Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks

Background  

Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks.     

Pretransfused patients with severe aplastic anaemia exhibit high numbers of cytotoxic T lymphocyte precursors probably directed at non-HLA antigens

Patients with severe aplastic anaemia (SAA) have a relatively high risk of graft rejection after transplantation of bone marrow from HLA-identical siblings compared with patients transplanted for leukaemia. This is presumed to be due to pretransplant blood transfusions which sensitize the recipient's immune system to non-HLA antigens expressed on donor marrow cells. To test this hypothesis, we estimated in the peripheral blood of 18 SAA patients, the frequencies of alloreactive cytotoxic T lymphocyte precursors (CTL-p) directed against mononuclear cells from syngeneic twins, HLA-identical siblings or HLA-matched unrelated individuals. The results were compared with the frequencies of CTL-p in 13 healthy subjects or leukaemia patients who had not been transfused. Pretransfused patients with SAA had significantly higher frequencies of CTL-p directed against HLA-identical siblings (P = 0.002), and against HLA-matched unrelated individuals (P = 0.004), than did untransfused individuals. In contrast, the frequency of CTL-p in two pretransfused patients against syngeneic mononuclear cells was very low. We propose that the increased numbers of CTL-p in the blood of pretransfused SAA patients are directed against non-HLA antigens on target cells and may be the result of prior blood transfusion.     

Do continence management strategies reduce falls? A systematic review

Urinary incontinence is associated with increased fall risk, and fall prevention programs include recommendations to manage continence as one component of fall reduction. However, the evidence to support this recommendation is unclear. The aim of this study was to identify continence management interventions that are effective in decreasing falls. A systematic review of the literature was conducted. Studies were included if they evaluated the effect of any type of continence management strategy on falls in older adults. The included studies were assessed for quality, and data relating to participants, interventions and outcomes were extracted by two independent reviewers. Four articles met the inclusion criteria. Two studies were randomised controlled trials, one a retrospective cohort study and one an uncontrolled intervention study. Interventions included pharmacological agents, a toileting regime combined with physical activity and an individualised continence program. Only the study evaluating the combination of physical activity and prompted voiding found an effect on falls. It is surprising that there has been so little research into continence management interventions that include fall outcomes. A toileting regime combined with physical activity may reduce falls in residential care. There is a need for further studies investigating the impact of continence management on falls.     

In vivo human cardiac fibre architecture estimation using shape-based diffusion tensor processing

In vivo imaging of cardiac 3D fibre architecture is still a practical and methodological challenge. However it potentially provides important clinical insights, for example leading to a better understanding of the pathophysiology and the follow up of ventricular remodelling after therapy. Recently, the acquisition of 2D multi-slice Diffusion Tensor Images (DTI) of the in vivo human heart has become feasible, yielding a limited number of slices with relatively poor signal-to-noise ratios. In this article, we present a method to analyse the fibre architecture of the left ventricle (LV) using shape-based transformation into a normalised Prolate Spheroidal coordinate frame. Secondly, a dense approximation scheme of the complete 3D cardiac fibre architecture of the LV from a limited number of DTI slices is proposed and validated using ex vivo data. Those two methods are applied in vivo to a group of healthy volunteers, on which 2D DTI slices of the LV were acquired using a free-breathing motion compensated protocol. Results demonstrate the advantages of using curvilinear coordinates both for the anaylsis and the interpolation of cardiac DTI information. Resulting in vivo fibre architecture was found to agree with data from previous studies on ex vivo hearts.     

A rigorous framework for diffusion tensor calculus.

In biological tissue, all eigenvalues of the diffusion tensor are assumed to be positive. Calculations in diffusion tensor MRI generally do not take into account this positive definiteness property of the tensor. Here, the space of positive definite tensors is used to construct a framework for diffusion tensor analysis. The method defines a distance function between a pair of tensors and the associated shortest path (geodesic) joining them. From this distance a method for computing tensor means, a new measure of anisotropy, and a method for tensor interpolation are derived. The method is illustrated using simulated and in vivo data.     

CHAPARRAL-INDUCED HEPATIC INJURY

Two patients with hepatic injury after ingestion of chaparral leaf are presented. The first patient, a 71-yr-old man. developed biopsy-proven hepatitis 3 months after ingesting chaparral leaf daily. His illness resolved with discontinuation of the herb and later recurred with rechallenge. The second patient is a 42-yr-old woman who developed hepatitis 2 months after chaparral leaf ingestion and recovered completely after discontinuation of the compound. Both patients have remained well with abstinence from chaparral. These reports provide evidence of the hepatotoxicity of this herb and stress the need for awareness of the potential harm from such nonprecription remedies.