Impact of Establishing Dental Access for Preventable Infectious Dental Diseases (PIDD) in Medical Settings: Case Study from Rural Wisconsin.

OBJECTIVE: The frequency of Preventable Infectious Dental Disease (PIDD) visits in medical centers was examined pre and post establishment of expanded dental access and adoption of an integrated medical-dental care delivery model. METHODS: A retrospective observational study of patient attributes and frequency of unscheduled PIDD visits between January 1, 1990 and February 29, 2020. Chi-squared tests compared (a) the number of PIDD visits (pre/post dental center establishment), (b) age at first diagnosis, (c) gender, (d) race, (e) primary insurance at the time of PIDD visits and (f) healthcare setting where visit occurred. RESULTS: System-wide, 21,957 unique patients were documented with a total of 34,892 PIDD visits as the primary diagnosis. Patients between 18-30 years and patients with Medicaid had the highest frequency of PIDD visits in medical settings. Following the establishment of dental centers, reduced relative risk of PIDD visits was observed for patients with no health insurance or self-pay/other coverage. PIDD visits in primary care settings was 0.87 times as likely as PIDD visits at ED/UCs after dental centers opened. CONCLUSIONS: The number of PIDD visits to medical centers increased before the dental infrastructure was established, followed by a decline afterwards, inclusive of disparity populations. Some residual persistence of PIDD visits to primary care settings was identified. This study reinforced importance of dental healthcare access for achieving appropriate PIDD management while reducing PIDD visits to medical settings.

Gaharitrema droneni n. gen., n. sp. (Digenea: Zoogonidae) from the Pudgy Cuskeel, Spectrunculus grandis (Ophidiiformes: Ophidiidae), from Deep Waters Off Oregon, with Updated Keys to Zoogonid Subfamilies and Genera.

Gaharitrema droneni n. gen., n. sp. (Digenea: Zoogonidae: Lepidophyllinae) is described from the intestine of the pudgy cuskeel, Spectrunculus grandis (Günther, 1877) (Ophidiiformes: Ophidiidae), collected at 2,800 m depth from the northeastern Pacific Ocean off Oregon. The new genus is distinguished from BrachyenteronManter, 1934 and SteganodermaStafford, 1904, the 2 closest lepidophylline genera, and from 4 other zoogonid genera erected since 2007, the last major revision of the family, by a combination of diagnostic features including a pyriform or spindle-shaped body, smooth testes and ovary, narrow ceca that reach with the vitellarium into the hindbody, an unspecialized ventral sucker, non-filamented eggs, a claviform cirrus pouch, and an unpocketed ejaculatory duct and metraterm, and the new genus lacks circumoral spines. We present updated keys to the 3 subfamilies of the Zoogonidae Odhner, 1902, as well as to the genera of the Cephaloporinae Yamaguti, 1934 and the Lepidophyllinae Stossich, 1903. A listing of the parasites known from S. grandis also is presented. This study documents the third family of digeneans (Zoogonidae) known to parasitize S. grandis, and it is a new host record (i.e., the first zoogonid reported from this host species). We discuss the relatively impressive presence of the Zoogonidae and their hosts within the deep sea. Specifically, of the 35 genera we recognize within this digenean family, 14 (40%) have deep-sea representatives. At least 37 species within 27 genera and 19 families within 11 orders of deep-sea fish are known to harbor zoogonids. Furthermore, of the 37 known deep-sea fish species parasitized by zoogonids, only 5 (13.5%) harbor 2 or more zoogonid species; the remaining 32 (86.5%) harbor only 1 parasite species each, indicating strong host specificity. Finally, the dietary ecology of S. grandis is presented, allowing us to speculate that Gaharitrema droneni may be utilizing gastropods and polychaetes as well as S. grandis to complete its life cycle in the deep sea.

Pseudopecoelus mccauleyi n. sp. and Podocotyle sp. (Digenea: Opecoelidae) from the deep waters off Oregon and British Columbia with an updated key to the species of Pseudopecoelus von Wicklen, 1946 and checklist of parasites from Lycodes cortezianus (Perciformes: Zoarcidae).

Pseudopecoelus mccauleyi n. sp. (Opecoelidae: Opecoelinae) is described from the intestine of the bigfin eelpout, Lycodes cortezianus (Gilbert, 1890) (Perciformes: Zoarcidae), collected at 200-800 m depths in the Northeastern Pacific Ocean off Oregon and Vancouver Island, British Columbia. The new species is distinguished by possessing a unique combination of the following diagnostic characters: vitelline fields that extend to the posterior margin of the ventral sucker; a slender, tubular and sinuous seminal vesicle that extends some distance into the hindbody; an unspecialized, protuberant ventral sucker; a genital pore at pharynx level; lobed to deeply multilobed testes; a lobed ovary; and an egg size of 68-80 µm × 30-46 µm. A single specimen of Podocotyle Dujardin, 1845 (Digenea: Plagioporinae) is also described from the intestine of an individual Coryphaenoides sp. (Gadiformes: Macrouridae) collected at 2,800 m depth off Oregon. A listing of parasites from the bigfin eelpout as well as observations of parasite diversity within relevant hosts are offered, new host and locality records are noted, and a brief discussion of Pseudopecoelus von Wicklen, 1946 in the deep sea is presented taking note of the low level of host specificity recorded (i.e. spp. of Pseudopecoelus are now known to parasitize deep-water fish from at least 20 piscine families). A new dichotomous key to the 39 recognized species of Pseudopecoelus is introduced.

Co-circulation of three pathogenic hantaviruses: Puumala, Dobrava, and Saaremaa in Hungary.

Hantaviruses (Bunyaviridae) cause hemorrhagic fever with renal syndrome (HFRS) in Eurasia and hantavirus (cardio)pulmonary syndrome (HCPS) in the Americas. HFRS is caused by Hantaan virus (HTNV), Seoul virus (SEOV), Dobrava virus (DOBV), Saaremaa virus (SAAV), and Puumala virus (PUUV). Of those, only HTNV is not present in Europe. In recent years, hantaviruses, described in other parts of Europe, were also detected at various locations in Hungary. To study the genetic properties of Hungarian hantaviruses in detail, sequences of the viral S and M segments were recovered from bank voles (Myodes glareolus), yellow-necked mice (Apodemus flavicollis), and striped field mice (Apodemus agrarius) trapped in the Transdanubian region. As expected, the sequences recovered belonged, respectively, to PUUV (two strains), DOBV (one strain), and SAAV (one strain). On phylogenetic trees two new Hungarian PUUV strains located within the well- supported Alpe-Adrian (ALAD) genetic lineage that included also Austrian, Slovenian, and Croatian strains. Analysis of the Hungarian SAAV and DOBV genetic variants showed host-specific clustering and also geographical clustering within each of these hantavirus species. Hungarian SAAV and DOBV strains were related most closely to strains from Slovenia (Prekmurje region). This study confirms that multiple hantaviruses can co-circulate in the same locality and can be maintained side-by-side in different rodent species.

A simple spatial model to explain the distribution of human tick-borne encephalitis cases in hungary.

Tick-borne encephalitis (TBE) is a common medical problem in Hungary and throughout much of Europe and Asia. This paper develops a geographic model that helps to predict the distribution of human tick-borne encephalitis cases in Hungary. The model is tested on a dataset of serologically confirmed TBE cases mapped by patients' residences. Case densities (incidence rates) are compared to predicted distributions of TBE derived from digital land-cover data. Maps are analyzed at the county level and on a smaller spatial scale. The analyses identified three major factors that shape the geographic distribution of human TBE cases in Hungary. The most important component is the distribution of forest habitat. TBE incidence correlates positively with the amount of forested habitat in each county. On a finer scale, the amount of forests within a 2500-meter radius of each town and village correlated significantly with TBE incidence rate. Based on these data, about 30% of the variation in TBE incidence is accounted for by the specific distribution of forest habitats in Hungary. Besides the distribution of forests, differences in human land-use practices among regions also affect the distribution of TBE cases. Additionally, because of the low transmission rate of the virus to humans, the perceived distribution of TBE cases is affected by random stochastic events. As a consequence of stochastic variation, meaningful patterns in the distribution of TBE cases can be only recognized when data are analyzed over broader temporal and spatial scales.

Central regulation of adrenal tyrosine hydroxylase: interaction between dopamine and GABA systems.

It has been previously demonstrated that nigrostriatal dopaminergic fibres participate in the neural regulation of the activity of adrenal tyrosine hydroxylase, specifically in its induction. To determine whether activation or inhibition of these fibres is responsible for this induction, the role of presynaptic dopamine receptors was investigated. Apomorphine (0.2 mg/kg), (+)3-PPP (10 mg/kg) and BHT 920 (1-3 mg/kg), drugs that are reported to bind to presynaptic dopamine receptors and thereby inhibit the release of that neurotransmitter, caused significant increases in the activity of the enzyme. As a central GABA (gamma-aminobutyric acid) system is believed to exert inhibitory control over the release of dopamine, GABA agonists were also tested for their effects. Muscimol (3 mg/kg), gamma-hydroxybutyrate (500 mg/kg) and HA-966 (150 mg/kg) produced significant induction of the adrenal enzyme; this induction was not blocked by dopamine postsynaptic receptor antagonists. After intraventricular administration (5 micrograms/rat) in normal animals, HA-966 produced significant induction of tyrosine hydroxylase. Its systemic administration did not induce the enzyme in animals with the adrenal denervated. When administered together at submaximal doses, HA-966 and BHT 920 produced an additive effect in the induction of adrenal tyrosine hydroxylase.

Reduced amounts of S-adenosylmethionine decarboxylase in the adrenal glands of rats following administration of piribedil or 2-deoxyglucose.

The activity of S-adenosylmethionine decarboxylase (SAM-DC) is decreased in the adrenal gland of the rat following physical stress, metabolic stress or administration of dopamine agonists [M. Ekker and T. L. Sourkes, Endocrinology 120, 1299 (1987)]. Immunotitration studies with a serum directed against purified rat liver SAM-DC show that the reduction in activity of the enzyme following administration of 2-deoxyglucose or piribedil was paralleled by a decrease in the amount of immuno-reactive protein. There was no difference in the half-life of SAM-DC activity between piribedil-treated rats and controls. The properties of an extensively purified preparation of the adrenal enzyme resembled those of SAM-DC obtained from rat liver. It is suggested that the reduction in adrenal SAM-DC activity and protein content caused by stress is due to a reduction in the rate of synthesis of the enzyme.

On the metabolic radioprotection.

The effect of different factors (0.025 mol/l of cysteine, 0.0003 mol/l of iodoacetamide, 0.328 mol/l of hydroxyurea, deprivation of glucose or essential amino acid and uracil from the medium) on the resistance to gamma rays was studied in the cells of E. coli TAU- during the logarithmic phase. The resistance to gamma rays was also investigated during the stationary phase. It was established that treatments, including reversible inhibition of cell division and unbalance of macromolecular synthesis of a type in which the DNA synthesis was continued without a simultaneous RNA- and protein synthesis enhanced the radioresistance. This type of asynchrony of macromolecular synthesis could increase radioresistance by promotion of repair processes of single-strand breaks in DNA after a single dose of 15 krads irradiation. For this latter studies E. coli K12 (AB 2497) strain and the technique developed by McGrath and Williams was used.