Chronic migraine headache and multiple dental pathologies causing cranial pain for 35 years: the neurodental nexus.

We report a case that illustrates how chronic migraine headaches and multiple dental pathologies caused severe and long-standing cranial pain that affected the quality of life of a man for more than 35 years. His case was investigated at several settings including the neurology outpatient clinic of the hospital without a definitive diagnosis or resolution. After investigations, multiple oral pathologies including two occult dental abscesses were diagnosed. Once both affected teeth and associated abscesses were surgically removed, with subsequent antibiotic therapy the headaches resolved.

Microbial quality of "doubles" sold in Trinidad

A cross-sectional study was conducted to determine the prevalence and characteristics of Escherichia coli, Staphylococcus aureus, Bacillus spp. and Salmonella spp. in "bara", "channa", condiments/spices and ready-to-eat "doubles" sold by vendors in the St. George and Caroni counties of Trinidad. Of 196 samples of each of "bara", "channa", condiments/spices and ready-to-eat "doubles" examined, E. coli was detected in 0 (0.0 per cent), 14 (7.1 per cent), 96 (49.0 per cent) and 67 (34.2 per cent), respectively; Staphylococci were isolated from 104 (53.1 per cent), 71 (36.2 per cent), 129 (65.8 per cent) and 123 (62.8 per cent) samples, respectively; and Bacillus spp. were recovered from 22 (11.2 per cent), 85 (43.4 per cent), 100 (51.0 per cent) and 88 (44.9 per cent) samples, respectively. Salmonella spp. were not isolated from any sample. Of the 177 isolates of E. coli recovered from all sources, 9 (5.1 per cent), 7 (4.0 per cent) and 47 (26.6 per cent) were mucoid, haemolytic and non-sorbitol fermenters (NSF), respectively, but none agglutinated with O157 antiserum. Of 427 staphylococcal isolates, 130 (30.4 per cent) were confirmed as S. aureus of which 20 (15.4 per cent) were haemolytic and 84 (64.6 per cent) pigmented, while 17 (20.7 per cent) of 82 strains of S. aureus tested produced enterotoxins. Ready-to-eat "doubles", a popular food in Trinidad, therefore pose a potential health risk to consumers due to the high level of contamination with bacteria.

Why do some women bypass their family physician in seeking preventive care?: a qualitative study [abstract]

The Health Watch clinic at Women's College Hospital, Toronto, provides screening and preventive services primarily to women in Ontario. These services can be seen as a duplication of those that can be provided by family physicians. Nevertheless, some Ontario women continue to bypass their family physicians and attend this clinic. This study was done to understand the decision-making processes women go through in deciding to bypass their family physician when seeking preventive health services and to understand which features of this model of preventive care are so attractive. Seventeen women attending the Health Watch Clinic agreed to participate. In-depth interviews were carried out until saturation was achieved. The interviews were taped and later transcribed. The data were analyzed using qualitative methods, specifically, grounded in theory. Emergent themes were extracted while listening to tapes and reading transcripts. Themes were discussed between researchers and an agreement was arrived at. These themes were relayed back to participants to confirm interpretation. The emerging themes suggest that women bypass the family physician for several reasons, including: "Women negative" experiences, the inherent qualities of the woman, such as her locus of control, normative influences, and perceived positive aspects of the Health Watch Clinic and the Women's College Hospital. The findings suggest that women who bypass their family doctor have generally had a negative experience with the traditional healthcare system. The women in this study were highly educated with high internal motivation and tended to have extensive family and friend support and advice regarding health matters. (AU)