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.

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.

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.

Physical activity, total energy expenditure, and food intake in grossly obese and normal weight women.

The doubly labeled water method was used to measure average daily total energy expenditure (TEE) in 10 healthy normal weight women classified as unrestrained eaters and in 10 grossly obese women. The body mass index was 20.0 +/- 1.3 kg/m2 in the control group and 37.4 +/- 8.1 kg/m2 for the obese group. TEE was measured over a 2-week period. TEE was 2,357 +/- 504 kcal/day for the controls and 3,708 +/- 367 kcal/day for the obese group during a cognitive-behavioral treatment.

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.

An oral-diffusion-sink device for extended sampling of multiple steroid hormones from saliva.

Performance of a new oral-diffusion-sink (ODS) device for sampling the steroid hormones cortisol, progesterone, estradiol, and testosterone from human saliva was tested in vitro. The tested device differed from an earlier ODS sampler by using a polymeric composition of beta-cyclodextrin rather than an antiserum to bind analytes diffusing into the device. The capacity of the cyclodextrin-driven device to accumulate the steroid hormones from a simple buffer, human saliva, and saliva fortified with high concentrations of glucocorticosteroids was evaluated. Further, the ability of this device to accurately register the average analyte concentration resulting from treatments simulating physiological episodic secretion events was tested. Each steroid showed a characteristic rate of uptake that was unaffected by saliva or high physiological concentrations of competing steroids, and ODS uptake resulting from temporally varied concentrations of the hormone in the medium accurately reflected the time-integrated average concentration. This ODS provides a potential noninvasive and unobtrusive means of sampling the tissue-available concentrations of multiple steroid hormones, with averaging over physiological secretion events.