The role of Polish school nurses in the oral health promotion for 7-19 year-old children and adolescents.

PURPOSE: The assessment of the role of school nurses in the oral health education and counselling of children and adolescents aged 7-19 years. METHODS: A self-administered questionnaire was used to evaluate nurses' practice in oral health education, previous training in caries prevention, collaboration with a dentist and self-assessment of knowledge. Data were analysed with the Chi square test. RESULTS: The study group consisted of 140 Polish school nurses. Respondents declared the following activities: dietary counselling (99.2%), oral hygiene education (92.8%), NHS-funded supervised fluoride prophylaxis (82.8%), and caries screenings (4.3%). 47.1% participated in training on caries prevention, 25.7% had a collaboration with a dentist. Nurses from schools located in towns less frequently provided oral hygiene education (p < 0.005) and dietary counselling, but more often had a collaboration with a dentist (p < 0.05). The youngest nurses were more confident about their knowledge (p < 0.05). There was an association between participation in training on caries prevention and positive opinion on a school-based fluoride prophylaxis (p < 0.01). Nurses who did not include dental topics in their practice worked mainly with pupils older than 15 years, had shorter experience (p < 0.05), secondary education, worked in urban areas and had no training on dental problems (p < 0.01). CONCLUSION: Polish school nurses have potentially crucial roles in improving the oral health status in pupils through oral hygiene education, dietary counselling and fluoride prophylaxis included in their duties.

Dentin dysplasia type I.

This paper describes a rare case of genetically determined dentin dysplasia type Iin 26-year-old male patient. The paper highlights anatomical and radiologicalaspects of dental abnormalities and emphasizes the significance of the educationof both general practitioners and paediatricians as regards referring patients withdiagnosed dentin dysplasia for a multi-specialty therapy.

Use of standardised patients in the evaluation of a residency mood disorders curriculum: a brief report.

Background and objectives The purpose of this paper is to describe the use of resident performance on an observed structured clinical examination (OSCE) as a tool to refine a mood disorders curriculum, and to disseminate a mood disorders OSCE for use in other residency settings. Methods A depression-focused OSCE and a direct observation evaluation tool were developed and implemented. A total of 24 first-year family medicine residents (PGY1) participated in the OSCE, and their performance was used to direct changes in a mood disorders curriculum. Results Residents performed well on general interview behaviours, and 67% were able to uncover depression in a patient presenting with headaches. Less than 50% of the residents asked about suicidal ideation and recreational drug use. Curriculum was added that addressed the latter deficiencies. Conclusions Tracking of resident performance on specific behaviours during OSCE sessions can be used for curriculum evaluation purposes. The mood disorders curriculum in additional family medicine residency programmes can now be evaluated using our depression-focused OSCE and Clinical Performance Checklist.

[Dental decay treatment in hemophilia patients].

Intensive dental decay is a constant symptom in hemophilia patients while its treatment may be challenging because of need for effective but sparing techniques. Rational and safe techniques for dental decay treatment in hemophilia patients are discussed in the study.

Expression of antimicrobial peptides and proteins in etanercept-treated psoriasis patients.

Recent papers highlight the role of dysregulated expression of antimicrobial peptides and proteins (AMPs) in the pathogenesis of psoriasis. Etanercept, a blocker of the pro-inflammatory cytokine tumour necrosis factor-α (TNF-α), is effective in the treatment of psoriasis. We aimed to evaluate the expression profiles of AMPs in psoriatic skin before and after a 6-week course of etanercept therapy. We included 12 psoriasis patients who underwent medium-dose etanercept treatment for 6weeks. At baseline and at the end of therapy immunohistochemistry from lesional skin was performed for psoriasin, LL-37, and human ß-defensin 2 (hBD-2). After 6-week treatment, the modified psoriasis area and severity index significantly decreased from 37.5±5.9 to 14±13.4. Lesional immunoreactivity scores of psoriasin, LL-37, and hBD-2 also significantly decreased after a 6-week course of etanercept. We have demonstrated that etanercept-induced improvement of psoriasic lesions is associated with a significant decline of AMP protein expression.

How to treat diversion colitis?--Current state of medical knowledge, own research and experience.

The aim of this study was to present current knowledge about a nospecific inflammation of mucosa within segments of colon excluded from normal bowel passage called as a "diversion colitis" (DC) and to try to determine the role of factors which might modify the clinical course of DC. We also unswered the question; how to treat DC: conservatively or surgically? Our own experience with DC concerns 145 patents (which is most numerous and well exactly examined series presented in literature). In the group of patients studied, clinical signs of DC were present in over 70% of patients (early signs were low abdominal pain and tenesmus, while anal oozing appeared later). Predominating endoscopic features of DC in the group of patients studied were: a. blurring of vascular pattern (in app. 90% of patients); b. contact bleeding (in app. 80% of patients); c. mucosal oedema (in app. 60% of patients). Results of own observations and literature data indicate, that morphologic alterations in the segment of bowel excluded from normal passage are probably vasogenic consisting in atrophy and inflammation of the allergic type (this would confirm the theory about vascular etiology of DC). In our material, we have not noticed any trend toward hyperproliferation or dysplasia in the excluded segment of colon, supporting the thesis that these disturbances are largely reversible. Clinical pathology of DC does not depend on age, sex, cause and type of surgical procedure performed, mode of surgery or concomitant diseases. Authors suggested an alternative algorithm of diagnostic work-up in patients suspected of DC, and proposed that patients with a segment of bowel excluded from normal passage be subdivided into three groups: 1. Patients with no clinical, endoscopic nor morphologic signs of DC. 2. Patients with moderate signs of DC. 3. Patients with severe signs of DC. Patients in the group 1 should remain under continuous specialised supervision, because they are at risk of developing DC, while patients in the groups 2 and 3 should undergo surgical restoration of bowel continuity. This applies particularly to group 3, where indications for surgery do not stem from risk of hyperproliferation, dysplasia or malignant transformation, but from that of a massive inflammation, which may constitute a danger for patientis health and even life. Authors also underline that DC can be treated conservatively but the best and most successful and remained method of treatment of DC is the operation of decolostomy, which means restoration continuity of digestive tract.

Psychosexual aspects of vulvar vestibulitis.

OBJECTIVE: To explore the psychological, interpersonal and sexual correlates of vulvar vestibulitis via qualitative and quantitative analysis. STUDY DESIGN: Sixty-nine women diagnosed with vestibulitis were recruited from a vulvar/vaginal disease clinic to complete a comprehensive quantitative and qualitative questionnaire designed to assess general health concerns, mental health, sexual functioning and interpersonal relationships. RESULTS: The majority of participants reported drastic changes in sexuality associated with the onset of vestibulitis. Upon developing vestibulitis, 88% reported decreased interest in sexual activity, 87% indicated that they were less willing to participate in sexual activity, and 94% maintained that they were less able to participate in sexual activity. High levels of frustration and symptoms of depression also were frequently reported. CONCLUSION: Vulvar vestibulitis is associated with significant changes in sexuality, intimate relationships and psychological well-being. When treating women with vestibulitis, medical professionals should consider the psychological and sexual aspects of the disease in addition to physical concerns.