Proposed requirements for a European Doctorate in Dentistry: a discussion document prepared by a special interest group under the auspices of the Association for Dental Education in Europe.

In the Bologna process a third cycle is distinguished at the doctoral level. In documents on the Bologna process it is advocated to harmonise the structure and requirements of the doctorate, which in Europe are characterised by a wide variety. Differences exist in all possible requirements between countries, and even between schools within one country differences can be seen. In this paper an inventory is made of these differences in the dental doctorate between European countries. Moreover, the need for necessary harmonisation of requirements for a European dental doctorate is strongly advocated and a proposal is presented.

Immediate erosive potential of cola drinks and orange juices.

Little is known about the erosive potential of soft drinks within the first minutes of exposure to teeth, and about the potentially protective role of salivary proteins. We hypothesized that the erosive potential is determined primarily by pH and decreases in the presence of salivary proteins. To investigate this, we first added uncoated hydroxyapatite crystals and, second, salivary-protein-coated hydroxyapatite crystals to 20 commercially available cola drinks and orange juices simultaneously, with pH recordings every 15 sec for 3 min. The amount of apatite lost per liter of soft drink per sec was calculated from titratable acidity values to each pH obtained by crystal addition. The erosive potential within the first minutes of exposure was determined solely by the pH of the drink, and the erosive potential was ten-fold higher in cola drinks compared with juices. However, salivary proteins reduced the erosive potential of cola drinks by up to 50%.

Calcium-dependent incorporation of choline into phosphatidylcholine (PC) by base-exchange in rat brain membranes occurs preferentially with phospholipid substrates containing docosahexaenoic acid (22:6(n-3)).

The fatty acid composition of phosphatidylcholine (PC) formed by base-exchange was examined in rat brain membranes in vitro. The free choline incorporated into subspecies of PC by this phospholipase-D type activity can be distinguished from that which might enter indirectly via the last enzyme of the de novo pathway for phospholipid biosynthesis, cholinephosphotransferase, by its ionic requirements. Choline base-exchange in lysed synaptosomes is optimal when assayed at extracellular (mM) calcium concentrations and is blocked by magnesium. As much as 40% of the choline incorporated by base-exchange into rat brain membranes was recovered in subspecies of PC, representing no more than 10% of the total PC pool, which contained docosahexaenoic acid (22:6(n-3)). Docosahexaenoic acid is enriched in electrically-excitable membranes and its content in phospholipids of rat and human brain change during early development and increase with age.

Bis(monoacylglycero)phosphate from PC12 cells, a phospholipid that can comigrate with phosphatidic acid: molecular species analysis by fast atom bombardment mass spectrometry.

Phospholipids from pheochromocytoma (PC12) cells were purified by one-dimensional thin-layer chromatography (TLC). Material corresponding in RF to phosphatidic acid (PA) was analyzed by fast atom bombardment mass spectrometry (FAB). The molecular ions of the major constituents corresponded in mass to phosphatidylglycerols (PG), which, however, have a lower RF value. Analysis of the mass spectra demonstrated that this material consists of bis(monoacylglycero)phosphates (BMP, lysobisphosphatidic acid), a structural isomers of PG. Linked scans of individual molecular ions indicate that BMP from PC12 cells is esterified almost exclusively with monounsaturated (16:1 and 18:1) and polyunsaturated (20:4 and 22:6) fatty acids. One of the two major molecular species contains two monounsaturated (18:1/18:1), while the other contains both a monounsaturated (18:1) and a polyunsaturated (22:6) fatty acid ester. FAB in combination with TLC is ideally suited for analysis of molecular species of phospholipids.

Phospholipase D-catalyzed hydrolysis of phosphatidylcholine occurs with P-O bond cleavage.

Mammalian phospholipase D has been implicated in signal-transduction mechanisms, most recently in association with stimuli that enhance phosphatidylcholine (PC) turnover. It was previously unknown whether hydrolysis of PC by phospholipase D proceeds via P-O or C-O bond cleavage. Commercially available phospholipase D isolated from Streptomyces chromofuscus was used to hydrolyse distearoyl phosphatidylcholine (PC) in a detergent-containing buffer consisting of 90% 18O-water. The product of hydrolysis, phosphatidic acid (PA), was purified by thin-layer chromatography and analyzed using californium-252 plasma desorption mass spectrometry. An increase of two mass units was observed, compared to a distearoyl PA control, consistent with a reaction mechanism involving cleavage of the P-O bond.

Recognizing the pleckstrin homology domain fold in mammalian phospholipase D using hidden Markov models.

Phospholipase D was first described in plant tissue but has recently been shown to occur in mammalian cells where it is activated by cell surface receptors. Its mode of activation by receptors in unclear. Biochemical studies suggest that it may occur downstream of other effector proteins and that small GTP-dependent regulatory proteins may be involved. The sequence in a non-designated region of mammalian phospholipase D1 and 2 shows similarity to a structural domain that is present in signalling proteins that are regulated by protein kinases or heterotrimeric G-proteins. Mammalian phospholipase D has structural similarities with other lipid signalling phospholipases and thus may be regulated by receptors in an analogous fashion.

Characterization of estradiol receptors in brain cytosols from perinatal ferrets.

Studies were undertaken to characterize the binding of [3H]estradiol ([3H]E2) to blood plasma and to brain cytosols collected from perinatal ferrets of both sexes. A dialysis experiment showed that the binding capacity of plasma for [3H]E2 was low in neonatal ferrets. Saturable, high-affinity binding of [3H]E2 to cytosols prepared from ferret hypothalamus + preoptic area (H + POA), basal temporal lobe, and midbrain + brainstem (sexes pooled) was demonstrated 5 days prior to the date of expected parturition (42-day gestation), as well as on the day of birth and on postnatal days 5 and 10. The binding of E2 to cytosols prepared from H + POA and temporal lobe of newborn ferrets met established criteria for estrogen receptors: (a) it was saturable; (b) it had a high affinity (Kd approximately 10(-10) M); (c) it was apparently macromolecular since it migrated in front of a 4.7 S dansyl-bovine serum albumin marker on sucrose gradients of low ionic strength and eluted in the void volume of Sephadex LH-20 columns; (d) it was apparently proteinaceous since binding was destroyed by preincubation with pronase; and (e) it was steroid-specific. Previous research suggests that perinatal exposure to E2 causes neither behavioral defeminization nor masculinization in the developing ferret. The present findings raise the question of whether estrogens, acting via neural receptors, normally affect brain development in ferrets of either sex.

Malnutrition in critically ill infants and children.

The prevalences of acute and chronic protein-energy malnutrition (PEM) and deficiencies in stores of fat and somatic protein have not been previously examined in pediatric intensive care unit. One hundred eight nutritional assessments were performed using anthropometric techniques on infants and children in a multidisciplinary intensive care unit. Overall, the prevalence of acute PEM was 19% and chronic PEM was 18%. The prevalence of fat store depletion was 14% and somatic protein store depletion was 21%. In general, children less than 2 years had poorer nutritional status compared to children greater than 2 years. There was not a statistically significant difference between medical and surgical patients. It is concluded that PEM and deficiencies in the macronutrient stores of fat and somatic protein are common in critically ill infants and children.

Issues in airway management--1988.

Knowledge of the airway is expanding. New conditions, modern management strategies, and a more complete understanding of the interaction between the airway and fluid flux in the lung are presented.

Pediatric disaster medicine.

Disaster situations often involve children. The specific injuries that may be expected and the implications of these injuries for both acute caregivers and disaster planners are discussed in this article.

Immune dysfunction in the critically ill infant and child.

Factors contributing to the high prevalence of immunodeficiency in the PICU population include conditions that lead to frequent requirement of intensive care, suppression of immunity secondary to an acute insult, and iatrogenic measures. The immunodeficiency observed in the critically ill correlates well with their susceptibility to infection and explains the high prevalence of nosocomial sepsis in the PICU--a major cause of morbidity and mortality in critically ill children. Dysactivation of the immune system during an acute insult, with the subsequent release of humoral mediators from activated immune cells, leads to tissue injury and may be involved in the pathogenesis of ARDS, DIC, capillary leak syndrome, and to the development of multiple organ system failure. Suggested approaches to correct the immunodeficiency in the critically ill include reconstitutional immunotherapy, mediator-inhibiting drugs, and mediator removal by plasma exchange. Intensivists should be aware of the phenomenon of immunodeficiency in the critically ill, be accordingly aggressive in diagnosing and treating infections, and avoid, as much as possible, measures that further suppress immunity.

Adult respiratory distress syndrome in children.

Respiratory distress syndrome is the clinical manifestation of injury to the terminal alveolar-capillary unit, and may result from a variety of nonpulmonary insults including shock, sepsis, and trauma. The clinical characteristics, pathophysiology, and treatment of respiratory distress syndrome in children are reviewed.

Caries experience in Icelandic 12-year-old urban children between 1984 and 1991.

In order to evaluate trends in caries experience, a 20% random sample of 12-yr-old residents of Reykjavik, Iceland (252 children) was examined clinically and radiographically in 1991 under conditions consistent with those of the survey conducted in 1984. In addition to caries data, frequency of toothbrushing and use of fluoride dentifrice were recorded. The mean DFT and DFS were 3.0 and 4.1, respectively. The decrease in caries experience reached 60% with an annual fall in DFS of nearly 10%. During the 7-yr period between examinations the decline in DFT and DFS scores averaged 5.2 and 8, respectively, the annual reduction amounting to 0.7 DF teeth or 1.1 DF surfaces per child. The ratio of approximal/occlusal caries and the proportion of approximal caries were similar in both surveys. Fourteen percent of the children were free from manifest caries in 1991, but only 2% in 1984. Polarization between low and high prevalence individuals had intensified. Ninety-five percent of the children brushed their teeth regularly and 97% reported using a fluoride dentifrice.

The effect of a mock trial on nursing students' ability to make clinically sound legal judgments.

In an attempt to enhance nursing students' abilities to make legally sound clinical judgments, a mock trial experience was developed and evaluated. Using a quasi-experimental design, students' learning was assessed using scenarios derived from actual cases involving nurses. Satisfaction with a traditional learning approach was compared to learning through attendance at a mock trial. A significant difference was found in learning before and after the trial (t = 2.26, P < 0.05), and students preferred the mock trial experience to traditional classroom presentations.

Watchdog.

Q >I have recently commenced an English National Board course in Orthopaedics (No 219), as a post-basic student. Part of the course requires us to complete a research study of our own choice.

Watchdog.

Q I have recently secured a post as a non-teaching assistant/ RGN (registered general nurse) at a school for children with learning difficulties.

Watchdog.

Q Can you please clear up a point or two for me? I have been asked by members if they choose to opt out of the National Health Service superannuation scheme, will they still be entitled to SERPS (State Earnings Related Pension Scheme)?

Watchdog.

Q I am currently studying for a course in Business Studies. For my final assessment I have to study and discuss the format, membership and current standing of trade unions. In particular, I have to discuss the nurses' unions.

Watchdog.

We are a group of nurses working on an Ear, Nose and Throat ward and hold the Midland Institute Diploma of Otorhinocology. Our managers have always encouraged the staff to obtain this diploma. We were granted half-day release to the Queen Elizabeth Hospital, Birmingham, for lectures, and the Diploma was presented at the annual prizegiving.

Watchdog.

Q ln some areas a Nursing Access course is arranged through the technical college, but quickly becomes oversubscribed in favour of those with the necessary 'O' level passes or even degrees. Are there any hospitals which recruit students for nurse training without the required 'O' levels by using the DC test, and if so, where might I obtain a list of such hospitals?