Population-Level Patterns of Prostate Cancer Occurrence: Disparities in Virginia.

Prostate cancer is the most common cancer and the second leading cause of cancer-related deaths among men in the United States. In Virginia, which is a representative, ethnically diverse state of more than 8 million people that was established nearly 400 years ago, prostate cancer has the highest rate of new detection for any type of cancer. All men are at risk of developing prostate cancer regardless of demographics, but some men have an increased mortality risk due to cancer metastasis. Notably, one in five African American men will be diagnosed with prostate cancer in their lifetime and they have the highest prostate cancer mortality rate of any ethnic group in the United States, including Virginia. A person's genetic profile and family history are important biological determinants of prostate cancer risk, but modifiable environmental factors (e.g., pollution) appear to be correlated with patterns of disease prevalence and risk. In this review, we examine current perspectives on population-level spatial patterns of prostate cancer in Virginia. For context, recent, publicly available data from the Centers for Disease Control and Prevention are highlighted and presented in spatial format. In addition, we explore possible co-morbidities of prostate cancer that may have demographic underpinnings highlighted in recent health disparity studies.

The histone chaperone Asf1 is dispensable for direct de novo histone deposition in Xenopus egg extracts.

Histone chaperones that escort histones during their overall lifetime from synthesis to sites of usage can participate in various tasks. Their requirement culminates in the dynamic processes of nucleosome assembly and disassembly. In this context, it is important to define the exact role of the histone chaperone Asf1. In mammals, Asf1 interacts with two other chaperones, CAF-1 and HIRA, which are critical in DNA synthesis-coupled and synthesis-uncoupled nucleosome assembly pathways, respectively. A key issue is whether Asf1 is able or not to deposit histones onto DNA by itself in both pathways. Here, to delineate the precise role of Asf1 in chromatin assembly, we used Xenopus egg extracts as a powerful system to assay de novo chromatin assembly pathways in vitro. Following characterization of both Xenopus Asf1 and p60 (CAF-1), we used immunodepletion strategies targeting Asf1, HIRA, or CAF-1. Strikingly, the depletion of Asf1 led to the simultaneous depletion of HIRA and consequently impaired the DNA synthesis-independent nucleosome assembly pathway. The rescue of nucleosome assembly capacity in such extracts was effective when adding HIRA along with H3/H4 histones, yet addition of Asf1 along with H3/H4 histones did not work. Moreover, nucleosome assembly coupled to DNA repair was not affected in these Asf1/HIRA-depleted extracts, a pathway impaired by CAF-1 depletion. Thus, these data show that Asf1 is not directly involved in de novo histone deposition during DNA synthesis-independent and synthesis-dependent pathways in egg extracts. Based on our results, it becomes important to consider the implications for Asf1 function during early development in Xenopus.

Pseudo-dental pain and sensitivity to percussion.

Two case reports examine a little-known cause of dental pain and sensitivity to percussion. Contrary to the traditional assumption that pain and sensitivity to percussion almost always are diagnostic of pulpal inflammation and/or necrosis, these symptoms actually may be referred to the sensitive tooth from trigger points in the masticatory muscles. Therefore, myofascial pain syndrome must be ruled out in patients who have dental pain and display sensitivity to percussion.

Enigmatic pain referred to the teeth and jaws.

A number of obscure syndromes can mimic dental or jaw pain in the absence of pathosis within these structures. This enigmatic dental pain includes conditions such as pretrigeminal neuralgia, complex regional pain syndrome, temporal tendinitis, and carotodynia. Each of these syndromes is described through a pertinent case report to illustrate appropriate diagnosis and treatment.

Anesthetic efficacy of the supplemental intraosseous injection for teeth with irreversible pulpitis.

The purpose of this study was to determine the efficacy of a supplemental intraosseous injection (IOI) of 2% lidocaine with 1:100,000 epinephrine using the Stabident device, after conventional anesthetic methods had failed. Patients who experienced pain during endodontic access and required a supplemental IOI using 0.45 to 0.90 ml of the local anesthetic were identified. All 37 of the patients treated had teeth diagnosed with irreversible pulpitis. Thirty-four of the teeth were mandibular posterior teeth, 2 were maxillary posterior teeth, and 1 was a maxillary anterior tooth. Patients with maxillary teeth had received infiltration anesthesia, and those with mandibular teeth had received an inferior alveolar nerve block in conjunction with long buccal infiltration. A minimum of 3.6 ml of local anesthetic was used with the conventional techniques. Modified visual analogue scales, coupled with operator evaluations, were used to measure success. The Stabident IOI was an effective supplemental anesthetic technique in 89% (+/- 5.1) or 33/37 patients evaluated. The 95% confidence interval was 74 to 97%. The IOI was successful in 91% (+/- 4.9) of the mandibular posterior teeth (31/34), and 67% of the maxillary teeth (2/3).

Current perspectives on dental patients receiving coumarin anticoagulant therapy.

Despite approximately 40 years of experience with oral anticoagulant drugs, controversy still exists about the safety of dental treatment in a patient receiving this therapy. The authors review the topic in depth and offer detailed recommendations for the dental management of patients receiving coumarin anticoagulant therapy.

Angina: an update for dentistry.

Advances in medicine have dramatically altered the diagnosis and treatment of angina and the prognosis for patients with this condition. The authors review current medical practices and make recommendations for the dental management of patients.