Medical and Dental Electronic Health Record Reporting Discrepancies in Integrated Patient Care.

INTRODUCTION: Oral health mirrors systemic health; yet, few clinics worldwide provide dental care as part of primary medical care, nor are dental records commonly integrated with medical records. OBJECTIVES: To determine the degree to which misreporting of underlying health conditions poses problems for dental clinicians, we assessed misreporting of 2 common medical health conditions-hypertension and diabetes-at the time of dental examination and assessment. METHODS: Using comparative chart analysis, we analyzed medical records of a diverse group of patients previously seen at the University of Texas Physician outpatient practice and then treated at the University of Texas Health Science Center at Houston School of Dentistry. Electronic health records of patients aged ≥18 y were extracted from 2 databases: Allscripts (University of Texas Physician) and axiUm (University of Texas Health Science Center at Houston). We identified 1,013 patients with the commonly occurring conditions of diabetes, hypertension, or both, with nonintegrated records contained in Allscripts and axiUm. We identified the percentage of those patients previously diagnosed with diabetes and/or hypertension by their physicians who failed to report these conditions to their dental clinicians. RESULTS: Of those patients with diabetes, 15.1% misreported their diabetes condition to their dental clinicians, while 29.0% of patients with hypertension also misreported. There was no relationship between sex and misreporting of hypertension or diabetes, but age significantly affected reporting of hypertension, with misreporting decreasing with age. CONCLUSIONS: Because these conditions affect treatment planning in the dental clinic, misreporting of underlying medical conditions can have negative outcomes for dental patients. We conclude that policies that support the integration of medical and dental records would meaningfully increase the quality of health care delivered to patients, particularly those dental patients with underlying medical conditions. KNOWLEDGE TRANSFER STATEMENT: Our study illustrates an urgent need for policy innovation within a currently fragmented health care delivery system. Dental clinicians rely on the accuracy of health information provided by patients, which we found was misreported in ~15% to 30% of dental patient records. An integrated health care system can close these misreporting gaps. Policies that support the integration of medical and dental records can improve the quality of health care delivered, particularly for dental patients with underlying medical conditions.

Impact of probiotics on development and behaviour in Drosophila melanogaster - a potential in vivo model to assess probiotics.

In vitro models are frequently used in probiotic research. However, such models often fail to predict in vivo functionality and efficacy. This fact complicates the screening process for selecting the most suitable strains, prior to accomplish expensive animal studies and clinical intervention trials. Therefore, additional sensitive, discriminating and cost-effective models are needed to conduct preliminary assays before undertaking human intervention studies definitely proving efficacy. With this purpose in mind, we explored the potential of axenic Drosophila melanogaster populations as well as of these axenic flies treated with probiotic microbial strains as a model to test the effects of probiotics on a subset of developmental and behavioural traits. An axenic D. melanogaster progeny from the wild-type Canton S strain was obtained and its eggs were further developed until pupae eclosion occurred in growth medium containing either of two probiotic strains: Bifidobacterium animalis subsp. lactis Bb12 or Lactobacillus rhamnosus GG. Whereas B. animalis Bb12 colonised the flies, the capacity of L. rhamnosus LGG to colonise was considerably lower in our experimental conditions. Regarding the influence of microbial load on the flies' development, the axenic condition caused a decrease in egg survival, and lowered adults' average weight with respect to wild-type flies. Both probiotics were able to counteract these effects. An earlier emergence of adults was observed from eggs treated with L. rhamnosus GG in comparison to the other fly populations. The axenic condition did not influence negative geotaxis behaviour in Drosophila; however, flies mono-associated with B. animalis Bb12 moved faster than wild-type. Our results suggest that the use of axenic/probiotic-treated D. melanogaster populations may be an affordable model for preliminary testing of the effects of probiotics on developmental or behavioural aspects.

Magnesio, calcio y fósforo séricos en neonatos de alto riesgo y controles / Serum magnesium, calcium and phosphorus in normal and high risk neonates

Las convulsiones son un problema neonatal frecuente y grave. Las principales determinaciones sugeridas para investigar su origen tiene relaión por ejemplo con la medición de los niveles de glucosa, magnesio, calcio, etc. Se estudiaron a 32 recién nacidos de alto riesgo y en un grupo control, formado por 30 neonatos sanos, los niveles de magnesio, calcio y fósforo por las metódicas de Calmagite-dye y o-Cresolftaleína-Complexona y Molibdato-Vanadato, respectivamente. Los valores en controles fueron 2,55 ñ 0,28 mg/dl para magnesio; 8,21 ñ 1,20 mg/dl para calcio y 5,96 ñ 1,18 mg/dl para fósforo y en el grupo de riesgo fueron: 2,39 ñ 0,41 mg/dl; 8,21 ñ 1,32 mg/dl y 5,87ñ 1,14 mg/dl. El grupo de riesgo evidenció valores más bajos para magnesio con una mayor dispersión, siendo esto significativo para la prueba de F con un p<0,05. También se observaron niveles levemente más altos de calcio en este grupo, con mayor dispersión de valores pero, no siendo significativas estas diferencias. Los valores de fósforo en ambos grupos fueron muy similares. Se concluye que solamente el magnesio podría ser un indicador sensible ante la presencia de convulsiones, aunque deberían estudiarse estos parámetros conjuntamente con los niveles de glicemia