Adequate bone support is an essential factor to avoid undue stress to the tooth. This is especially important, when the tooth is endodontically treated and requires a post. The purpose of the present finite element analysis study was to evaluate the stress distribution in endodontically treated teeth with post with different alveolar bone height.Method and materials: A 3D model was fabricated using software to represent an endodontically treated mandibular second premolar restored with titanium post and a full ceramic crown restoration and was analyzed using finite element analysis. A load of 300 N at an angle of 60 to the vertical was applied to the triangular ridge of the buccal cusp in a buccolingual plane. The relationship of alveolar bone height at 2 mm and 4 mm was calculated using von Mises stresses.Results: The finite element analysis showed the maximum stresses of 137.43 Mpa in dentin with alveolar bone height of 4 mm as compared to 105.91 Mpa in the model with alveolar bone height of 2 mm from the CEJ.Conclusion: Stress was observed more in alveolar bone height level of 4 mm from CEJ than 2 mm alveolar bone height level from CEJ.

Серед основних причин смертності населення України у 2012–2013 рр. перше місце посідають хвороби системи кровообігу (68,2 %). Cеред основних етіологічних чинників хронічних порушень мозкового кровообігу важливу роль відіграє тривало існуюча артеріальна гіпертензія, що призводить з часом до розвитку гіпертонічної енцефалопатії. Тому метою нашого дослідження було вивчити клініко-неврологічні особливості перебігу гіпертонічної дисциркуляторної енцефалопатії у державних службовців. Пацієнтів було розподілено за рівнем артеріального тиску, наявністю супутньої патології, сімейного анамнезу з боку гіпертонічної хвороби та ішемічної хвороби сердця, обстежено за Фрамінгемським дослідженням вік ­серця/судин, також було виконано розподіл пацієнтів чоловічої та жіночої статі за показниками антропометрії, проаналізовано основні скарги хворих та основні неврологічні синдроми, згідно з чим була виявлена значна перевага з боку координаторних порушень. Таким чином, існуючі клініко-неврологічні характеристики гіпертонічної дисциркуляторної енцефалопатії можуть бути доповнені та розширені запропонованими нами критеріями з метою покращення методів первинної профілактики інсультів серед працездатного контингенту, а саме — державних службовців., Среди основных причин смертности населения Украины в 2012–2013 гг. первое место занимают болезни системы кровообращения (68,2 %). Среди основных этиологических факторов хронических нарушений мозгового кровообращения важную роль играет длительно существующая артериальная гипертензия, которая приводит со временем к развитию гипертонической энцефалопатии. Поэтому целью нашего исследования было изучить клинико-неврологические особенности течения гипертонической дисциркуляторной энцефалопатии у государственных служащих. Пациенты были распределены по уровню артериального давления, наличию сопутствующей патологии, семейного анамнеза со стороны гипертонической болезни и ишемической болезни сердца, обследован по Фрамингемскому исследованию возраст сердца/сосудов, также было выполнено распределение пациентов мужского и женского пола по показателям антропометрии, проанализированы основные жалобы больных и основные неврологические синдромы, согласно чему было обнаружено значительное преимущество со стороны координаторных нарушений. Таким образом, существующие клинико-неврологические характеристики гипертонической дисциркуляторной энцефалопатии могут быть дополнены и расширены предложенными нами критериями с целью улучшения методов первичной профилактики инсультов среди трудоспособного контингента, а именно — государственных служащих., Among the main reasons of mortality of population in Ukraine in 2012–2013 disturbed circulation takes the first place (68.2 %). Arterial hypertension prevails among the etiologic reasons of the impairment of cerebral circulation. Eventually it causes hypertensive dyscirculatory encephalopathy development. That is why the aim of our study was investigation of the clinical and neurological characteristics of the clinical course of hypertensive dyscirculatory encephalopathy in civil servants. The patients were divided depending on blood pressure level, presence of concomitant disease, family anamnesis of hypertensive disease and ischemic heart disease, examined according to Framingham Heart Study age of the heart/blood vessels. They were also considered anthropometry dates in the patients of both genders; there were analyzed the main complaints of the patients and basic neurological syndromes, according to which it was revealed a significant prevailing of coordination disorders. Thus, the existing clinical and neurological characteristics of hypertensive dyscirculatory encephalopathy may be added and expanded the criteria proposed by us to improve the methods for primary prevention of stroke among the working contingent, namely civil servants.

У нашій роботі ми порівнювали вираженість постуральних змін гемодинаміки під час оперативного втручання з приводу каменів нирок, у тому числі й коралоподібних каменів, при різних схемах загальної анестезії (тотальна внутрішньовенна анестезія пропофолом та інгаляційна анестезія севофлураном). Для цього аналізували та порівнювали показники артеріального тиску на різних етапах оперативного втручання у двох групах хворих, що різнились за видом анестетика для підтримання загальної анестезії. У результаті дослідження виявлено, що постуральні зміни гемодинаміки не залежать від виду анестетика, який використовується для підтримання загальної анестезії при проведенні черезшкірної нефролітотрипсії, за умови підтримання оптимальної глибини анестезії (біспектральний індекс у межах 40–60 одиниць)., В нашей работе мы сравнивали выраженность постуральных изменений гемодинамики во время оперативного вмешательства по поводу камней почек, в том числе и коралловидных камней, при разных схемах общей анестезии (тотальная внутривенная анестезия пропофолом и ингаляционная анестезия севофлураном). Для этого оценивали и сравнивали показатели артериального давления на разных этапах оперативного вмешательства в двух группах пациентов, которые различались по виду анестетика для поддержания общей анестезии. В результате исследования было выявлено, что постуральные изменения гемодинамики не зависят от вида анестетика, который используется для поддержания общей анестезии при проведении чрескожной нефролитотрипсии, при условии поддержания оптимальной глубины анестезии (биспектральный индекс 40–60 единиц)., In our study, we compared the severity of postural hemodynamic changes during surgery for kidney stones, including coral calculi, in various schemes of general anesthesia (total intravenous anesthesia with propofol and inhalation anesthesia using sevoflurane). To do this, we have analyzed and compared the blood pressure parameters at different stages of surgery in two groups of patients, who differed by type of anesthetic for maintaining general anesthesia. The study found that postural hemodynamic changes do not depend on the type of anesthetic used to maintain general anesthesia, when carrying out percutaneous nephrolithotripsy, provided support of optimal depth of anesthesia (bispectral index within 40–60 units).

Вступ. Висока частота дегенеративно-дистрофічного ураження хребта за недостатньої ефективності терапії спондилоартрозу зумовлює актуальність застосування при нижньопоперековому болю, спричиненому переважно спондилоартрозом, інноваційного мініінвазивного методу радіочастотної денервації (РЧД) дуговідросткових суглобів (ДВС).Мета. Визначити ефективність РЧД ДВС на підставі аналізу ранніх і віддалених результатів лікування хворих з приводу нижньопоперекового больового синдрому (НПБС) з переважанням ознак спондилоартрозу.Матеріали і методи. Проведений аналіз ранніх і віддалених результатів лікування з використанням методу РЧД за допомогою апарата RFG-1A/RFG-1B (фірми Radionics) 136 пацієнтів (73 чоловіків, 63 жінок, віком від 44 до 81 року) з приводу НПБС, у яких провідним клінічним проявом був артроз ДВС (основна група). Виразність больового синдрому оцінювали до операції, через 1 тиж після неї, через 3 міс і 1 рік після лікування. Використовували візуальну аналогову шкалу (ВАШ) болю та опитувальник індексу непрацездатності Освестрі.В контрольну групу включений 31 пацієнт (15 жінок, 16 чоловіків, віком від 42 до 83 років), яких з приводу НПБС з переважанням ознак спондилоартрозу лікували консервативно.Результати. Відразу після лікування статистично значущий ефект досягнутий як в основній, так і контрольній групі при всіх структурно-морфологічних змінах хребта (крім хворих контрольної групи, у яких спондилоартроз поєднувався з стенозом хребтового каналу, спондилолістезом та великими грижами міжхребцевих дисків) як за індексом непрацездатності Освестрі, так і за ВАШ болю. Через 3 міс та 1 рік після лікування статистично значущий ефект спостерігали лише в основній групі, що свідчило про високу ефективність методу РЧД ДВС.Висновок. Аналіз ранніх та віддалених результатів лікування хворих з приводу НПБС з переважанням ознак спондилоартрозу свідчить про ефективність та безпечність РЧД ДВС. Метод доцільно включити в алгоритм лікування фасеткового синдрому за неефективності ко, Вступление. Высокая частота дегенеративно-дистрофического поражения позвоночника при недостаточной эффективности терапии спондилоартроза обусловливает актуальность применения при нижнепоясничном болевом синдроме (НПБС), вызванном преимущественно спондилоартрозом, инновационного миниинвазивного метода радиочастотной денервации (РЧД) дугоотростчатых суставов (ДОС).Цель. Оценить эффективность РЧД ДОС на основе анализа ранних и отдаленных результатов лечения по поводу НПБС с преобладанием признаков спондилоартроза.Материалы и методы. Проанализированы ранние и отдаленные результаты лечения с применением метода РЧД с помощью аппарата 1 RFG-1A/RFG-1B (фирмы Radionics) 136 пациентов (73 мужчин и 63 женщин, в возрасте от 44 лет до 81 года) по поводу НПБС, у которых ведущим клиническим проявлением был артроз ДОС. Выраженность болевого синдрома оценивали до операции, через 1 нед после нее, через 3 мес и 1 год после лечения. Использовали визуальную аналоговую шкалу (ВАШ) боли и опросник индекса нетрудоспособности Освестри.В контрольную группу включен 31 пациент (15 женщин и 16 мужчин, в возрасте от 42 до 83 лет), которых по поводу НПБС с преобладанием признаков спондилоартроза лечили консервативно.Результаты. Сразу после лечения статистически значимый эффект достигнут как в основной, так и контрольной группе при всех структурно-морфологических изменениях позвоночника (кроме больных контрольной группы, у которых спондилоартроз сочетался с большими грыжами межпозвонковых дисков, стенозом позвоночного канала, спондилолистезом) по показателям как индекса нетрудоспособности Освестри, так и ВАШ боли. Через 3 мес и 1 год статистически значимый эффект наблюдали только в основной группе, что свидетельствовало о высокой эффективности метода РЧД ДОС.Вывод. Анализ ранних и отдаленных результатов лечения больных по поводу НПБС с преобладанием признаков спондилоартроза свидетельствовал об эффективности и безопасности РЧД ДОС. Метод целесообразно включить в алгоритм лечения фасеточного синдро, Background. The high prevalence of degenerative-dystrophic spine injury and low effectiveness of spondyloarthritis therapy makes relevant the treatment of low lumbar pain syndrome caused mainly by spondyloarthritis by innovative minimally invasive method of high-frequency denervation of facet joints.Purposes. To determine the effectiveness of the radiofrequency denervation of facet joints, taking into account early and long-term results of treatment, to eliminate the pain syndrome in patients with lower lumbar pain syndrome with predominating spondyloarthritis.Materials and methods. The early and long-term results of treatment by the method of high-frequency denervation of facet joints were analyzed using 1RFG-1A/RFG-1B (produced by Radionics) in 136 patients (73 men and 63 women aged from 44 to 81 years) with lower lumbar pain syndrome with the leading clinical manifestation of arthrosis of the articular joints. The pain syndrome was assessed four times – in the preoperative and postoperative periods (during the week), 3 months and a year after treatment. The visual analogue scale (VAS) of pain and the Oswestry index of disability index were used. The control group consisted of 31 patients (15 women and 16 men aged from 42 to 83 years) with lower lumbar pain with spondyloarthrosis dominating, which were treated non-operatively.Results. Immediately after treatment, a reliable result of treatment of chronic low-back pain syndrome in the basic and control groups with all structural and morphological changes of the spine was obtained both by the Oswestry disability scale and the visual analogue scale of pain (except the control group where spondyloarthritis was combined with large herniated discs, spinal stenosis, spondylolisthesis). Meanwhile there is clear and reliable difference between the basic group and the control group immediately after the treatment. After three months and a year after the treatment in both groups a reliable result was obtained only in the bas

The whole plant extracts of Stelleria media were examined for the presence of alkaloids and phenolics with simultaneous study on the antimicrobial properties of these extracts. Investigation was carried out using four different concentration (62.5, 125, 250 and 500 mg/ml) of extract to determine the quantitative effectiveness. Preliminary evaluation of both the aqueous and the chloroform fractions showed a broad spectrum of activity ((p<0.05)) since the extracts inhibit the growth of both gram positive and gram negative bacterial isolates. Clinical isolates used in present investigation were E.coli, S.typhi, K. pneumonia, Staph. Aureus, Pseudomonas aeruginosa, Bacillus subtilis. The phytochemical analysis revealed the presence of alkaloids, saponins, tannins, flavonoids, cardiac glycosides, anthraquinones and cyanogenetic glycosides in varying concentration. Both the chloroform and aqueous extracts inhibited the growth of the test organisms with Salmonella typhi and E.coli showing the highest susceptibility but the pathogens were found to be less sensitive for chloroform extract in comparison to the aqueous extract which could be due to the domination of antimicrobial activity of water soluble polar compounds. This research supports the local use of the plant, Stelleria media for prophylactic and therapeutic purposes against bacterial infection.Keywords: Stelleria media, Chickweed phytochemical analysis, antimicrobial activity, activity index, therapeutic purpose

Background 131 I-Metaiodobenzylguanidine ( 131 I-MIBG) provides targeted radiotherapy for children with neuroblastoma, a malignancy of the sympathetic nervous system. Dissociated radioactive iodide may concentrate in the thyroid, and 131 I-MIBG is concentrated in the liver after 131 I-MIBG therapy. The aim of our study was to analyze the effects of 131 I-MIBG therapy on thyroid and liver function. Procedure Pre- and post-therapy thyroid and liver functions were reviewed in a total of 194 neuroblastoma patients treated with 131 I-MIBG therapy. The cumulative incidence over time was estimated for both thyroid and liver toxicities. The relationship to cumulative dose/kg, number of treatments, time from treatment to follow-up, sex, and patient age was examined. Results In patients who presented with Grade 0 or 1 thyroid toxicity at baseline, 12????????4% experienced onset of or worsening to Grade 2 hypothyroidism and one patient developed Grade 2 hyperthyroidism by 2 years after 131 I-MIBG therapy. At 2 years post- 131 I-MIBG therapy, 76????????4% patients experienced onset or worsening of hepatic toxicity to any grade, and 23????????5% experienced onset of or worsening to Grade 3 or 4 liver toxicity. Liver toxicity was usually transient asymptomatic transaminase elevation, frequently confounded by disease progression and other therapies. Conclusion The prophylactic regimen of potassium iodide and potassium perchlorate with 131 I-MIBG therapy resulted in a low rate of significant hypothyroidism. Liver abnormalities following 131 I-MIBG therapy were primarily reversible and did not result in late toxicity. 131 I-MIBG therapy is a promising treatment for children with relapsed neuroblastoma with a relatively low rate of symptomatic thyroid or hepatic dysfunction. Pediatr Blood Cancer 2011;56:191???201. ?? 2010 Wiley-Liss, Inc.

High-level aminoglycoside resistance was assessed in 190 commensal erythromycin-resistant α-hemolytic streptococcal strains. Of these, seven were als aminoglycoside-resistant: one Streptococcus mitis strain was resistant to high levels of kanamycin and carried the aph(3´)-III gene, four S. mitis strains were resistant to high levels of streptomycin and lacked aminoglycoside-modifying enzymes, and two S. oralis strains that were resistant to high levels of kanamycin and streptomycin harbored both the aph(3´)-III and the ant(6) genes. The two S. oralis strains also carried the ant(6)-sat4-aph(3´´)-III aminoglycoside-streptothricin resistance gene cluster, but it was not contained in a Tn5405-like structure. The presence of this resistance gene cluster in commensal streptococci suggests an exchange of resistance genes between these bacteria and enterococci or staphylococci. [Int Microbiol 2007; 10(1):57-60]

Multiple system atrophy (MSA) is a neurodegenerative disorder exhibiting a combination of parkinsonism, cerebellar ataxia, and autonomic failure. A disease-specific scale, the Unified Multiple System Atrophy Rating Scale (UMSARS), has been developed and validated to measure progression of MSA, but its use as an outcome measure for therapeutic trials has not been evaluated. On the basis of twelve months of follow-up from an observational study of 67 patients with probable MSA, we evaluated three disease-specific scores: Activities of Daily Living, Motor Examination, and a combined score from the UMSARS and two general health scores, the Physical Health and Mental Health scores of the SF-36 health survey, for their use as outcome measures in a therapeutic trial. We discuss related design issues and provide sample size estimates. Scores based on the disease-specific UMSARS seemed to be equal or superior to scores based on the SF-36 health survey. They appeared to capture disease progression, were well correlated and required the smallest sample size. The UMSARS Motor Examination score exhibited the most favorable characteristics as an outcome measure for a therapeutic trial in MSA with 1 year of follow-up. ?? 2007 Movement Disorder Society

The ratio of male and female genetic map distances varies dramatically across the human genome. Despite these sex differences in genetic map distances, most multipoint linkage analyses use sex-averaged genetic maps. We investigated the impact of using a sex-averaged genetic map instead of sex-specific maps for multipoint linkage analysis of affected sibling pairs when identity-by-descent states are incompletely known due to missing parental genotypes and incomplete marker heterozygosity. If either all or no parental genotypes were available, for intermarker distances of 10, 5, and 1 cM, we found no important differences in the expected maximum lod score (EMLOD) or location estimates of the disease locus between analyses that used the sex-averaged map and those that used the true sex-specific maps for female:male genetic map distance ratios 1:10 and 10:1. However, when genotypes for only one parent were available and the recombination rate was higher in females, the EMLOD using the sex-averaged map was inflated compared to the sex-specific map analysis if only mothers were genotyped and deflated if only fathers were genotyped. The inflation of the lod score when only mothers were genotyped led to markedly increased false-positive rates in some cases. The opposite was true when the recombination rate was higher in males; the EMLOD was inflated if only fathers were genotyped, and deflated if only mothers were genotyped. While the effects of missing parental genotypes were mitigated for less extreme cases of missingness, our results suggest that when possible, sex-specific maps should be used in linkage analyses. Genet. Epidemiol . 2006. © 2006 Wiley-Liss, Inc.

Air Force Public Health personnel tasked with sampling food suspected of causing illness do not have readily available or standard equipment to perform this task. When presented with a foodborne illness emergency, personnel must scramble to find the necessary sterile tubes, media, and insulated shipping materials. In the present work, three commercially available off-the-shelf cold chain shipping systems were evaluated for temperature holding capacity under the ISCgold Summer and International Safe Transit Association (ISTA)-7D extreme summer temperature shipping profiles. Despite each manufacturer s claims, which indicated that maintenance of temperatures during transport would be highly likely, none of the evaluated boxes were able to sustain sample temperatures between 2 C and 10 C for 96 hours. The NanoCool long haul shipper lasted 55 hours under the ISTA-7D profile and 38 hours under the ISCgold. ThermoSafe s VIP shippers and Pelican BioThermal s Credo Cube performed similarly; VIP shippers maintained sample temperatures under 10 C for 28 hours with the ISTA-7D profile and 15 hours with ISCgold, while the Credo Cube lasted 31 hours under ISTA-7D and 15 hours with ISCgold. Although falling well short of the 96-hour goal, the NanoCool box performed nearly twice as well as the other boxes under the extreme temperature profiles. It has outer dimensions approximately half the size of the other boxes, while providing a similar inner sample space. Additionally, the NanoCool can be re-iced during transit lasting longer than 55 hours with a replaceable chilling unit in the lid, making the unit appropriate for the shipment of all types of temperature-sensitive samples.

Рак толстой кишки может развиваться из латерально распространяющихся опухолей. Эффективность колоноскопии для диагностики таких опухолей недостаточно изучена.Цель. Изучить диагностическую ценность колоноскопии с высокой разрешающей способностью, исследованием в узком спектре света и хромоскопией уксусной кислотой для выявления латерально распространяющихся опухолей.Материалы и методы. Были исследованы 1632 протокола колоноскопии: 735 — видеоколоноскопом Olympus CF-HQ190L и 897 — Olympus CF-150. Результаты и обсуждение. В исследовании показатель выявления аденом в опытной группе был достоверно выше, чем в группе контроля: 0,78 (571/735) против 0,47 (422/897), р < 0,00001; χ2 = 157,9. Индекс выявления аденом в опытной группе был в 3,6 раза выше, чем в контрольной: 2,9 (2104/735) против 0,8 (708/897). В опытной группе пациенты с латерально распространяющимиси опухолями были выявлены в 2,2 раза чаще, чем в контрольной: 22 % (187/735) против 10 % (85/897), р < 0,00001; χ2 = 53,6. Выводы. Колоноскопия с высокой разрешающей способностью, исследованием в узком спектре света и хромоскопией уксусной кислотой обладает высокой диагностической ценностью для выявления латерально распространяющихся опухолей толстого кишечника., Рак товстої кишки може розвиватися з пухлин із латеральним поширенням. Ефективність колоноскопії для діагностики таких пухлин мало вивчена. Мета. Вивчити діагностичну цінність колоноскопії з високою роздільною здатністю, дослідженням у вузькому спектрі світла і хромоскопією оцтовою кислотою для виявлення пухлин із латеральним поширенням. Матеріали і методи. Були досліджені 1632 протоколи колоноскопії: 735 — відеоколоноскопом Olympus CF-HQ190L і 897 — Olympus CF-150. Результати та обговорення. У дослідженні показник виявлення аденом у дослідній групі був вірогідно вищим, ніж у групі контролю: 0,78 (571/735) проти 0,47 (422/897), р < 0,00001; χ2 = 157,9. Індекс виявлення аденом у дослідній групі був у 3,6 раза вищий, ніж у контрольній: 2,9 (2104/735) проти 0,8 (708/897). У дослідній групі пацієнти з пухлинами з латеральним поширенням були виявлені у 2,2 раза частіше, ніж у контрольній: 22 % (187/735) проти 10 % (85/897), р < 0,00001; χ2 = 53,6. Висновки. Колоноскопія з високою роздільною здатністю, дослідженням у вузькому спектрі світла і хромоскопією оцтовою кислотою має високу діагностичну цінність для виявлення пухлин із латеральним поширенням., Colon cancer may arise from laterally spreading tumors. Efficacy of colonoscopy for the diagnosis of these tumors is underinvestigated.Objective. To study diagnostic accuracy of high resolution colonoscopy with narrow band imaging and acetic acid chromoscopy in detecting laterally spreading tumors.Materials and Methods. 1632 colonoscopy protocols were studied: 735 — by using video colonoscope Olympus CF-HQ190L and 897 — Olympus CF-150. Results and Discussion. In study group, adenoma detection rate was higher than in control one: 0.78 (571/735) vs. 0.47 (422/897), p < 0.00001; c2 = 157.9. Adenoma detection index was 3.6 times higher in study group than in control one: 2.9 (2,104/735) vs. 0.8 (708/897). Laterally spreading tumors were diagnosed 2.2 times more often in study group than in control one: 22 % (187/735) vs. 10 % (85/897), p < 0.00001; c2 = 53.6. Conclusions. High resolution colonoscopy with narrow band imaging and acetic acid chromoscopy has a high diagnostic value for detection of laterally spreading tumors of the colon.

Метою нашого дослідження стала перевірка адекватності відображення параметрів газообміну неінвазивними методами (капнометрія, пульсоксиметрія) при проведенні черезшкірної нефролітотрипсії в положенні хворого на животі під загальною анестезією.Матеріали та методи. Хворим проводили дослідження газового складу артеріальної крові та порівнювали їх результати з даними неінвазивних методів у трьох точках: через 10 хв після інтубації; через 10 хв після повороту пацієнта на живіт та виведення валика операційного столу; через 10 хв після опущення валика операційного столу.Результати. У хворих в усіх точках виміру статистично значуща різниця між показниками SpO2 та SO2 була відсутня (р > 0,05). Р(а-Еt)CO2 в положенні на спині та в положенні на животі без валика дорівнював 3,70 ± 0,51 мм рт.ст. та 3,80 ± 0,73 мм рт.ст. відповідно. Статистично значущої різниці між показниками немає (р = 0,361). Отримані результати повністю відповідають нормі. У положенні хворого на животі з висунутим валиком операційного столу в епігастральній ділянці Р(а-Еt)CO2 становив 7,10 ± 0,78 мм рт.ст. (різниця статистично значуща порівняно з першим та третім етапами операції, р < 0,05). При цьому значення градієнта СО2 не виходили за межі допустимих величин — до 10 мм рт.ст., Целью нашего исследования стала проверка адекватности отображения параметров газообмена неинвазивными методами (капнометрия, пульсоксиметрия) при проведении чрескожной нефролитотрипсии в положении больного на животе под общей анестезией.Материалы и методы. Больным проводили исследование газового состава артериальной крови и сравнивали их результаты с данными неинвазивных методов в трех точках: через 10 мин после интубации; через 10 мин после поворота пациента на живот и вывода валика операционного стола; через 10 мин после опускания валика операционного стола.Результаты. У больных во всех точках измерения статистически достоверная разница между показателями SpO2 и SO2 отсутствовала (р > 0,05). Р(а-Еt)CO2 в положении на спине и в положении на животе без валика составил 3,70 ± 0,51 мм рт.ст. и 3,80 ± 0,73 мм рт.ст. соответственно. Статистически значимой разницы между показателями нет (р = 0,361). Полученные результаты полностью соответствуют норме. В положении больного на животе с выдвинутым валиком операционного стола в эпигастральной области Р(а-Еt)CO2 составил 7,10 ± 0,78 мм рт.ст. (разница статистически достоверна по сравнению с первым и третьим этапами операции, р < 0,05). При этом значение градиента СО2 не выходило за пределы допустимых величин — до 10 мм рт.ст., The objective of our study was to test the adequacy of the reflection of gas exchange parameters by using non-invasive methods (capnometry, pulse oximetry) during percutaneous nephrolithotripsy in the prone position under general anesthesia.Materials and Methods. Patients underwent arterial blood gas analysis, and we compared their results with the data of non-invasive methods at three points: in 10 min after intubation; in 10 min after prone positioning and removing the roller of operating table; in 10 min after putting down the roller of operating table.Results. Patients in all measurement points had no statistically significant difference between the indices of SpO2 and SO2 (р > 0.05). P(a-Et)CO2 in the supine position and in the prone position without roller comprised 3.70 ± 0.51 mmHg and 3.80 ± 0.73 mmHg respectively. There was no statistically significant difference between the indices (p = 0.361). The findings are fully comply with the norm. In the prone position with extended roller of operating table in the epigastric region ­P(a-Et)CO2 was 7.10 ± 0.78 mmHg (the difference is statistically significant in comparison with the first and third stages of the operation, р < 0.05). The value of CO2 gradient does not exceed the allowable values — up to 10 mmHg.

The overall goal of this project was to develop a database that will allow investigators to examine how environmental and occupational factors affect risk-taking behaviors and health outcomes among United States Air Force personnel. With an appropriate database, investigators will be able to explore the general hypothesis that environmental and occupational factors influence both health outcomes and risk-taking behavior of service members in certain career fields, with identification of high-risk career fields for targeted interventions. Additionally, low-risk career fields could be identified for potential protective factors. The result of this project was a comprehensive database that has been formatted and cleaned, which will enable investigators to identify environmental and occupational factors specific to the Air Force that impact health and safety outcomes. The analysis of the database will be conducted in Phase 2 of the project.

The United States Air Force School of Aerospace Medicine (USAFSAM), Epidemiology Consult Service (PHR), Hearing Conservation Program (HCP) prepares an annual status report on the USAF HCP in accordance with Air Force Occupational Safety and Health Standard 48-20, Occupational Noise and Hearing Conservation Program, 2.3.7 and Department of Defense Instruction 6055.12, Hearing Conservation Program. This report covers calendar year 2013. The purpose of this report is to provide a corporate view of the status of the USAF HCP with data reported from the Defense Occupational and Environmental Health Readiness System Data Repository (DOEHRS-DR). Major command and installation level reports are available quarterly and by request from USAFSAM/PHR, as well as by those who have user-defined roles in the data repository. This report covers information regarding software implementation status; HCP effectiveness metrics, to include an overview of a few standard reports currently available in the DOEHRS-DR database; and our recommendations.

В статье представлены некоторые аспекты проблемы остеопороза, а также современные методы лабораторной диагностики остеопороза, которые применяются в лаборатории ООО «Синэво Украина»., У статті представлені деякі аспекти проблеми остеопорозу, а також сучасні методи лабораторної діагностики остеопорозу, які застосовуються в лабораторії ТОВ «Сінево Україна»., The article presents some aspects of osteoporosis, as well as modern methods of laboratory diagnosis of osteoporosis, which are being used in the laboratory of «Synevo Ukraine» LLC.

At the request of 21 AMDS/SGPB, the U.S. Air Force School of Aerospace Medicine/Epidemiology Consult Services (USAFSAM/PHR) entomologist, two USAFSAM/Public Health Education entomologists, and the chief entomologist from the Air Force Aerial Spray Flight (USAF Reserve Command, Youngstown, OH) conducted a base-wide mosquito vector survey on 13 June-1 July 2012. One species of mosquitoes, Aedes impiger, was collected and more than 3000 were processed for virus testing. Active mosquito breeding sites were located throughout the base and surrounding valley. The USAFSAM/PHR entomologist and a U.S. Army Human Resource Command, Ohio State University graduate student conducted molecular testing on the mosquitoes for arboviruses. Two pools of mosquitoes from Thule AB were positive for an Orthobunyavirus; however, DNA sequencing of the viral amplicons was not complete enough to fully identify the agent. No vector surveillance or control programs are in effect at Thule AB. Based on the history of mosquito pest problems and the potential for mosquito-borne viruses, we recommend that these be established.

This document is the final report of the project entitled Developing and Testing a Self-Regulated Learning Assessment Methodology for Medical Education. This project was sponsored by the U.S. Air Force Medical Research Program, Office of the Air Force Surgeon General, Directorate for Modernization. This report discusses the project's purpose, methodology, results, and conclusions., Prepared in collaboration with Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ. The original document contains color images.

Rodent baits containing systemic insecticides are potential tools to interrupt the cycle of transmission of Leishmania parasites by killing sand flies that take bloodmeals from rodents as adults. Bio-indicators that can be used in conjunction with rodent-targeted sand fly control methods also have been developed to demonstrate that the insecticide treatments are reaching the targeted life stages of sand flies and to quantify the effect of the insecticide treatments on sand fly populations. This article presents new results from a field study on the use of rodent bait containing a systemic insecticide in Kenya. The objective of this field study was to incorporate the fluorescent dye rhodamine B into rodent baits to determine the level of blood feeding by the sand fly Phlebotomus duboscqi on targeted rodents, and to demonstrate the effect of rodent bait containing the systemic insecticide ivermectin on blood-feeding adult females of P. duboscqi. Over 50% of the blood-fed females of P. duboscqi collected at sites that were treated with rodent baits containing rhodamine B alone were positive for the presence of rhodamine B while no blood-fed females of P. duboscqi collected at the sites treated with rodent baits containing rhodamine B plus ivermectin were positive for the presence of rhodamine B. The results of this field trial constitute proof of concept for the targeted control of an epidemiologically significant portion of the population of the sand fly vector of Leishmania major, and demonstrate the potential for the interruption of the transmission of L. major using applications of systemic insecticide-treated rodent baits., Published in Pesticide Biochemistry and Physiology, v106 p113 117, 28 Apr 2013. Prepared in collaboration with the Walter Reed Army Institute of Research, Silver Spring, MD, and the US Army Medical Research Unit-Kenya. Prepared in cooperation with the Department of Entomology, Louisiana State University Agricultural Center, and the Division of Laboratory Animal Medicine, Louisiana State University School of Veterinary Medicine, Baton Rouge.

The mission of the Accession Medical Standards Analysis & Research Activity (AMSARA) is to support the development of evidence based medical standards for the Department of Defense (DoD) by guiding improvement of medical and administrative databases and conducting epidemiologic and special studies analyses. AMSARA's mission has recently expanded to include analysis and studies of existing disability tri-service evaluation system by the request of the Office of Assistant Secretary of Defense, Health Affairs. The DES Annual Report includes executive summary, methods, history of medical disqualification, pre-existing conditions, accession medical waiver, and hospitalization among service members evaluated for disability, service disability evaluation databases limitations from FY 07 to FY12, data quality and standardization recommendations.

AMSARA's mission is to support the development of evidence based medical standards for the Department of Defense (DoD) by guiding improvement of medical and administrative databases and conducting epidemiologic and special studies analyses. Analyses presented in this annual report include analyses of accession medical disqualifications, waivers, existed prior to service and disability discharges. Descriptive statistics are reported for DoD enlisted accessions who enlisted in 2012 compared to FY 2007 through FY 2011 accessions totals. Data are collected while the recruits remain on active duty for the first fiscal year (through fiscal year 2012 for this report). The data are then merged, analyzed and results presented as aggregated tables and figures.

Obesity is a disease that is defined as the accumulation of excessive amounts of body fat and is associated with increased risk of serious illness, disability, and death. Treatment options are determined based on the body mass index, waist circumference, and adverse health consequences the patient is experiencing or is at an increased risk for facing in the future. Although endocrinologists are uniquely positioned to treat one of the major consequences of our current obesity epidemic, type 2 diabetes, we also need to be positioned and prepared to effectively treat one of its major causes — obesity. Type 2 diabetes and obesity are very much intertwined. Treatment of each disease affects the other. For these reasons, endocrinologists need to be experts in the treatment of obesity as well as diabetes. They should keep up with advances in obesity treatment including lifestyle, pharmaceutical, and surgical strategies. These strategies offer opportunities for improving the overall treatment for our obese patients today and will continue to improve and expand over the next decade., Ожирение является заболеванием, которое определяется как накопление избыточного количества жира в организме и связано с повышенным риском развития тяжелых заболеваний, инвалидности и смерти. Варианты лечения определяются на основе индекса массы тела, окружности талии и неблагоприятных последствий для здоровья, с которыми пациенты сталкиваются или имеют повышенный риск столкнуться в будущем. Хотя эндокринологи имеют уникальные возможности для лечения одного из главных последствий современной эпидемии ожирения — диабета 2-го типа, мы также должны быть готовы к тому, чтобы эффективно лечить одну из основных его причин — ожирение. Диабет 2-го типа и ожирение очень сильно взаимосвязаны. Лечение каждого заболевания влияет на другое. В связи с этим эндокринологи должны быть специалистами в лечении ожирения и диабета. Они должны идти в ногу со временем в плане лечения ожирения, включая модификацию образа жизни, фармацевтическую и хирургическую стратегии. Эти стратегии уже сегодня предоставляют возможности для улучшения общего состояния наших пациентов, страдающих ожирением, и будут способствовать улучшению и расширению возможностей лечения данного состояния в течение следующего десятилетия., Ожиріння є захворюванням, що визначається як накопичення надлишкової кількості жиру в організмі і пов’язане з підвищеним ризиком розвитку тяжких захворювань, інвалідності і смерті. Варіанти лікування визначаються на основі індексу маси тіла, окружності талії й несприятливих наслідків для здоров’я, із якими пацієнти стикаються або мають підвищений ризик зіткнутися в майбутньому. Хоча ендокринологи мають унікальні можливості для лікування одного з головних наслідків сучасної епідемії ожиріння — діабету 2-го типу, ми також повинні бути готовими до того, щоб ефективно лікувати одну з основних його причин — ожиріння. Діабет 2-го типу й ожиріння дуже міцно взаємопов’язані. Лікування кожного захворювання впливає на інше. З огляду на це ендокринологи повинні бути спеціалістами в лікуванні ожиріння й діабету. Вони повинні іти в ногу з часом щодо лікування ожиріння, включаючи модифікацію способу життя, фармацевтичну й хірургічну стратегії. Ці стратегії вже сьогодні надають можливості для покращення загального стану наших пацієнтів, які страждають від ожиріння, і будуть сприяти покращенню й розширенню можливостей лікування цього стану протягом наступного десятиліття.