Lawsuit against a dentist related to serious ocular infection possibly linked to water from a dental handpiece

This case report highlights the risks that may be associated with amoebae in the water of a dental unit. A woman with contact lenses visited her dentist for replacement of a bridge. During the treatment, a stream of water was directed from the handpiece into her right eye. Because of subsequent pain in the eye, the patient consulted several ophthalmologists, who discovered abrasive lesions of the cornea and inflammation. Despite antibacterial and anti-inflammatory treatments, the patient"s visual acuity declined gradually over a period of several days. A microbiological examination nearly 2 months later revealed amoebae in corneal samples. A lawsuit against the dentist was initiated. Although a causal relation with the dental treatment was rejected by the judge in this case, high numbers of amoebae in the water of dental units can present a risk if a patient with pre-existing corneal lesions is splashed. According to the precautionary principle, complete evidence of risk does not have to exist to institute measures to protect individuals and society from that risk. This case reinforces the importance of having patients wear safety glasses during dental treatments and of dental personnel draining the waterlines of dental units, as recommended by the Canadian Dental Association.     

Prevalence of human papillomavirus in squamous cell carcinoma of the tongue

Oncogenic human papillomaviruses (HPVs) are important agents in the genesis of gynecological cancer, and have also been implied in the genesis of oral cancer. With the purpose of evaluating the relationship between HPV and squamous cell carcinoma (SCC) of the tongue, a case-control study was performed. Fifty white male patients who were smokers and had the histological diagnosis of SCC of the tongue were selected. The control group was composed of 10 matched patients with no clinical evidence of tongue lesions. Polymerase chain reaction (PCR) was used to detect the presence of HPV genome in fresh-frozen tissue specimens from SCC of the tongue margin. Thirty-seven patients (74%) had a positive PCR for oncogenic papillomavirus, and only 1 specimen (10%) of the control group was positive for nononcogenic papillomavirus. Based on the statistical analysis of this study there was a 25.6% higher risk for SCC of the tongue to harbor oncogenic HPV than the healthy control tongue tissue.     

The role of dental hygienists, assistants, and office staff in CAMBRA

The role of the dental team in caries management by risk assessment is critical to successful patient outcomes. Positive patient interactions and communication, proper appointment scheduling, diagnostics and data gathering, as well as implementation of noninvasive or minimally invasive procedures can be the responsibility of all members of the dental team. This article will evaluate the role of the clinical and administrative staff in maintaining a practice with a focus on disease prevention and management..     

An erythroid chaperone that facilitates folding of alpha-globin subunits for hemoglobin synthesis

Erythrocyte precursors produce abundant alpha- and beta-globin proteins, which assemble with each other to form hemoglobin A (HbA), the major blood oxygen carrier. alphaHb-stabilizing protein (AHSP) binds free alpha subunits reversibly to maintain their structure and limit their ability to generate reactive oxygen species. Accordingly, loss of AHSP aggravates the toxicity of excessive free alpha-globin caused by beta-globin gene disruption in mice. Surprisingly, we found that AHSP also has important functions when free alpha-globin is limited. Thus, compound mutants lacking both Ahsp and 1 of 4 alpha-globin genes (genotype Ahsp(-/-)alpha-globin*(alpha/alphaalpha)) exhibited more severe anemia and Hb instability than mice with either mutation alone. In vitro, recombinant AHSP promoted folding of newly translated alpha-globin, enhanced its refolding after denaturation, and facilitated its incorporation into HbA. Moreover, in erythroid precursors, newly formed free alpha-globin was destabilized by loss of AHSP. Therefore, in addition to its previously defined role in detoxification of excess alpha-globin, AHSP also acts as a molecular chaperone to stabilize nascent alpha-globin for HbA assembly. Our findings illustrate what we believe to be a novel adaptive mechanism by which a specialized cell coordinates high-level production of a multisubunit protein and protects against various synthetic imbalances.     

Rescuing nursing education from content saturation: the case for a concept-based curriculum

Nursing education has been plagued with a saturation of content for many years. The multiple contributing factors underscore the complexity of the problem and validate the need for educational reform. The purpose of this article is to discuss various factors contributing to content saturation and propose a conceptual approach for curriculum development and teaching in nursing education.     

Preparing nursing faculty for baccalaureate-level and graduate-level nursing programs: role preparation for the academy

This article explores the multiple roles expected of nursing faculty teaching in baccalaureate and graduate programs, as well as the preparation required to accomplish those roles. The educational preparation for the challenging roles nurse educators are required to assume is explored, along with suggestions on how to support faculty in their roles to ensure they are both productive and retained in their work. Although the research mission remains an important priority role for faculty today, it can easily overshadow and conflict with the equally compelling faculty roles needed to address the holistic development of the next generation of the profession: teaching; service, and practice. Boyer's dimensions of scholarship are used to suggest a structure for the roles that baccalaureate and graduate faculty in nursing programs need to be prepared to assume: the scholarship of discovery, the scholarship of integration, the scholarship of application, and the scholarship of teaching.     

Metabolic training: new paradigms of exercise training for metabolic diseases with exercise calorimetry targeting individuals.

For patients with metabolic diseases, as with other diseases, exercise training is a fully recognized therapy. Such training helps obese patients stabilize weight after slimming. For patients with type 2 diabetics, it is both a prevention and a glucose-lowering treatment and reduces health care costs. We propose a targeted training for individuals at the level of maximal lipid oxidation (LIPOXmax) with a protocol of exercise calorimetry (four 6-min workloads) based on Brooks and Mercier's crossover concept. Calorimetric interpretation of gas exchange at the fifth and sixth minutes of each stage shows a bell-shaped curve for lipid oxidation that peaks at LIPOXmax, a point that varies considerably among individuals. As well, glucose oxidation is a linear function of power (carbohydrate cost of the watt). Such a calculation predicts fairly actual lipid oxidation over 45 min at the same level. Other protocols, with 3-min workloads used in sports medicine, are not reliable for patients with metabolic diseases. For obese adults and teenagers, as well as those with type 2 diabetes, 2 months' training at the LIPOXmax (three sessions at 45 min per week) results in a net loss of fat mass, with preserved fat-free mass, and increased ability to oxidize lipids. At the end of this period, training can be "re-targeted" to be more effective and, possibly, associated with other strategies with stronger exercise intensities. Therefore, metabolic training is a viable option for patients with metabolic diseases, but the full concept is still evolving. However, the major challenge remains to transform inactive individuals into active ones.