Temporomandibular joint involvement caused by Borrelia Burgdorferi

BACKGROUND: Lyme borreliosis is an endemic disease in Slovenia with an incidence of around 150 patients per 100,000 inhabitants. Although the large joints are most typically affected in Lyme borreliosis, there are also periods of disease activity with arthritis or arthralgias involving smaller joints, including the temporo-mandibular joint. PATIENTS: During the years between 2000 and 2003, two patients with Lyme borreliosis affecting the temporo-mandibular joints were treated. The patients presented with fatigue and pain in diverse muscle groups accompanied by arthralgia, which was most pronounced in the temporomandibular joint area. None of the patients were febrile or had joint effusions. METHODS: Both patients were examined by means of biochemical and serological examinations for Borrelia burgdorferi using ELISA assay and Western blot test (both for IgM and IgG), plain radiographs, MR and CT scans, and scinti-scan of the temporo-mandibular joints They both had positive serum markers for an acute B. burgdorferi infection and were treated with intravenous ceftriaxone. RESULTS: None of the patients had clinical or laboratory signs of chronic Lyme disease activity two and four years following therapy, respectively. Roentgenographic and nuclear magnetic resonance imaging of the temporo-mandibular joints had not shown any persistent sign of acute inflammation. CONCLUSION: There are only few reports of patients with manifest temporo-mandibular joint involvement of Lyme borreliosis in the literature. This report emphasizes the importance of differential diagnosis of acute temporo-mandibular joint arthralgia, of early diagnosis of Lyme borreliosis, and of the necessity for prompt antibiotic treatment.     

Immunotherapy of HNSCC: Studies in a murine model of oral cancer

Annual incidence of Head and Neck Squamous cell carcinoma (HNSCC) is over 500,000 worldwide and it is the sixth leading cause of cancer related deaths.     

Utility of radiographic crestal lamina dura for predicting periodontitis disease-activity

Abstract. The relationship between radiographic crestal lamina dura and periodontitis disease-activity was studied longitudinally in 51 treated adult patients on a systematic 3-month maintenance program. The presence or absence of crestal lamina dura at 1809 interproximal sites was scored from periapical and bitewing radiographs taken at baseline of a 36-month maintenance care period. Semi-annual clinical evaluations by 2 independent examiners were carried out on each patient, with disease recurrence defined as sites revealing a 3 mm increase in probing depth from baseline, or a 2 mm increase in probing depth together with a 2 mm loss of relative attachment level from an occlusal stent. Over the 36-month study period, 23 (45%) patients exhibited disease recurrence at 55 (3%) interproximal tooth sites scored for baseline crestal lamina dura. Absence of detectable baseline crestal lamina dura yielded high sensitivity (87–100%), but low specificity (17%) and low positive predictive values (0.8–3.2%), for localized periodontitis recurrence. In contrast, no sites exhibiting an intact baseline crestal lamina dura demonstrated periodontitis recurrence up to 24 months from baseline (100% positive predictive values). Presence of radiographic crestal lamina dura was positively associated with clinical periodontal stability (summary odds ratio for sites = 2.6, P = 0.0004), and negatively associated with periodontitis recurrence (summary odds ratio for sites = 0.4, P = 0.0004), for the 36-month study period. Evaluation of radiographic crestal lamina dura status appears valuable for assessing the risk of periodontitis disease-activity at interproximal tooth sites in patients on maintenance care programs.     

A Profile of Black and Hispanic Subgroups'' Access to Dental Care: Findings from the National Health Interview Survey

This study examined which black and Hispanic minority subgroups were least likely to obtain dental care and why, based on logistic regression analyses of the 1986 National Health Interview Survey. Blacks and Hispanics were less apt to have private dental insurance coverage, to be knowledgeable about the purpose of fluoride, to have been to a dentist in the past year, and, when they did go, were more apt to have gone in response to symptoms rather than for preventive reasons, compared to whites. Logistic regression analyses for adults 18 years of age and older and for children and adolescents 2 to 17 years of age showed that the following individuals had the lowest probability of having been to a dentist in the past year: males, members of larger families, adults who were unemployed or in blue-collar jobs, those who lived in the South or nonmetropolitan areas, people who perceived their health to be fair or poor, and those with no private dental insurance. Mexican-Americans were least likely to have been to a dentist regardless of their income or education. In general, the findings confirmed the importance of dental insurance, as well as suggesting a need for more school-based dental programs and public health clinic-based dental health education and outreach efforts for targeting minority children and adults.     

Validation of the Defining Characteristics of the Nursing Diagnosis Ineffective Airway Clearance

The investigators designed this validation study to determine the defining characteristics of the nursing diagnosis ineffective airway clearance. Using Fehring's Diagnostic Content Validity Model, 546 nurses who care for respiratory clients validated one major and 19 minor defining characteristics. Nine characteristics previously described in the literature were eliminated. Clarification of the defining characteristics of this diagnosis improves communication in practice, education and research.     

Evaluation of dot-ELISA for serological diagnosis of amebiasis

 We improved the dot enzyme-linked immunosorbent assay (dot-ELISA) reported by Itoh and Sato, and assessed the usefulness of this test for the diagnosis of amebiasis. The sensitivity of dot-ELISA was compared with that of plate ELISA, the indirect hemagglutination test (IHA), and the indirect fluorescent antibody test (IFA) for the diagnosis of amebiasis. Of 37 serum samples from patients with documented amebiasis, 36 (97.3%) were positive by dot-ELISA. There was consistency among the results of dot-ELISA, plate ELISA, and IFA, although the positive rate of IHA was lower than that of the others (78.4%; 29 of 37 cases were positive). The specificities of dot-ELISA and plate ELISA were assessed using a total of 68 sera, collected from 38 patients infected with seven different parasites other than Entamoeba histolytica, 10 patients showing diarrhea or liver abscess without parasitic infection, and 20 healthy individuals. The two assays showed no false-positive results. There were no differences in sensitivity and specificity between dot-ELISA and plate ELISA. However, the dot-ELISA technique seems to be more feasible for clinical application than plate ELISA techniques, because the assay does not require any specific equipment. Received: July 8, 2002 / Accepted: December 7, 2002 RID="*" ID="*" A summary of this paper was presented at the 74th General Meeting of the Japanese Association for Infectious Diseases (Fukuoka, April 2000). Acknowledgments The authors are indebted to Professor Tsutomu Takeuchi and Dr. Seiki Kobayashi, Department of Tropical Medicine and Parasitology, Keio University School of Medicine, for supplying E. histolytica antigen, and to Dr. Hiroshi Yamasaki, Department of Parasitology, Juntendo University School of Medicine, for supplying recombinant Toxocara canis antigen for this study.     

A knowledge based interpretation system for EMG abnormalities

The conventional method of diagnosis in electromyography is complex and time consuming, not only due to the large number of parameters, to be considered for diagnosis, but also because of the usual procedure of evaluating the different parameters of EMG signal by visual scanning of the plotted signal. So there is a clear need to make use of computer aided decision support system. In the present work an attempt has been made in the direction of integration into one automated system, the qualitative knowledge of the physician, with possibly sophisticated signal analysis tools which must replace the visual scanning. A software program (in Turbo-C) on a PC-AT has been developed to evaluate the different parameters of MUAP's (motor unit action potential) in a EMG signal. Then an Expert system (in Turbo-Prolog) has been implemented for diagnostic purposes of different muscular abnormalities by making a knowledge base from the different parameters involved in the decision making procedure of clinical electromyography. A hybrid model of rule and frame based Expert system is implemented. An attempt has been made for making a complete system, i.e., for recording, analysis and decision making for diagnosis.     

悬雍垂腭咽成形术治疗睡眠呼吸障碍的有效性与安全性的系统评价

目的系统评价悬雍垂腭咽成形术(UPPP)治疗睡眠呼吸障碍的有效性及安全性.方法电子检索MEDLINE(1966～2005)、EMBASE(1984～2005)、Cochrane图书馆(2005年第1期)、中国生物医学文献光盘数据库(1979～2005)、中文学术期刊全文数据库(1994～2005)、中文科技期刊全文数据库(1989～2005),中文生物医学期刊数据库(1994～2005)、万方数据库以及互联网资料.文献检索语种限制为英文及中文.纳入有关UPPP的随机对照试验、半随机对照试验以及前瞻性对列研究.由两名研究者独立对纳入研究的方法学进行质量评价,资料统计分析采用RevMan4.2.7软件.结果共纳入12个研究,其中随机对照研究5个,前瞻性队列研究7个.UPPP与口腔矫形器(DA)比较,DA组多导睡眠呼吸监测(PSG)参数的改变优于UPPP组,但UPPP组术后生存质量评价及治疗依从性优于DA组;UPPP与激光悬雍垂腭咽成形术(LAUP)、低温等离子射频消融术(RFTVR)比较,后两者术后疼痛较UPPP组轻,术后并发症发生率UPPP与LAUP比较差异无统计学意义,与RFTVR比较除术后1周鼻腔反流的发病率较高外,其余差异无统计学意义.没有试验对UPPP与LAUP及RFTVR术后PSG参数的改变进行比较;与持续鼻腔正压通气比较,UPPP对PSG参数改变更优.结论目前尚无充分证据表明UPPP治疗睡眠呼吸障碍疗效优于其它治疗,也无证据表明哪种治疗方式疗效最佳.由于本研究纳入的文献语种仅限于中文及英文,可能会漏掉一些有价值的文献;所纳入的文献数量少、质量低,使论证强度受到一定限制,在今后的临床工作中有必要进行大样本含量,高质量的临床随机对照研究.