Preventing Porcelain Fractures During Endodontic Treatment.

Attempting endodontic access through ceramic or veneering porcelain can be wrought with challenges. Clinicians must take every precaution to assist patients who are in pain without causing harm through chipping or fracturing the restoration. This article discusses strategies clinicians can consider when facing the task of achieving endodontic access through an all-ceramic crown.

Communicating emerging infectious disease outbreaks to the public through local television news: public health officials as potential spokespeople.

OBJECTIVE: To assess how West Nile virus (WNV) was reported to the American public on local television news and identify the main factors that influenced coverage. METHODS: A representative sample of WNV stories that were reported on 122 local television news stations across the United States during October 2002, covering 67% of the nation's population, were coded for self-efficacy, comparative risk scenarios, symptoms and recommendations, high-risk individuals, and frame. In addition, public service professionals (PSPs) interviewed in the segments were identified. Comparisons were made between stories in which a PSP was interviewed and stories without an interview with respect to discussion of the 5 variables coded. RESULTS: Of the 1,371 health-related stories captured during the study period, 160 WNV stories aired, the second most common health topic reported. Forty-nine of the 160 WNV stories contained at least 1 of the 5 reporting variables. Forty-two PSPs were interviewed within 33 unique WNV stories. Public health officials composed 81% of all PSP interviews. Stories containing a public health official interview had 15.2 times (odds ratio 15.2, confidence interval 5.1-45.9) higher odds of reporting quality information, controlling for station affiliate or geographic location. CONCLUSIONS: Emerging infectious disease stories are prominently reported by local television news. Stories containing interviews with public health officials were also much more likely to report quality information. Optimizing the interactions between and availability of public health officials and the local news media may enhance disaster communication of emerging infections.

Does Local Television News Coverage Cultivate Fatalistic Beliefs about Cancer Prevention?

A substantial proportion of American adults hold fatalistic beliefs about cancer prevention despite evidence that a large proportion of cancer deaths are preventable. Several scholars suggest that news media coverage is one source of these beliefs, but scant evidence has been brought to bear on this assertion. We report findings from two studies that assess the plausibility of the claim that local television (TV) news cultivates fatalistic beliefs about cancer prevention. Study 1 features a content analysis of an October 2002 national sample of local TV and newspaper coverage about cancer (n=122 television stations; n=60 newspapers). Study 2 describes an analysis of the 2005 Annenberg National Health Communication Survey (ANHCS, n=1,783 respondents). Study 1 indicates that local TV news stories were more likely than newspaper stories to mention cancer causes and scientific research and less likely to provide follow-up information. Study 2 reveals that local TV news viewing was positively associated with fatalistic beliefs about cancer prevention. Overall, findings are consistent with the claim that local TV news coverage may promote fatalistic beliefs about cancer prevention. We conclude with a discussion of study implications for cultivation theory and the knowledge gap hypothesis and suggest foci for future research.

Injury reporting on local TV news: a prime-time opportunity for prevention.

BACKGROUND: Local television news is America's primary source of information and may be an opportunity to shape public opinion surrounding issues such as injury prevention. OBJECTIVE: This study sought to systematically evaluate unintentional-injury coverage on local television news and to identify frequently interviewed public-service professionals and factors associated with discussion of risk factors and prevention. METHODS: Late news broadcasts from 122 local television stations within the U.S. during October 2002 were analyzed. The main outcomes variables were counts of case-injury stories: motor-vehicle crashes, fires, falls, drowning, poisonings, and sports-recreational injuries; identification of interviewed public service professionals; and discussion of risk factors and prevention. Bivariate and mulitvariate analysis was performed to identify predictors of discussion of prevention measures, risk factors, or both. Data were analyzed in Fall 2006. RESULTS: From 2795 broadcasts, 1748 case-injury stories were identified. Fires and motor-vehicle crashes constituted 84% of the case-injury stories. There were 245 case-injury stories containing an interview with a public service professional. Police officers and firefighters accounted for 82% of these interviews. Interviews with police officers and firefighters were independently associated with discussion of risk factors and prevention measures for motor-vehicle crashes (OR=2.49, CI=1.7-3.6) and fires (OR=2.77, CI=1.2-5.9), respectively. CONCLUSIONS: Motor-vehicle crashes and fires were the most commonly reported injury topics. Police officers and firefighters were most commonly interviewed and, if interviewed, increased the likelihood that risk factors, prevention measures, or both were discussed. Optimizing the messages delivered by public service professionals through public service professional-level and media-level interventions may be an opportunity for disseminating injury-prevention information to the public and to policymakers, and methods to increase the likelihood of media interviews with public service professionals should be explored.

Local television news reporting of kidney disease.

BACKGROUND: Local television is the primary news source for the majority of Americans. This study aims to describe how local news reports on kidney disease. METHODS: Using our searchable database of health-related late local news segments from 2002, we identified stories with the key words kidney, hypertension, blood pressure, or diabetes. This database is a representative sample of the late local news on 122 stations in the 50 largest US media markets, comprising 60% of the population. The content of each identified story was reviewed to determine whether it mentioned: (1) chronic kidney disease (CKD), (2) screening for kidney disease, or (3) kidney disease as a potential complication (for blood pressure- or diabetes-related stories). RESULTS: Only 2 of 1,799 database news stories (0.11%) included "kidney" as a summary key word; neither referred to CKD, screening, or complications of other diseases. Of 19 stories about hypertension or blood pressure (1.06% of all stories) and the 14 stories about diabetes (0.78% of all stories), none mentioned these criteria. CONCLUSION: Despite efforts to increase public awareness of and screening for CKD, local television news (the most important news source for a majority of Americans) did little to help achieve these goals. Further work will be needed to confirm whether this paucity of coverage varies over time and determine why so little attention is given to CKD. Educating physicians and public relations personnel who advocate for kidney disease about journalists' needs may be an important step to help advance public awareness of CKD.

Multiple metachronous brain metastases from primary ureteral carcinoma.

Transitional cell carcinoma (TCC) of the ureter is an uncommon urologic malignancy, with approximately 150 cases diagnosed annually. Metastatic brain disease from ureteral TCC is exceedingly rare. To our knowledge, our case report represents only the second report of brain metastasis from ureteral TCC and the only reported patient to undergo resection of their TCC brain metastasis.

Stroke information reported on local television news: a national perspective.

BACKGROUND AND PURPOSE: Local television news commonly reports on health. This study aimed to characterize local TV news stroke reporting in America. METHODS: Content analysis of stroke stories reported on 122 US local television stations. All stroke stories were coded for main focus and discussion of risk factors, stroke signs and symptoms, recombinant tissue plasminogen activator, treatment within 3 hours, or recommendation to call 911. RESULTS: Of the 1799 health stories, only 13 stroke stories aired, and the median story length was 24 seconds (interquartile range 21 to 48). Stroke was the 22nd most common health topic. Few stroke stories discussed useful information about prevention or treatment of stroke. CONCLUSIONS: Stroke stories were nearly nonexistent in our sample, and those reported failed to discuss important messages needed to improve stroke prevention and treatment.

Medical news for the public to use? What's on local TV news.

BACKGROUND: Local television news is the number 1 source of information for most Americans, and media health reporting has increased significantly during the past 10 years. OBJECTIVE: To evaluate the health topics and reporting characteristics of health stories on local television news across the United States. STUDY DESIGN: Content analysis of full-length broadcasts of local television news from a representative sample of the top 50 US media markets (122 stations). METHODS: Two trained coders evaluated all health stories for topics and reporting characteristics. Any discrepancies were resolved by a third independent coder. RESULTS: Among 2795 broadcasts reviewed, 1799 health stories were aired. Seventy-six percent of all stories were about medical conditions. The median story airtime was 33 seconds. Breast cancer and West Nile virus were the 2 most common topics reported on. Among 1371 stories about disease, few gave recommendations, cited specific data sources, or discussed prevalence. Egregious errors were identified that could harm viewers who relied on the information. CONCLUSIONS: Local television news devotes significant airtime to health stories, yet few newscasts provide useful information, and some stories with factually incorrect information and potentially dangerous advice were aired. Regularly reaching 165 million people, local television news has the power to provide health information to most Americans. It is crucial that television reporting of health news be improved and that reporting errors be eliminated.

An indolent case of T-prolymphocytic leukemia with t(3;22)(q21;q11.2) and elevated serum beta2-microglobulin.

We report a novel case of T-prolymphocytic leukemia, small cell variant, associated with complex cytogenetic findings including t(3;22)(q21;11.2) and elevated serum beta2-microglobulin. The diagnosis is based on morphologic, immunophenotypic, cytogenetic, and molecular analysis of peripheral blood and bone marrow. In contrast to most reported cases of T-prolymphocytic leukemia, this patient did not present with lymphadenopathy or organomegaly. Moreover, only a moderate leukocytosis (25.3 x 10(3)/microL) was evident at presentation. In the absence of any specific treatment, the patient is doing well, with a stable white blood cell count 12 months following presentation. Further investigation may be warranted to determine whether the unusual cytogenetic findings and elevated serum beta2-microglobulin are associated with the indolent clinical course in this patient.

Femoral artery to prosthetic graft anastomotic dehiscence owing to infection: successful treatment with arterial reconstruction and limb salvage.

A 66-year-old man had foot gangrene and a fixed contracture of the knee following two failed femoropopliteal bypasses, one with vein and one with polytetrafluoroethylene (PTFE). An external iliac to anterior tibial artery bypass and skeletal traction via the os calcis resulted in limb salvage and successful normal ambulation. After 3 months, he ruptured the infected femoral anastomosis of the failed PTFE femoropopliteal bypass with external bleeding. The use of arteriography and a balloon catheter to obtain proximal control allowed arterial repair, removal of the graft, and preservation of flow within a patent common and deep femoral artery. This flow preservation maintained the viability and function of the limb when the anterior tibial bypass closed 4 years later, and the limb continues to be fully functional 3 years later. Aggressive secondary attempts at limb salvage are worthwhile even in unfavorable circumstances.

Effects of kindled seizures upon hematopoiesis in rats.

OBJECTIVE: Studies conducted in epilepsy patients and experimental animals have suggested a linkage between seizure activity and alterations in immune functions. However, little is known about the underlying mechanisms. The present study sought to determine whether chronic seizures result in changes in hematopoietic functions that contribute to alterations in immune function. MATERIALS AND METHODS: Sprague-Dawley rats were implanted with electrodes in the basal amygdala or frontal cortex for induction of focal seizures by kindling. After inducing stage 5 seizures for 30 days, rats were sacrificed and assays for colony-forming units granulocyte/macrophage (CFU-GM) were performed to study progenitor cell functions. Long-term culture-initiating culture (LTC-IC) assays were employed to determine the effects of kindling upon bone marrow stroma. A Western blot for caspase-3 and CFU-GM assays from peripheral blood were used to determine the cause of reduced cellularity of bone marrow. RESULTS: Kindled seizures of the basal amygdala resulted in decreases in bone marrow cellularity and hyperproliferation of colony-forming cells in peripheral blood and bone marrow. Modified LTC-IC assays, where co-cultures of bone marrow cells and stroma from experimental animals were employed, revealed that hyperproliferation of progenitor cells was not associated with alterations in stromal functions. The changes observed in this study were associated with seizure foci in the basal amygdaloid complex but not the frontal cortex. CONCLUSION: Kindled seizures of the basal amygdala induce hyperproliferation of bone marrow progenitor cells, suggesting that alterations in immunological functions observed following seizure activity may be due to changes in hematopoietic functions. Such changes appear to be site specific within the brain.

Effects of hemispheric lateralization and site specificity on immune alterations induced by kindled temporal lobe seizures.

The effects of kindled seizures elicited from sites in the left and right temporal lobes on mitogen-induced proliferation (LPS, Con A, PHA) and induction of representative TH1 (IFN-gamma) and TH2 (IL-10, IL-4) cytokines were determined in activated rat splenocytes. With reference to cell proliferation, the changes depended on the hemispheric side and location of kindling. Kindling of the left side mediated significant increase in cell proliferation by LPS. Left side kindling resulted in decreased cell proliferation by PHA. Although right side kindling showed no change when taken together, further analysis showed that the reduced proliferation by PHA was mediated when the pyriform cortex was kindled with no change from amygdaloid nuclei. Similar hemispheric polarization was observed in the production of IL-10 and IFN-gamma by Con A-stimulated splenocytes in left side kindled rats. Hence, kindled temporal lobe seizures induced changes in specific immune functions. These effects are not only lateralized but are also specific with respect to the particular region kindled. Since epileptic patients have altered immune functions, this report contributes to our understanding of this complex immune-brain cross-talk in epilepsy.