Oral cancer screening: knowledge is not enough.

OBJECTIVES: The purpose of this cross-sectional study was to investigate whether dental hygienists are transferring their knowledge of oral cancer screening into practice. This study also wanted to gain insight into the barriers that might prevent dental hygienists from performing these screenings. METHODS: A 27-item survey instrument was constructed to study the oral cancer screening practices of licensed dental hygienists in Nova Scotia. A total of 623 practicing dental hygienists received the survey. The response rate was 34% (n = 212) yielding a maximum margin of error of 5.47 at a 95% confidence level. Descriptive statistics were calculated using IBM SPSS Statistics v21 software (Armonk, NY:IBM Corp). Qualitative thematic analysis was performed on any open-ended responses. RESULTS: This study revealed that while dental hygienists perceived themselves as being knowledgeable about oral cancer screening, they were not transferring this knowledge to actual practice. Only a small percentage (13%) of respondents were performing a comprehensive extra-oral examination, and 7% were performing a comprehensive intra-oral examination. The respondents identified several barriers that prevented them from completing a comprehensive oral cancer screening. CONCLUSIONS: Early detection of oral cancer reduces mortality rates so there is a professional responsibility to ensure that comprehensive oral cancer screenings are being performed on patients. Dental hygienists may not have the authority in a dental practice to overcome all of the barriers that are preventing them from performing these screenings. Public awareness about oral cancer screenings could increase the demand for screenings and thereby play a role in changing practice norms.

Naturally occurring Parelaphostrongylus tenuis-associated choriomeningitis in a guinea pig with neurologic signs.

An adult male guinea pig (Cavia porcellus) with a 1-month history of hind limb paresis, torticollis, and seizures was euthanized and submitted for necropsy. Gross examination was unremarkable, but histologic examination revealed multifocal eosinophilic and lymphoplasmacytic choriomeningitis and cross sections of nematode parasites within the leptomeninges of the midbrain and diencephalon. Morphologic features of the nematode were consistent with a metastrongyle, and the parasite was identified as Parelaphostrongylus tenuis by polymerase chain reaction testing and nucleotide sequencing. Further questioning of the owner revealed that the guinea pig was fed grass from a yard often grazed by white-tailed deer (Odocoileus virginianus). To the authors' knowledge, this is the first report of a naturally occurring P. tenuis infection in a guinea pig.

Risk factors associated with Cryptosporidium infection on dairy farms in a New York State watershed.

A cross-sectional study was carried out to determine the prevalence of Cryptosporidium parvum-like oocyst shedding on dairy farms in a watershed in New York State and to identify the factors that put animals at risk. A proportional sample of dairy herds in the targeted area was obtained, and animals were selected using a stratified sampling design to ensure representation of the population at risk. Fecal samples were collected per rectum and analyzed for the presence of C. parvum-like oocysts using the quantitative centrifugation concentration flotation technique and a proprietary enzyme-linked immunoassay. Additionally, isolates of Cryptosporidium were examined via bidirectional DNA sequencing. Data on putative risk factors were collected at the time of sampling and analyzed for association using logistic regression. The herd prevalence was 42% and the overall animal prevalence was 3.2%. The prevalence among animals less than 60 d of age was 20%. The likelihood of shedding Cryptosporidium decreased with the age of the animal and varied with the type of barn water source. Both the number of unweaned calves present at the time of the study, and whether the calves were tied vs. not tied increased the risk of infection. There was significant agreement between the flotation and PCR techniques. Sequencing revealed that 50% of the isolates were Cryptosporidium bovis, an isolate thought to be nonzoonotic.

Utility of an oral diffusion sink (ODS) device for quantification of saliva corticosteroids in human subjects.

Measurement of cortisol by assay of single blood or saliva samples is inherently imprecise due to the episodic secretion of cortisol. In addition, assay of blood usually quantifies total cortisol, rather than separating free hormone, which is proportionately the much smaller fraction. Furthermore, the free fraction may be disproportionately higher in hypercortisolism. Urinary free cortisol is one measure that provides both a time integral and a focus on the free fraction, but it is inconvenient and prone to collection error in unsupervised ambulatory subjects. The Oral Diffusion Sink (ODS) apparatus takes up corticosteroids from saliva according to first-order kinetics and may provide a practical alternative. We assessed the utility of the ODS in a study of seven healthy volunteers admitted to the CRC for three days. Data on day two from 0700-1100 h and 1100-1500 h were compared between the ODS and three other means of assessing cortisol: urinary free cortisol (UFC), blood, and saliva. The subjects all tolerated wearing the ODS device without any complaint. High correlations were observed between ODS values vs. data for UFC, plasma, and saliva determinations. In summary, the ODS device was well tolerated and collected reliable corticosteroid data, and thus provides a new, non-invasive methodology for studies of HPA function in health and disease.

Saliva as a monitoring medium for chemicals.

Saliva has been used to estimate plasma levels in humans for a variety of analytes. The potential for estimating the internal dose of pesticides in humans has been demonstrated with the rat. The utility and problems of saliva-sampling techniques remain to be investigated. Measurement of pesticides and other environmental toxicants in saliva has great potential because of sampling simplicity and the potential accuracy of using the saliva concentration of a chemical to estimate its concentration in human tissues.

Risk factors associated with Cryptosporidium parvum infection in dairy cattle in southeastern New York State.

An observational analytical epidemiologic study was carried out to identify factors associated with the risk of infection with Cryptosporidium parvum in dairy herds in southeastern New York state. A random sample of 2943 cattle on 109 farms was selected from the target population. Fecal samples were collected from animals in three different age groups and examined for the presence of C. parvum using a quantitative centrifugation concentration flotation method. Data on intrinsic, preweaning, postweaning, maternity, and general management factors were collected and evaluated for their association with the risk of infection with C. parvum. Indices for each of these categories of management were developed from factors significantly associated with the risk of infection with C. parvum. Significant factors were identified using the logistic regression statistical technique. A final analysis, including the indices, age, and season, was performed to identify factors significantly associated with the risk of infection with C. parvum while simultaneously controlling for the effect of other factors. The farm effect was evaluated using a mixed effect model. Preweaning factors found to be significantly associated with a decreased risk of infection were: use of ventilation in calf rearing areas, daily addition of bedding, feeding of milk replacer, daily disposal and cleaning of bedding, and use of antibiotics. Postweaning factors such as moving of the animals after weaning, cleaning of soiled bedding, and use of antibiotics and ionophores as preventive measures were significantly associated with the decreased risk of an infection with C. parvum. Consideration of maternity management factors showed that winter housing of cows individually within 2 months of calving, use of fresh colostrum to feed calves, and having a concrete floor in the calving area were significantly associated with decreased risk of C. parvum infection. The total number of dairy cattle, total number of other species of agricultural animals on the farm, and the distance of the barn water source from the septic system were found to be significantly associated with increased risk of C. parvum infection. In the final analysis, the risk of infection with C. parvum was significantly decreased with an increased value of the maternity management index score. The general management significantly affected the risk of infection with C. parvum where the risk increased with the increase of the value of the index. The risk of infection significantly decreased with increase in the age of the animal.

Epidemiologic study of Giardia sp. infection in dairy cattle in southeastern New York State.

To identify animal and management factors associated with the risk of Giardia sp. infection in dairy cattle in southeastern New York State, an observational analytical epidemiologic study was conducted. A random sample of 2943 animals in 109 dairy herds located in five counties of southeastern New York was selected from the target population. Fecal samples were collected from animals in the study population and examined for the presence of Giardia sp. using a quantitative centrifugation concentration flotation technique. Data on each animal, and on general management, maternity, preweaning, and postweaning practices were collected by personal interview with the farmer or farm manager. The significance of association of these factors, within each management practice group, with the risk of infection was evaluated using the logistic regression analysis. Weighted indices for each of these four groups were developed, and were evaluated together with the age of the animal and season of sampling for their significance of association with the risk of infection using mixed effect logistic regression analysis. Only the maternity management practices, age of the animal, and the season of sampling were significantly associated with the risk of infection with Giardia sp. Summer housing of bred heifers, on pasture or in tie stalls, was associated with increased risk of infection. Calves that were fed fresh colostrum or separated immediately after birth from the dam were at decreased risk of infection. The risk of infection decreased with the age of the animal and varied by the season of sampling. There was no significant extra binomial variation in the risk of infection in this data. If consideration is to be given to reducing the risk of infection with this parasite, management must be a top priority, especially in younger animals.

Prevalence of Giardia sp. Cryptosporidium parvum and Cryptosporidium andersoni (syn. C. muris) [correction of Cryptosporidium parvum and Cryptosporidium muris (C. andersoni)] in 109 dairy herds in five counties of southeastern New York.

A cross-sectional study was undertaken to determine the prevalence of Giardia sp. (G. duodenalis group), Cryptosporidium parvum and Cryptosporidium andersoni (C. muris) [corrected] in dairy cattle in three different age groups, and to evaluate the association of age and season with prevalence. One hundred and nine dairy farms, from a total of 212 farms, in five counties of southeastern New York volunteered to participate. On these farms, 2943 fecal samples were collected from three defined age groups. The farms were randomly assigned for sampling within the four seasons of the year. Each farm was visited once during the study period from March 1993 to June 1994 to collect fecal samples. Demographic data on the study population was collected at the time of sampling by interviewing the farm owner or manager. At collection, fecal samples were scored as diarrheic or non-diarrheic, and each condition was later related to positive or negative infection with these parasites. Fecal samples were processed using a quantitative centrifugation concentration flotation technique and enumerated using bright field and phase contrast microscopy. In this study, the overall population prevalence for Giardia sp. was 8.9%; C. parvum, 0.9%; and C. muris, 1.1%. When considering animals most at the risk of infection (those younger than 6 months of age) Giardia sp. and C. parvum was found in 20.1 and 2.4% of the animals, respectively. Giardia sp. and C. muris were found in all age groups. There was no significant seasonal pattern of infection for any of these parasites.

Detection of Cryptosporidium oocysts in soil samples by enzyme-linked immunoassay.

An ELISA protocol was adapted for detection of Cryptosporidium parvum oocysts in soil samples and the limit of detection of the test was determined. A modified indirect antigen capture ELISA protocol was developed using monoclonal antibodies against the oocyst outer wall. The accuracy of the ELISA was compared to spiked soil samples and measured in terms of sensitivity and specificity of the test. The performance of the ELISA was evaluated in field soil samples and measured using the kappa-statistics. Similarly, the performance of the ELISA was compared to the concentration flotation method, to a modified concentration flotation method and to a commercial ELISA (ProSpecT) in field fecal and soil samples. The limit of detection of the test was selected to be 10,000 oocysts/g. At this limit of detection, the ELISA had a sensitivity of 95% and specificity of 100%. The agreement between the ELISA and the modified flotation-concentration method in detecting Cryptosporidium oocysts in soil samples was 32% (kappa=0.32). The ELISA had the same relative sensitivity (82%) in comparison to both the flotation and ProSpecT in determining Cryptosporidium-infection status of an animal. The kappa-statistics was 0.26 for both tests. The developed ELISA proved to be a valuable diagnostic test for detecting oocysts in soil samples and has a potential application in determining the infection status of animals.

Radiolabeling and autoradiographic tracing of Toxocara canis larvae in male mice.

Artificially hatched infective larvae of Toxocara canis were labeled with 75Se in Medium 199 (Gibco) containing 75Se-methionine. Male CD-1 mice were infected with radiolabeled larvae by intragastric intubation or by intraperitoneal injection. At intervals of 3-56 days mice were killed and the organs prepared for compressed organ autoradiography. Radioactivity of parasitic larvae showed an exponential decrease with time, reflecting catabolism of label with a biological half life of 26 days (effective half life of 21 days) making possible experiments lasting several months. Total body larva counts, estimated by total body autoradiography, displayed an overall downward trend, but the rate of reduction was probably not constant because no significant positive or negative trends were noted from day 14 onward in the numbers of larvae. The carcass accumulated the greatest number of larvae followed by the central nervous system, liver, and lung in that order. When the numbers of larvae were considered in relationship to the mass of tissue, there were 4 groupings: central nervous system, liver, lung, carcass, and kidney, and genito-urinary organ, pelt, and intestine. No significant difference between intragastric and intraperitoneal administration was observed in the larval distribution after the larvae had left the initial site of deposition.

Schistosoma mansoni: mechanism of attrition and routes of migration from lungs to hepatic portal system in the laboratory mouse.

The number of schistosomula in the axillary lymph nodes of mice was determined by compressed tissue autoradiography at 13 intervals from 0.5 to 28 days after exposure of abdominal skin to 75Se-labeled cercariae of S. mansoni. Significant accumulations were observed between days 3 and 6 and peaked on day 4 at which time 9.4 +/- 1.1% of the schistosomula present in the whole body were found in the axillary lymph nodes. The total number and distribution of schistosomula in all tissues of mice were likewise determined at 12 intervals from 3 to 24 days following exposure. The frequent appearance of small numbers of schistosomula in trachea and esophagus suggested that normal attrition resulted at least in part from physical expulsion of schistosomula from the body by way of the tracheobronchial tree and gastrointestinal tract. The distribution of schistosomula observed in heart chambers, caudal vena cava, hepatic portal vein, aorta, intestinal wall, thoracic cavity rinses, and diaphragm supported all 3 standing hypotheses regarding route of migration from lungs to hepatic portal system, i.e., that schistosomula migrate via (1) the pulmonary artery, right heart, caudal vena cava, and hepatic veins, (2) the pulmonary vein, left heart, aorta, and cranial mesenteric artery, and (3) the thoracic cavity and diaphragm.

Prevalence of patent Baylisascaris procyonis infection in raccoons (Procyon lotor) in Ithaca, New York.

The prevalence of patent Baylisascaris procyonis infection in raccoons was determined by examining fecal samples collected between July 1986 and May 1987 in Ithaca, New York. September, October, and November had the highest prevalence of infection (35-48%). Significant differences (P less than 0.001) were found when months were grouped by season to test the hypothesis that a fecal sample's probability of being positive does not vary from month to month. Fall was the season contributing most to the overall chi-square statistic. Host sex/age class and prevalence of patent infection were investigated. The raccoons were aged as either juveniles or adults. A significantly higher prevalence of patent infection (P less than 0.001) was found in juveniles when compared to adults. No statistically significant difference was found in other comparisons of host sex and age. Contingency analysis tested the independence of sex/age class/season and presence of eggs. The results of the test were significant (P less than 0.001).

Prevalence of enteric zoonotic agents in cats less than 1 year old in central New York State.

A prevalence study of several enteric zoonotic bacterial and parasitic infections was conducted in 263 fecal samples from cats that were between 1 and 12 months old, and that were in humane shelters (n = 149) or were presented to primary-care veterinarians (n = 114). Of these samples, 2 (0.8%) were positive for Campylobacter, 2 (0.8%) were positive for Salmonella, and 10 (3.8%) were positive for Cryptosporidium, confirming that these zoonotic agents are relatively rare in cats. Toxocara cati (33.0%) and Giardia (7.3%) were found more commonly. At least 1 zoonotic agent was detected in 105 samples (40.7%). Our results suggest that clinical signs such as diarrhea are not reliable predictors of whether a cat is actively shedding enteric organisms. Therefore, the decision to test a newly adopted cat should be based on the potential risks to the client rather than on the cat's clinical presentation. The high prevalence of T. cati confirms that comprehensive testing or treatment for ascarids is warranted in newly adopted kittens.

Number of Cryptosporidium parvum oocysts or Giardia spp cysts shed by dairy calves after natural infection.

OBJECTIVE: To determine the total number of Cryptosporidium parvum oocysts and Giardia spp cysts shed by dairy calves during the period when they are most at risk after natural infection. ANIMALS: 478 calves naturally infected with C. parvum and 1,016 calves naturally infected with Giardia spp. PROCEDURE: Oocysts or cysts were enumerated from fecal specimens. Distribution of number of oocysts or cysts versus age was used to determine the best fitting mathematic function. Number of oocysts or cysts per gram of feces for a given duration of shedding was computed by determining the area under the curve. Total number of oocysts or cysts was calculated by taking the product of the resultant and the expected mass of feces. RESULTS: Intensity of Cparvum oocyst shedding was best described by a second-order polynomial function. Shedding increased from 4 days of age, peaked at day 12, and then decreased. An infected 6-day-old calf would produce 3.89 x 10(10) oocysts until 12 days old. Pattern of shedding of Giardia spp cysts was best described by exponential functions. Intensity of shedding increased from 4 days of age, peaked at day 14, and then decreased. An infected calf would produce 3.8 x 10(7) cysts from day 50 until day 56. CONCLUSIONS AND CLINICAL RELEVANCE: The large number of oocysts and cysts shed indicates that shedding by dairy cattle poses a risk for susceptible calves and people. Estimates reported here may be useful to aid in designing cost-effective strategies to manage this risk.

Eurytrema procyonis in a raccoon (Procyon lotor) from New York state--a first report.

The digenean, Eurytrema procyonis, found in the pancreatic ducts of the raccoon (Procyon lotor), is reported for the first time from a juvenile female raccoon captured in July 1987, in New York State (USA). The presence of greater than 183 trematodes in the pancreatic ducts was an incidental finding at necropsy to an interstitial pneumonia which had caused emaciation, and for which the animal was euthanized. The pancreas, with the exception of the major pancreatic duct, was histologically normal. The duct, containing the parasites, was dilated and contained a diffuse subepithelial inflammatory infiltrate consisting primarily of eosinophils. Epithelial hyperplasia was present in tubulo-alveolar glands, and goblet cells were prominent.

Diffusion-sink sampling for minimally invasive measurement of tissue available hormones.

The interpretation of hormone concentrations measured in blood plasma is made difficult by some features of hormone physiology that are common to many endocrine systems: 1) secretion occurs in episodes; and 2) specific binding proteins profoundly influence the availability of hormone to tissue. Frequently repeated sampling and specific measurement of the freely diffusing hormone concentration are thus desirable. Traditional methods to this end are invasive, laborious, and frequently impractical. Diffusion-sink (DS) devices that are able to continuously sample the freely-diffusing concentration of a hormone in a biological fluid over a period of time have been built; these devices can be used for minimally invasive sampling. For some steroid hormones, DS devices can be worn orally to estimate tissue-available hormone in saliva; direct installation of DS devices in interstitial fluid is also possible. Experience to date in using these devices to measure corticosteroids and progesterone suggests several practical advantages, including: 1) similar time-averaging capability as with invasive area-under-the-curve methods; 2) specificity for the freely-diffusing concentration even in the presence of varying concentrations of protein-bound forms; and 3) ability to sample under conditions where traditional methods are prohibitively invasive, such as normal work and sleep. The diffusion-sink sampling approach can probably be combined with appropriate immunoassay methodologies to yield measurements that are simple and quick enough for routine clinical use.

Verminous encephalitis in a horse produced by nematodes in the family protostrongylidae.

Parasitic granulomatous eosinophilic inflammation was observed in the central nervous system (CNS) of a 6-month-old Arabian colt from New York state. Inflammation was associated with eggs, larvae, and adult nematodes in the cerebellum. Nematodes had histological characteristics of the superfamily Metastrongyloidea. The presence of dorsal-spined larvae in the CNS was further indicative of infection with a nematode in the family Protostrongylidae. Infections were most compatible with Parelaphostrongylus tenuis but specific diagnosis was not possible. This is the first definitive report of a protostrongylid nematode infection in a horse.

Less-invasive measurement of tissue availability of hormones and drugs: diffusion-sink sampling.

The use of small diffusion-sink sampling devices allows the relatively noninvasive and unobtrusive collection of a specimen that represents, in a precisely interpretable way, the average freely diffusing concentration of an analyte over a biologically relevant period of time. In an orally worn configuration, these sampling devices reject artifacts arising from blood plasma contamination of saliva and provide a time-averaged sample without requiring the subject to adhere to a frequent-sampling schedule. The practical advantages of noninvasiveness are thus combined with a fairly direct method for measuring what seems, in light of our current understanding, most important to know about the relative abundance of the steroid hormones. Whether this specificity of measurement also has practical benefits has yet to be tested.