Profiles of orofacial dysfunction in different diagnostic groups using the Nordic Orofacial Test (NOT-S)—A review

Objective. The Nordic Orofacial Test-Screening (NOT-S) was developed as a comprehensive method to assess orofacial function. Results from the screening protocol have been presented in 11 international publications to date. This study reviewed these publications in order to compile NOT-S screening data and create profiles of orofacial dysfunction that characterize various age groups and disorders. Materials and methods. NOT-S results of nine reports meeting the inclusion criteria were reviewed. Seven of these studies not only provided data on the mean and range of total NOT-S scores, but also on the most common domains of orofacial dysfunction (highest rate of individuals with dysfunction scores), allowing the construction of orofacial dysfunction profiles based on the prevalence of dysfunction in each domain of NOT-S. Results. The compiled data comprised 669 individuals, which included healthy control subjects (n = 333) and various patient groups (n = 336). All studies reported differences between individuals with diagnosed disorders and healthy control subjects. The NOT-S data could measure treatment effects and provided dysfunction profiles characterizing the patterns of orofacial dysfunction in various diagnoses. Conclusions. This review corroborates previous results that the NOT-S differentiates well between patients and healthy controls and can also show changes in individuals after treatment. NOT-S could be used as a standard instrument to assess orofacial dysfunction, evaluate the outcomes of oral habilitation and rehabilitation and improve comparability in clinical practice and research.     

New approaches to the treatment of sepsis

The clinical spectrum of sepsis, severe sepsis, and septic shock is responsible for a growing number of deaths and excessive health care expenditures. Until recently, despite multiple clinical trials, no intervention provided a beneficial outcome in septic patients. Within the last 2 years, studies that involved drotrecogin alfa (activated), corticosteroid therapy, and early goal-directed therapy showed efficacy in those with severe sepsis and septic shock. These results have provided optimism for reducing sepsis-related mortality.     

Energy dependence of cytosolic enzyme efflux from rat skeletal muscle

(1) A recirculating isolated superfused skeletal muscle preparation has been developed for the study of rat soleus muscles at physiological temperature using 31P Nuclear Magnetic Resonance (NMR). (2) This system has been used to study intracellular muscle high energy phosphate content and pH during experimental damage to the muscle induced by 2,4-dinitrophenol, deoxycholate and the calcium ionophore, A23187. (3) Results indicate that release of intracellular cytosolic enzymes from damaged skeletal muscle may be induced by phosphocreatine (PCr) and adenosine trisphosphate (ATP) depletion, but under certain circumstances intracellular enzymes can be released from skeletal muscle without any fall in muscle PCr or ATP content.     

Pharmacological properties of N-(3,5-diamino-6-chloropyrazine-2-carbonyl)-N'-4-[4-(2,3-dihydroxypropoxy)phenyl]butyl-guanidine methanesulfonate (552-02), a novel epithelial sodium channel blocker with potential clinical efficacy for cystic fibrosis lung disease

Amiloride improves mucociliary clearance (MC) by blocking airway epithelial sodium channels (ENaC) and expanding airway surface liquid (ASL). However, the low potency and rapid absorption of amiloride by airway epithelia translated into a short duration of efficacy as an aerosolized therapy for cystic fibrosis (CF) patients. To improve ENaC blocker CF pharmacotherapy, a more potent and durable ENaC blocker tailored for aerosol delivery was synthesized. Parion compound N-(3,5-diamino-6-chloropyrazine-2-carbonyl)-N'-4-[4-(2,3-dihydroxypropoxy)phenyl]butyl-guanidine methanesulfonate (552-02) was tested for potency and reversibility of ENaC block, epithelial absorption and biotransformation, selectivity, durability of ASL expansion under isotonic and hypertonic conditions in canine and human CF bronchial epithelial cells, and drug dissociation on ENaC in Xenopus oocytes. Short-circuit current assessed compound potency and reversibility, patch-clamp recordings of ENaC current assessed drug off-rate (k(off)), a gravimetric method and confocal microscopy measured mucosal water retention and ASL height, and drug absorption and biotransformation were assessed using liquid chromatography-mass spectrometry. Amiloride and 552-02 were tested in vivo for MC activity in sheep immediately and 4 to 6 h after aerosol dosing. Compared with amiloride, compound 552-02 was 60 to 100-fold more potent, it was 2 to 5-fold less reversible, it was slower at crossing the epithelium, and it exhibited a 170-fold slower k(off) value. 552-02 exhibited greater ASL expansion over 8 h in vitro, and it was more effective than amiloride at increasing MC immediately and 4 to 6 h after dosing. When combining hypertonic saline and 552-02, a synergistic effect on ASL expansion was measured in canine or CF bronchial epithelia. In summary, the preclinical data support the clinical use of 552-02 +/- hypertonic saline for CF lung disease.     

Using portfolios to evaluate achievement of population-based public health nursing competencies in baccalaureate nursing students

Public health nurses from 13 local public health agencies and nurse educators from five schools of nursing developed population-based public health nursing competencies for new graduates and novice public health nurses. Educators in one nursing program used a portfolio assignment to measure achievement of the competencies by traditional and RN to BSN students in a community health nursing course. Data were collected from surveys and focus groups to determine students' responses to the portfolio and their use of population-based public health nursing concepts. The assignment enhanced students' critical thinking skills; however, concerns about the structure and evaluation of the portfolio decreased student satisfaction. Recommendations are made for improving the portfolio format, increasing students' valuing of the portfolio, managing the tension between assessment and learning, and orienting clinical agency staff and nursing instructors.     

Diffusion-weighted imaging in acute stroke

Diffusion MR imaging has improved evaluation of acute ischemic stroke vastly. It is highly sensitive and specific in the detection of infarction at early time points when CT and conventional MR sequences are unreliable. The initial DWI lesion is believed to represent infarction core and usually progresses to infarction unless there is early reperfusion. The initial DWI lesion volume and ADC ratios correlate highly with final infarction volume and with acute and chronic neurologic assessment tests. ADC values may be useful in differentiating tissue destined to infarct from that potentially salvageable with reperfusion therapy. ADC values also may be useful for determining tissue at risk of HT after reperfusion therapy. DTI can quantify differences in the responses of gray versus white matter to ischemia. FA may be important in determining stroke onset time, and tractography provides early detection of wallerian degeneration that may be important in determining prognosis. Finally, DWI can determine which patients who have TIA are at risk for subsequent large vessel infarction and can differentiate stroke from stroke mimics. With improvements in MR software and hardware, diffusion MR undoubtedly will continue to improve the management of patients who have acute stroke.     

Analysis of RNA-protein interactions by flow cytometry

Flow cytometry, in combination with advances in bead coding technologies, is maturing as a powerful high-throughput approach for analyzing molecular interactions. Applications of this technology include antibody assays and single nucleotide polymorphism mapping. This review describes the recent development of a microbead flow cytometric approach to analyze RNA-protein interactions and discusses emerging bead coding strategies that together will allow genome-wide identification of RNA-protein complexes. The microbead flow cytometric approach is flexible and provides new opportunities for functional genomic studies and small-molecule screening.     

An Eating Disorders Prevention Program

PROBLEM. To develop, implement, and evaluate a school personnel training program on eating disorders.
METHODS. The pretest-posttest control group design zuas used to examine effects of this training with 117 high school personnel. Both experimental ( n = 85) and control ( n = 32) groups were given a pretest and a posttest on knowledge and attitudes. The experimental group participated in a training program. Both groups zuere asked to keep a 3-month count of students at risk for eating disorders.
FINDINGS. Results included a significant difference in knowledge between the experimental and control groups. School personnel in the experimental group were more likely to identify students at risk for developing eating disorders.
CONCLUSIONS. Training school personnel to identify students at risk for eating disorders holds promise as a strategy for dealing with this disease. All at-risk students for eating disorders should be further evaluated and additional treatment initiated as needed.     

Susceptibility of Gram-Negative Aerobic Bacilli Resistant to Carbenicillin in a General Hospital to Piperacillin and Ticarcillin

During an 8-month period, 858 gram-negative aerobic rods resistant to carbenicillin (minimum inhibitory concentration, >/=128 mug/ml) were isolated. Susceptibility testing of 233 of these suggested that piperacillin might be active against more of these organisms than would carbenicillin or ticarcillin.