Genuine halitosis in patients with dental and laryngological etiologies of mouth odor: severity and role of oral hygiene behaviors.

The aims of the study were to determine the severity of halitosis and the association between oral hygiene practices and the severity of malodor in patients with dental and laryngological etiologies of genuine halitosis. Thirty-five laryngological and 40 dental patients with halitosis completed a structured interview and underwent laryngological and dental examinations. Halitosis was assessed using organoleptic and halimeter tests. Greater halitosis severity in laryngological patients was associated with worse clinical status of the palatine tonsils, less frequent toothbrushing, less frequent use of tongue cleaners, fewer daily meals, and increased use of mouthrinses. Among dental patients, more severe halitosis was associated with worse clinical status of the periodontium, more tongue coating, less saliva secretion, and less frequent use of dental floss, interdental toothbrushes, and tongue cleaners. Oral hygiene was found to be a key moderator of the relationship between status of the periodontium or tonsils and severity of halitosis. The severity of halitosis in laryngological patients and dental patients is essentially similar; however, oral hygiene routines are associated with different effects in each group. Consequently, individual recommendations for patients with halitosis should be adjusted for the underlying disease and emphasize the role of effective specific hygiene behaviors.

Skin care during the menopause period: noninvasive procedures of beauty studies.

Ageing is a resultant of two processes, including genetically encoded changes in an organism and modifications caused by a negative external environment impact. In the histological aspect, the skin ageing, due to endogenous factors and hormonal changes shows: excessive dryness, Malpighian layer thinning, microcirculation disorders, collagenic or elastin fiber degradation and simultaneous glycation, decreased speed of sebum and perspiration secretion. It is said that skin is a functional picture of the organism and endocrinological system. Any hormone concentration ups and downs may improve its appearance or significantly worsen its condition as well as it may lead to occurrence of dermatological changes. In adult women, the ageing process changes its significance step by step. Despite the passage of time, women want to feel good inside their skins. The adult skin is more requiring and it needs special care, often using a cosmetic apparatus. For better effect and permanent revitalization of the ageing skin, it is recommended to apply properly selected home-use cosmetic preparations. A holistic approach makes it possible to reach the skin density and thickness increase, wrinkles shallowing, humidity and resilience improvement and also recovery of the proper face oval.

Gnathostomiasis, another emerging imported disease.

Gnathostomiasis is a food-borne zoonosis caused by the late-third stage larvae of Gnathostoma spp. It is being seen with increasing frequency in countries where it is not endemic and should be regarded as another emerging imported disease. Previously, its foci of endemicity have been confined to Southeast Asia and Central and South America, but its geographical boundaries appear to be increasing, with recent reports of infection in tourists returning from southern Africa. It has a complex life cycle involving at least two intermediate hosts, with humans being accidental hosts in which the larvae cannot reach sexual maturity. The main risks for acquisition are consumption of raw or undercooked freshwater fish and geographical exposure. Infection results in initial nonspecific symptoms followed by cutaneous and/or visceral larva migrans, with the latter carrying high morbidity and mortality rates if there is central nervous system involvement. We review the literature and describe the epidemiology, life cycle, clinical features, diagnosis, treatment, and prevention of gnathostomiasis.

Gnathostomiasis acquired by British tourists in Botswana.

Infection with Gnathostoma spinigerum has been generally confined to Southeast Asia and Central and South America. However, gnathostomiasis was recently found in British tourists who had visited Botswana. Consequently, travel to Africa should now be considered a risk factor for gnathostomiasis.

[Radiotherapy of head and neck cancers]. / Radioterapia nowotworów glowy i szyi.

Radiotherapy remains the basic method of treatment of cancers. In association with surgery and chemotherapy allows to obtain higher percent of total recovery and to reduce radical operation area. The use of ionizing rays in craniofacial region risks of many complications. The typical treatment lasts 5-8 weeks, patient absorbs fractional doses once or twice a day 5 days per week. Early acute complications appear during treatment and 3 months after completing radiotherapy. They are usually reversible and last shortly. Late complications are observed within several months and even many years after completing radiotherapy. All oral complications arising from radiation can be prevented if the proper care of the patient is taken before cancer therapy begins. The dental management during radiotherapy consists of intensive fluoride prophylaxis, the use of anti-inflammatory, antibacterial, antifungal, antihistaminic and locally anaesthetic agents for prevention and treatment of mucositis. When xerostomia develops there is possibility to introduce saliva substitutes and drugs stimulating salivary flow rates. It is very important to protect the patient against osteoradionecrosis.

Advising the traveller.

Global travel continues to increase, particularly to tropical destinations that have different health risks from those encountered closer to home. Currently, over a billion people travel annually, with over 65 million visits made from the UK. Seeking pre-travel advice should be an essential part of any trip for a traveller. The key elements of pre-travel advice are health risk assessment, health promotion and risk management; this involves advice on prevention of malaria, travellers' diarrhoea, sexually transmitted infections and accidents, as well as appropriate vaccinations. Higher risk groups of travellers, such as those visiting friends and relatives, those with co-morbidities, pregnant women and very young or elderly individuals, particularly need to be targeted.

Septic shock and multi-organ failure in HIV infection-'sepsis tuberculosa gravissima'.

A profoundly immunosuppressed HIV-infected man developed sepsis syndrome with multi-organ failure. A septic screen failed to identify a bacterial or fungal cause and despite empirical treatment for these pathogens the patient remained unwell. Investigations revealed disseminated tuberculosis. With specific anti-tuberculosis therapy the patient rapidly recovered. Although most cases of sepsis syndrome in HIV-infected patients are due to bacteria, tuberculosis should be added to the differential diagnosis of this presentation.

The analysis of a personality profile of selected groups of nurses.

AIM: The analysis of a personality profile of selected groups of Polish nurses. MATERIAL AND METHODS: 72 nurses working in internal diseases departments and departments of surgery in Szczecin were investigated. To examine the personality profiles a diagnostic survey was used. It was based on an authorised Polish elaboration of Cattell's 16 Personality Factors Test. To examine their personality profile an authorised Polish elaboration of a diagnostic survey based on a standardized elaboration of personality profiles by Raymond B. Cattell was used. RESULTS: The analysis of the results indicated no significant differences between groups. The average sten scores from each of 16 examined factors were within the established limits. CONCLUSIONS: The personality profiles of the examined groups of nurses indicated a greater probability of the appearance of desirable features among the investigated people working in medical professions and demanding team cooperation, as well as relationship-building skills. Nurses, regardless of workplace, had personality traits indicating the need for education and improving occupational qualifications.

Vaccine-preventable diseases and their prophylaxis.

Global uptake of new vaccines shapes the epidemiology of infections, and in turn this changing epidemiology guides vaccine development. Once introduced, surveillance and monitoring of the impact of vaccines on disease and adverse events is vital for further development. This article reviews the use of vaccines as part of routine health care, vaccines that may be required for entry into a destination country, and vaccines that are recommended because of risk during travel. Considerations and advances in the vaccination of travelers are addressed.

Clinical predictors of bacterial meningitis in infants and young children in The Gambia.

BACKGROUND: Bacterial meningitis is an important cause of childhood morbidity and mortality world-wide. In the developing world, where the burden of acute meningitis and its long-term sequelae are especially high, staff with limited training at primary health care facilities must be able to recognize the symptoms and signs of meningitis, so that suspected cases can be referred urgently to hospitals. METHODS: Children who presented with possible invasive bacterial infection to health facilities in The Gambia, West Africa, between 1993 and 1995 were investigated in a standardized manner and clinical findings were documented. Bacterial meningitis was defined as the growth of bacteria from the cerebrospinal fluid. Clinical findings were compared between cases of meningitis and other children. RESULTS: Of 2097 children between 2 months and 3 years of age investigated, 51 had a confirmed diagnosis of bacterial meningitis. In multivariate analysis using a model adjusting for age but not including respiratory signs, the variables associated independently with meningitis were appearance of being very sick (odds ratio for meningitis vs. no meningitis or no lumbar puncture performed (OR) 4.1, 95% CI 1.5-11.1), being lethargic or unconscious (OR 5.2, 95% CI 2.1-13), a stiff neck (OR 29.3, 95% CI 12.2-70.3), a bulging fontanel (OR 3.2, 95% CI 1.2-8.5) and reduced feeding as a prompted complaint (OR 2.9, 95% CI 1.3-6.7). A combination model of a history of convulsions, or being lethargic or unconscious, or having a stiff neck, as used in the WHO-Integrated Management of Childhood Illness (IMCI) guidelines, had a sensitivity of 98% and a specificity of 72% to predict meningitis. CONCLUSIONS: A combination of a limited number of signs is sufficient to predict meningitis with high sensitivity, without a large number of children who do not have meningitis being unnecessarily referred.