Assessment of atmospheric microbial contamination in a mobile dental unit.

INTRODUCTION: Bioaerosols are important considerations in infection control as well as in occupational health. Bioaerosols may carry potentially hazardous microbes, viruses, fungi, allergens, and other toxic substances that may harm the dental operator, patient, and the dental assistant by causing nosocomial infections. OBJECTIVE: To assess the level of atmospheric microbial contamination before, during, and after dental treatment procedures in the dental operatory of a mobile dental unit (MDU). MATERIALS AND METHODS: The study included three treatment sessions on different working days, with an interval of one month. The MDU was fumigated before the start of the study. Brain Heart Infusion Agar with 5% sheep blood was used to collect the gravitometric settling of aerosols produced before, during, and after dental treatment procedures. The agar plates were sent for aerobic and anaerobic culture. RESULTS: The results showed that atmospheric microbial contamination (CFUs/plate) was 4 times higher during working sessions as compared to the levels before the working sessions. At the end of the working day, aerosols decreased by almost 3 times that seen during work. CONCLUSION: The aerosols increased during and after work sessions. This shows the increased risk of transmission of infectious agents to the dentists who work in the MDU. Hence, all necessary preventive measures should be advised and need to be followed strictly.     

Postoperative adjuvant radiotherapy and 5-fluorouracil chemotherapy for rectal carcinoma

Postoperative combined modality therapy with radiotherapy and 5-fluorouracil (5FU) chemotherapy is an effective adjuvant approach that reduces locoregional and distant metastatic disease in patients with high-risk rectal carcinoma. However, this approach results in a treatment regimen of at least 6 months’duration. The present prospective study investigates the integration of radiotherapy and 5FU chemotherapy in a protocol designed to minimize toxicity and reduce the overall treatment time. A total of 40 patients with TNM stage II or III disease received postoperative radiotherapy at four fractions per week with weekly 5FU bolus injections delivered on the fifth non-radiotherapy day. Patients also received systemic chemotherapy with leucovorin both before and after pelvic irradiation, with the total treatment duration extending for only 18 weeks. Patients were able to complete radiotherapy in 90% of cases, while the delivery of full-dose chemotherapy was achievable in the vast majority. The incidence of haematologic and gastrointestinal toxicities requiring the cessation of treatment was acceptable. With a median follow-up of 20.9 months among surviving patients, the estimated progression-free and overall survival at 2 years were 71 % and 79%, respectively.     

Effects of protective immune serum on the yields of parasites and pulmonary cell reactions in schistosome-infected rats

Yields of parasites during the period of worm migration from the lungs to the portal circulation were measured in S. mansoni-infected Fischer rats passively immunized with protective serum from twice-infected donor rats. Two effects of protective serum were observed in recipient rats relative to normal serum recipients: yields of schistosomula from lungs were higher and yields of (immature) worms from the portal circulation were lower throughout the period analyzed. Histopathological analysis of lung tissue confirmed the presence of greater numbers of schistosomula in lungs of passively immunized rats. In addition, the percent of lung schistosomula involved in all categories of inflammatory reactions was greater in recipients of protective rat serum. The kinetics of accumulation of worms perfused from the portal circulation of normal and passively immunized rats indicate that in the latter group a smaller fraction of worms successfully migrates to the portal circulation. These findings support the hypothesis that protective activity of the serum prevents a portion of worms from successfully completing migration from the lung to the portal circulation.     

A case of mucormycosis limited to the parotid gland

BACKGROUND: Mucormycosis is a rare fungal infection commonly affecting structures in the head and neck such as air sinuses, orbits, and the brain. Common predisposing factors include diabetes and immunosuppression. To date, only one case of mucormycosis involving the parotid gland has been reported, and this infection was associated with a fatal outcome. METHODS: We report a case of parotid gland mucormycosis in a 45-year-old woman with type 2 diabetes, who was successfully treated with a superficial parotidectomy and intravenous amphotericin B. RESULTS: After initial surgical and antifungal therapy, the patient was left with a residual facial nerve palsy for which multiple sling procedures were performed. She is currently alive and well 6 years after the diagnosis of mucormycosis. CONCLUSIONS: Mucormycosis of the parotid gland is a rare form of this often-fatal infection. In this case, infection remained isolated to the parotid gland and was diagnosed soon after presentation. The patient most likely survived because of the early diagnosis, successful surgical removal of all infected tissue, use of intravenous amphotericin therapy, and the aggressive management of comorbidities such as her diabetes.     

Synchronous oral and gastric carcinoma. An incidental finding on Percutaneous Endoscopic Gastrostomy insertion

Synchronous oral and gastric carcinoma in the western world is rare. We report a case of synchronous oral squamous cell carcinoma (SCC) and gastric adenocarcinoma which was found as an incidental finding during placement of a Percutaneous Endoscopic Gastrostomy (PEG) before resection of the oral tumour.     

Slight Abduction/Adduction Deviations in Femur Positioning for Dual-Energy X-Ray Absorptiometry are Inconsequential

Straight femur alignment during dual-energy X-ray absorptiometry (DXA) acquisition is assumed to help ensure accurate bone mineral density (BMD) measurement. Use of bilateral femur positioners may not result in straight femur alignment. To assess the effect of a bilateral femur positioner on DXA results, we compared a standard fixed-width bilateral femur positioner with an adjustable-width positioner that allowed for straight femur alignment. BMD values obtained from the adjustable-width bilateral femur positioner were highly correlated (R² = 0.98–0.99) with those obtained using a fixed-width positioner. The mean bias in BMD between the fixed- and adjustable-width positioner was low (?0.001 to +0.006 g/cm²) at all proximal femur regions of interest. In this study, the use of a fixed-width bilateral femur positioner and associated deviations in femur alignment have little consequence on BMD measurement.