Type II diabetes and oral health: perceptions among adults with diabetes and oral/health care providers in Ghana.

OBJECTIVE: This study sought to examine oral health beliefs and attitudes, and utilisation of oral health care services among individuals with diabetes and health professionals who serve them in Ghana. BASIC RESEARCH DESIGN: A qualitative study using grounded theory was conducted. CLINICAL SETTING: University of Ghana Dental School at Korle Bu, University of Ghana School of Public Health, National Diabetes Research and Management Centre at Korle Bu, and New York University College of Dentistry. PARTICIPANTS: A convenience sample of 59 patients comprised 7 focus groups conducted in either Twi or English. Seven key informant interviews with healthcare professionals and one spiritual leader were completed. RESULTS: Data from the focus groups and interviews reveal: 1, half of the participants with diabetes have oral manifestations (e.g., bleeding gums) and participants are generally unaware of interrelationship between diabetes and oral health; 2, dental treatment utilisation is minimal and associated almost exclusively with reparative and emergency care; and 3, medical health providers do not acknowledge the interrelationship between oral health and diabetes nor do they incorporate oral health issues into diabetes screening/treatment. CONCLUSION: Oral health knowledge and practices are limited among patients with diabetes in Accra, Ghana. Collaborative efforts for in-service education and training for oral health and medical professionals may be beneficial in serving the oral and general health care needs as well as improving the oral health-related quality of life of Ghanaians with diabetes.

Long-term neurodevelopmental outcome after intrauterine transfusion for the treatment of fetal hemolytic disease.

OBJECTIVE: The aim of the study was to assess the developmental outcome of neonatal survivors of hemolytic disease of the neonate treated with modern intrauterine transfusion techniques. STUDY DESIGN: In this prospective, observational study, auditory evoked-response tests were performed in the nursery. Neurodevelopmental evaluation with the Gesell Developmental Schedules was performed between 9 and 18 months of corrected age to assess motor skills, language development, comprehension capacity, and social skills. The McCarthy Scales of Children's Abilities were administered between 36 and 62 months. RESULTS: Forty children who survived severe fetal hemolytic disease were followed up until 62 months old. Demographic data included gestational age at first intrauterine transfusion (26.4 +/- 3.7 weeks), median number of intrauterine transfusions (4, range 1-8), lowest fetal hematocrit (20.2% +/- 7.8%), peak fetal bilirubin (7.1 +/- 2.1 mg/dL), incidence of hydrops fetalis (45%), and mean gestational age at delivery (35.6 +/- 2.2 weeks). One case of severe bilateral deafness and 1 case of right spastic hemiplegia were diagnosed. The Gesell Developmental Schedules score was assessed between 9 and 18 months of corrected age in 22 infants. The global developmental quotient was 101.9 +/- 9.5 (mean for normal population is 100). Regression analysis revealed no correlation between the global developmental quotient and gestational age at the first intrauterine transfusion, gestational age at birth, or the severity of the fetal hemolytic disease (fetal hematocrit, fetal bilirubin, presence of hydrops fetalis, total number of intrauterine transfusions, duration of neonatal phototherapy, and number of neonatal exchange transfusions). Eleven of the 40 children were followed up until they were 62 months old, and the McCarthy Scales of Children's Abilities were administered. The mean cognitive index was 107.6 +/- 9.4 (90-109 is considered average). CONCLUSION: Despite severe fetal hemolytic disease, normal developmental outcome can be expected for children treated with intrauterine transfusions.

Dynamic scaling in the dielectric response of excised EMT-6 tumours undergoing hyperthermia.

A constant-phase-angle response (CPA) has been identified in the dielectric spectrum of EMT-6 tissues undergoing hyperthermia. A dynamic scaling relationship between the static permittivity and conductivity using the CPA frequency exponent n has been shown to occur during the destructive phase of hyperthermia. This behaviour has been attributed to the self-similar structure of the internal membrane compartments of the cells and described by means of a hierarchical circuit model. In this way the CPA exponent has been related to the convolution of internal membrane surfaces lying in between the mitochondria and the outer cell wall. The dynamic scaling is assigned to the progressive destruction of cell membranes in sequence from the outside inwards.

Maternal drug therapy: effect on fetal and neonatal growth and neurobehavior.

Fetal and neonatal growth retardation may result in long term neurological and mental morbidity. There are multiple causes for intrauterine growth retardation but one etiology proposed is maternal drugs. In many instances it is difficult to determine if the growth retardation is due to the drugs or it is due to the disease process for which the mother receives the drugs. Weight and FOC appear to be more adversely effected than length. Combination drug therapy, for example anticonvulsant drugs, results in a greater incidence in teratology, growth retardation and lower IQ than monotherapy. Neurobehavior can also be adversely effected by maternal drugs. Although symptoms may be limited to the first months of life there is some evidence that this abnormal behavior is a reflection of in utero neurological insult which becomes evident later as poor organizational, perceptual, reading and mathematical skills or even mental retardation.