The physiology of falling: assessment and prevention strategies for older people

Balance calls upon contributions from vision, peripheral sensation, vestibular sense, muscle strength, neuromuscular control and reaction time. With increased age, there is a progressive loss of functioning of these systems and an increased likelihood of falls. Falls can mark the beginning of a decline in function and independence and are the leading cause of injury-related hospitalisation in older people. By using simple tests of vision, leg sensation, muscle strength, reaction time and standing balance, it is possible to identify accurately older people at risk of falls and assess intervention outcomes. This approach overcomes the limitations associated with traditional methods of assessing falls risk via medical diagnoses, including varied severity between individuals. Using a physiological approach provides information at the impairment and functional capacity levels to assist in understanding falls and developing and evaluating optimal falls prevention strategies for older people.     

Detection of human herpesvirus-8 DNA in oral ulcer tissues of HIV-infected individuals

OBJECTIVE: To determine the frequency of detection of human herpesvirus-8 (HHV-8) in HIV-related oral ulcers. DESIGN: Analysis of archived biopsy material. METHODS: Nested polymerase chain reaction of DNA extracts. RESULTS: HHV-8 DNA was detected in six of 10 oral ulcers of HIV-positive patients without oral Kaposi's sarcoma (KS) lesions and five of 11 oral KS lesions. The positive non-KS samples were derived from various oral sites. CONCLUSIONS: In HIV-positive people, HHV-8 can infect oral tissues that are not affected by KS.     

Cross-infection compliance of UK dental staff and students

OBJECTIVES: The objectives of the study were to determine the compliance of a group of dental health care workers and students in aspects of cross-infection control.
DESIGN: The dentists and dental students working in a dental clinic were observed by a 'hidden' ceiling-mounted video camera. Procedures were recorded onto videotape and the actions of the observed clinicians and students assessed by two suitably qualified assessors.
SETTING: An emergency Oral Medicine clinic in a dental hospital.
SUBJECTS Seventy nine dentists and 35 dental undergraduates.
METHODS: The action of staff and students were recorded on videotape and assessed retrospectively.
MAIN OUTCOME MEASURES: Degree of compliance with recognised infection control policies.
RESULTS: Compliance with recommended guidelines for control of cross-infection was poor. In only 56% of health care worker-patient contacts were protective gloves changed between patients. Facemasks and protective eyewear were only worn in 38% and 29% of such contacts respectively.
CONCLUSIONS: Compliance with cross-infection control measures are poor in dentistry - even when clinicians are provided with appropriate facilities.     

A Rare Case of Obscure Gastrointestinal Bleeding in a Young Patient

The case is reported of obscure gastrointestinal bleeding in a young male. A 14-year-old male presented with severe anemia and a one-month history of passage of black colored stools with occasional fresh blood. Investigations revealed a gastrointestinal stromal tumor (GIST) in the jejunum which was managed by resection and jejuno-jejunal anastomosis.