Dentists' Perceptions of Personal Infection Control Measurements in Response to COVID-19.

OBJECTIVE: To explore through focus groups (FGs) the perceptions of dental practitioners (DPs) from different countries of the challenges of implementing coronavirus disease 2019 (COVID-19) related biosafety measures, especially personal protection equipment (PPE), during the COVID-19 pandemic period. METHODS: DPs from Colombia, Germany, the United Kingdom, and the United States were invited to participate in country-based FGs. These were facilitated by an experienced moderator who explored the factors that guided the implementation of COVID-19 related biosafety measures and PPE use. Data were analyzed through thematic analysis on the basis of categories defined by the researchers deductively and inductively. RESULTS: A total of 25 DPs participated in 3 FGs (Colombia:n = 8; United Kingdom: n = 7; United States: n = 9) and 1 in an in-depth interview (Germany). DPs described using several processes to judge which guidance document to adopt and which aspects of the guidance were important in their practice. These included making judgments concerning the views of any indemnity organization to which the DPs were responsible, the staff's views in the practice, and the views of patients. In the absence of a single overarching guidance document, DPs filtered the available information through several considerations to find a level of PPE that they deemed "implementable" in local practice. CONCLUSIONS: The findings suggest that the implementation of evidence-based practice is subject to modification through a lens of what is "feasible" in practice. KNOWLEDGE TRANSFER STATEMENT: Clinicians, educators, and policy makers can use the results of this study to understand the process through which guidance is transformed into implementable patient care pathways in the dental practice.

Forma esporádica de enfermedad de Creutzfeldt-Jakob: reporte dedos casos / Sporadic Creutzfeldt-Jakob disease: two case reports

La enfermedad de Creutzfeldt-Jakob es la encefalopatía espongiforme más común en el ser humano y prototipode las patologías causadas por priones. Se caracteriza histológicamente por astrogliosis y degeneración dela sustancia gris. Típicamente inicia con síntomas prodrómicos no específicos progresando a demencia conmioclonias y ataxia. Presentamos dos casos de mujeres en edad media con deterioro cognitivo progresivo,dificultades motrices, alteraciones del lenguaje y mioclonias que conducen a la muerte. En electroencefalogramasde ondas trifásicas lentas periódicas así como elevación de proteínas tau y 14-3-3 en LCR por apoyodel The National Prion Disease Pathology Surveillance Center - Cleveland, todos estos hallazgos definen lascondiciones para el diagnóstico clínico de enfermedad por priones. El diagnóstico diferencial en el contextode demencia rápidamente progresiva es amplio, incluyendo infecciones, intoxicaciones, trastornos metabólicos,autoinmunidad, vasculopatías y neoplasias que podrían explicar un posible subregistro en las estadísticasregionales. Existe una posible asociación de riesgo entre enfermedad por priones y médicos patólogos que,aunque discutida, podría limitar el estudio de los especímenes histológicos que son la clave del diagnósticodefinitivo. A pesar de la importancia en salud pública de estas condiciones, el actual modelo de salud limita elmanejo integral de los pacientes.

Creutzfeldt-Jakob is the most common spongiform encephalopathy in humans and the prototype of prions diseases. Astrogliosis and degeneration of the gray matter are the histological features. Typically starts with nonspecific prodromal symptoms that progressing to dementia with myoclonus and ataxia. We present two cases of women in middle age with progressive cognitive impairment, motor difficulties, language disorders and myoclonus that lead to death. EEG slow periodic triphasic waves and elevated protein tau and CSF14-3-3 support for The National Prion Disease Pathology Surveillance Center - Cleveland, all these findings define the conditions for the clinical diagnosis of prion disease. The differential diagnosis in the context of rapidly progressive dementia is broad including infections, poisoning, metabolic disorders, autoimmunity, vascular disease and neoplasms that could explain a possible underreporting in regional statistics. There is a possible risk association between disease and Medical Pathologists that although discussed could limit the study of histological specimens that are key to definitive diagnosis. Despite the public health importance of these conditions the current model of health limits the comprehensive management of patients.

Tomato infectious chlorosis virus Associated with Tomato Diseases in Baja California, Mexico.

Tomato (Solanum lycopersicum L.) is an important vegetable crop in Mexico. The national production in 2009 was 2,043,814 metric tons with a value of $163,560,636 US. Since 2007, abnormal yellow and crispy leaves were observed in commercial tomato fields in Ensenada County, Baja California, Mexico. In affected fields from two localities (San Quintín Valley and Ensenada), symptomatic plants were randomly distributed and symptoms resembled previous descriptions of crinivirus infections in tomato (3). The symptoms and the presence of whiteflies (Bemisia tabaci and Trialeurodes vaporariorum) in the affected fields suggested a viral etiology. Leaf samples of 143 symptomatic tomato plants were collected in the 2007 and 2008 growing seasons. Total RNA was extracted and analyzed by reverse transcription (RT)-PCR assay for simultaneous detection of Tomato infectious chlorosis virus (TICV) and Tomato chlorosis virus (ToCV). Degenerate primers (HS-11/HS-12) were used in combination with specific primers (TIC-3/TIC-4 and ToC-5/ToC-6) for detection of these viruses by nested-PCR (2). A PCR fragment of the expected size for TICV (223 bp) was amplified in 26 of 143 samples. None of the samples tested positive for ToCV. In addition, considering that whiteflies are vectors of begomoviruses, samples were also tested for presence of viral DNA. Results showed 30 positive samples and one with mixed infection. It is therefore possible that the viral disease symptoms observed could be caused in part by viruses other than TICV. Three amplicons from RT-PCR of tomato samples were cloned into the pGEM-T easy vector system II (Promega Corporation, Madison, WI) and sequenced. The sequence of one amplicon (GenBank Accession No. FJ609651) was compared with the sequences of other criniviruses reported in the NCBI/GenBank database using the Clustal V alignment method of the sequence analysis software suite Lasergene (MegAling, DNASTAR Inc., Madison, WI). Sequence analysis of the 223-bp PCR fragment corresponding to TICV showed 99.1% identity with a TICV isolate from Japan (GenBank Accession No. AB085602) and 100% identity with TICV isolates from the United States (GenBank Accession No. TIU67449). Although the presence of another crinivirus, ToCV, was reported previously in Mexico associated with tomato crops and two native weeds, S. nigrescens and Datura stramonium (1), this virus was not detected in Baja California during the present work. To our knowledge, this is the first report of TICV associated with tomato diseases in Mexico. The emerging of a previously unreported virus disease in tomato production areas of Mexico complicates disease management efforts. References: (1) P. Álvarez-Ruíz et al. Plant Pathol. 56:1043, 2007. (2) C. I. Dovas et al. Plant Dis. 86:1345, 2002. (3) G. C. Wisler et al. Plant Dis. 82:270, 1998.

Early and late humoral rejection: a clinicopathologic entity in two times.

Humoral rejection is an important cause of early and late graft loss. The late variant is difficult to diagnose and treat. There is a close correlation between sclerosing nephropathy and anti-HLA antibodies. We analyzed 113 renal allograft recipients between August 2004 and April 2007. Acute humoral rejection was defined as acute graft dysfunction in presence of donor-specific antibodies (DSA) detected by flow panel reactive antibodies (PRA) and/or C4d positive pericapilary tubules (PTC) detected histopathologically by immunofluorescent or immunoperoxidase at less than 3 months postransplantation. Late humoral rejection was defined as dysfunction occurring after 3 months postransplantation with histopathologic glomerulopathy or vasculopathy and positive C4d PTC. We included all patients who were diagnosed with early or late graft dysfunction and underwent biopsy, all of which were examined for C4d. Four patients had acute humoral rejection treated with IVIG or plasmapheresis. The patient and graft survivals were 100% and serum creatinine averaged 1.7 mg/dL. Three recipients experienced late humoral rejection at 3 to 10 years posttransplantation All received high-dose IVIG; one also was treated with thymoglobulin. Immunosuppression was switched to tacrolimus, mycophenolate mofetil, and steroids. Only one patient recovered renal function; the others returned to dialysis. Among seven patients only one had an actual PRA (>20%) and three showed 10% to 20%. However, six had a positive historical PRA of 10% to 50%. In conclusion, Recognition of acute humoral rejection has contributed to graft rescue by controlling alloantibody production through new specific immunosuppressive therapies in contrast with the clinical response to acute therapy, treatment of a chronic entity has shown poor outcomes, probably because antibody mediated chronic graft damage is already present when the late diagnosis is established by biopsy.

Bandpass filter with adjustable bandwidth based on a press-induced long-period twisted holey-fiber grating.

A bandpass filter with adjustable bandwidth based on a press-induced long-period grating in a twisted holey fiber is presented. By twisting the holey fiber prior to the application of periodic pressure, each rejection band of the nontwisted induced long-period grating is split into two shifted rejection bands that move further apart as the twist ratio increases. This feature results in a wide bandpass filter with controllable bandwidth. A bandpass filter at 1523 nm with adjustable bandwidth from 15 to 65 nm with near-linear response and insertion loss lower than 0.7 dB is demonstrated. Additionally, the bandpass filter can be tuned over 100 nm.

Epidemiology of early childhood caries (ECC) in Anguilla, British West Indies, 2000 [abstract]

The study was conducted to estimate the prevalence and severity of Early Childhood Caries (ECC) in infants aged 2 to 5 years. The teeth of 523 children aged between 24 and 71 months from all 18 primary and pre-schools (census) were assessed by one calibrated examiner (AA) following parental consent. Tooth-surfaced based data were collected for each child using the NIDCR diagnostic and scoring criteria and the WHO codes for teeth with non-cavitated lesions. A 15-item questionnaire on flouride exposure as well as the use of feeding bottles and pacifiers was completed by parents and gaurdians. The overall prevalence of ECC and Severe-ECC was 46 percent and 35 percent, respectively. It decreased with age and did not differ significantly with gender. Early childhood Caries prevalence was determined with and without non-cavitated lesions and by sextant. The mean dmft of infants without non-cavitated lesions was 1.68 (SD= 3.22) of which 1.08 teeth (SD= 2.01) were molars. The mean dmft with non-cavitated lesions was 2.57 (SD= 3.86) of which 60 percent represented untreated decayed teeth. The ECC prevalence was highest in the molar (32.5 percent) followed by upper (17.4 percent) and lower anterior (4.4 percent) sextants, respectively. A slightly higher proportion of children with ECC (55 percent) did not have non-cavitated lesions while 51 percent had non-cavitated lesions based on the affected molars. The highest site-specific prevalance (53.43 percent) occurred in the molar teeth of children aged 60 to 71 months. Children aged 48 to 59 months and the highest site-specific caries prevalence in the upper and lower anterior sextants (34.84 percent and 10.83 percent) for those with and without non-cavitated lesions. This is the first ever population-based study using the NIDCR criteria developed in 1998. The prevalence and severity of ECC in Anguilla is high. A high proportion of children had maxillary anteriors and molars as the only affected teeth. Oral health promotion programmes should be extended to preschools. Flouride exposure in 2 to 5-year-old children should be augmented in order to reduce the high prevalence of ECC. (AU)