How to Minimize Patient Anxiety From Screening Mammography.

Anxiety has been portrayed by the media and some organizations and societies as one of the harms of mammography. However, one experiences anxiety in multiple different medical tests that are undertaken, including screening examinations; it is not unique to mammography. Some may argue that because this anxiety is transient, the so-called harm is potentially overstated, but for some women the anxiety is significant. Anxiety can increase or decrease the likelihood of obtaining a screening mammogram. There are multiple ways that anxiety associated with screening mammography can be diminished, including before, during, and after the examination. These include simple measures such as patient education, improved communication, being aware of the patient's potential discomfort and addressing it, validating the patient's anxiety as well as providing the patient with positive factual data that can easily be implemented in every breast center. More complex interventions include altering the breast center environment with multisensory stimulation, reorganization of patient flow to minimize wait times, and relaxation techniques including complementary and alternative medicine. In this article we will review the literature on measures that can be taken to minimize anxiety that would maximize the likelihood of a woman obtaining an annual screening mammogram.

Estimation of Antimicrobial Properties of Aqueous and Alcoholic Extracts of Salvadora Persica (Miswak) on Oral Microbial Pathogens - An Invitro Study.

INTRODUCTION: Twigs of Salvadora persica (Miswak) plant are being used as a means of oral hygiene since ages for brushing teeth. Though clinical research and trials have shown promising results on effectiveness of Miswak, but some reports are conflicting. AIM: To evaluate the antimicrobial activity of crude aqueous and alcoholic extracts of Salvadora persica (Miswak) against the common microbial pathogens causing dental caries and periodontitis. MATERIALS AND METHODS: A prospective study of one year duration was conducted in Yenopoya dental and medical college, Mangalore. The twigs of Salvadora persica were collected and alcoholic and aqueous extracts were prepared using standard techniques. The antimicrobial properties of the extracts against common oral pathogens like Streptococcus mutans, Streptococcus mitis, Candida albicans, Lactobacillus acidophilus, Prevotella intermedia, & Peptostreptococcus were performed by agar well diffusion method and two fold broth dilution method. RESULTS: No significant results was obtained when water extracts of Salvadora persica was tested except for minimum inhibitory effect against Streptococcus mutans, Prevotella intermedia & Peptostreptococcus and Candida albicans. Relatively significant inhibitory effect was noted with respect to alcoholic extract of Salvadora persica. CONCLUSION: Although comparatively less than chlorhexidine which is a known antimicrobial agent, the alcoholic extracts of Salvadora persica showed antimicrobial effect against the common microbial pathogens causing dental caries and periodontitis indicating a potential beneficial effect of this plant. However, further research with more standardized extraction procedure and advanced techniques is required to find out the exact chemicals responsible for the antimicrobial properties of the plant extract.

Preclinical and clinical development of a dengue recombinant subunit vaccine.

This review focuses on a dengue virus (DENV) vaccine candidate based on a recombinant subunit approach which targets the DENV envelope glycoprotein (E). Truncated versions of E consisting of the N-terminal portion of E (DEN-80E) have been expressed recombinantly in the Drosophila S2 expression system and shown to have native-like conformation. Preclinical studies demonstrate that formulations containing tetravalent DEN-80E adjuvanted with ISCOMATRIX™ adjuvant induce high titer virus neutralizing antibodies and IFN-γ producing T cells in flavivirus-naïve non-human primates. The preclinical data further suggest that administration of such formulations on a 0, 1, 6 month schedule may result in higher maximum virus neutralizing antibody titers and better durability of those titers compared to administration on a 0, 1, 2 month schedule. In addition, the virus neutralizing antibody titers induced by adjuvanted tetravalent DEN-80E compare favorably to the titers induced by a tetravalent live virus comparator. Furthermore, DEN-80E was demonstrated to be able to boost virus neutralizing antibody titers in macaques that have had a prior DENV exposure. A monovalent version of the vaccine candidate, DEN1-80E, was formulated with Alhydrogel™ and studied in a proof-of-principle Phase I clinical trial by Hawaii Biotech, Inc. (NCT00936429). The clinical trial results demonstrate that both the 10 µg and 50 µg formulations of DEN1-80E with 1.25 mg of elemental aluminum were immunogenic when administered in a 3-injection series (0, 1, 2 months) to healthy, flavivirus-naïve adults. The vaccine formulations induced DENV-1 neutralizing antibodies in the majority of subjects, although the titers in most subjects were modest and waned over time. Both the 10 µg DEN1-80E and the 50 µg DEN1-80E formulations with Alhydrogel™ were generally well tolerated.