Subgingival microbiota in adult Down syndrome periodontitis.

BACKGROUND AND OBJECTIVE: The subgingival microbiota in Down syndrome and non-Down syndrome adults receiving periodic dental care was examined for 40 bacterial species using checkerboard DNA-DNA hybridization and the results were related to clinical periodontal attachment loss. MATERIAL AND METHODS: A total of 44 Down syndrome, 66 non-Down syndrome mentally retarded and 83 mentally normal adults were clinically evaluated. This involved, for each subject, the removal of subgingival specimens from three interproximal sites on different teeth; all subgingival samples per subject were then pooled and assessed for the presence and levels of 40 bacterial species using species-specific whole-genomic DNA probes and checkerboard DNA-DNA hybridization. Significant group differences in species proportions averaged across subjects were evaluated using the Kruskal-Wallis test, and associations between subgingival species and mean subject attachment loss within Down syndrome and non-Down syndrome subject groups were quantified using Pearson correlation and multiple linear regression analysis. RESULTS: Down syndrome subjects exhibited greater attachment loss than non-Down syndrome subjects (p=0.05). Most microbial species were present in Down syndrome subjects at levels similar to non-Down syndrome subjects, except for higher proportions of Selenomonas noxia, Propionibacterium acnes, Streptococcus gordonii, Streptococcus mitis and Streptococcus oralis in Down syndrome subjects compared with non-Down syndrome study subjects, higher proportions of Treponema socranskii in Down syndrome subjects compared with non-Down syndrome mentally retarded subjects, and higher proportions of Streptococcus constellatus in Down syndrome subjects compared with mentally normal subjects. Down syndrome adults classified with periodontitis revealed higher subgingival levels of T. socranskii than Down syndrome subjects with no periodontitis (p=0.02). Higher subgingival proportions of S. constellatus, Fusobacterium nucleatum ssp. nucleatum, S. noxia and Prevotella nigrescens showed significant positive correlations (r=0.35-0.42) and higher proportions of Actinomyces naeslundii II and Actinomyces odontolyticus showed negative correlations (r=-0.36 to -0.40), with increasing mean subject attachment loss in Down syndrome adults. CONCLUSION: Individuals with Down syndrome show higher levels of some subgingival bacterial species and specific associations between certain subgingival bacterial species and loss of periodontal attachment. These findings are consistent with the notion that certain subgingival bacteria may contribute to the increased level of periodontal disease seen in Down syndrome individuals and raise the question as to the reason for increased colonization in Down syndrome.

Who treats minorities?

We studied the characteristics of psychological service providers who treat ethnic minority clients in a representative random sample of psychologists listed in the National Register of Health Service Providers (NR) in 1986. Ethnic minority providers saw more than twice the proportion of ethnic minority clients than did non-Latino White providers (24.0% and 11.7%, respectively). Providers with cognitive-behavioral clinical/theoretical orientations saw significantly more ethnic minority clients than did those with psychodynamic or other orientations. Providers with eclectic orientations saw significantly more ethnic minority clients than did those with psychodynamic orientations, but eclectic providers did not differ from any other provider orientation group. The results suggest that more ethnic minority providers are needed and that other providers need to increase their ethnic minority clientele.

Bem Sex-role Inventory stereotypes for men and women varying in age and race among National Register psychologists.

554 psychologists listed in the National Register of Health Care Providers in Psychology used the Bem Sex-role Inventory to rare a "mature, healthy, socially competent" individual in one of 18 target groups (a black or race-unspecified man, woman, or adult in their late 20s, late 40s, or late 60s). Factor analysis produced factors which generated three scales--nurturant, agentic, and self-governing. The attributes "feminine" and "masculine" were treated as individual items. Old targets were viewed as less agentic than younger targets and as less self-governing than the middle-aged. Female targets were perceived as more feminine and less masculine than were men. Interactions for agentic and self-governing suggest age and race and sex of target influence person perceptions.

Attitudes of nursing and rest home administrators toward deinstitutionalized elders with psychiatric disorders.

The administrators of 92 nursing homes and rest homes in western Massachusetts were surveyed on their experiences with elderly residents with a history of psychiatric hospitalization and their willingness to admit such individuals in the future. A majority of those who had admitted deinstitutionalized elders with chronic psychiatric disorders reported having experienced severe problems with them. Most of the problems involved the resident going into crisis or producing some highly disruptive behavior. Although two-thirds of the facilities had admitted elders who had been deinstitutionalized from a public psychiatric hospital, only one-quarter clearly planned to do so in the future. Three quarters of the administrators reported that they did not have the support services that the deinstitutionalized elders in their facilities needed. A comparison of the services reported to be important and those reported to be available suggest that simply increasing the availability of psychiatric support services would probably not influence administrators to admit elders with chronic mental illness in the future.

Pseudohyperparathyroidism in a mare associated with squamous cell carcinoma of the vulva.

An 18-year-old Appaloosa mare was examined because of squamous cell carcinoma of the vulva, anorexia with pronounced weight loss, and hypercalcemia. The tumor had developed rapidly over a period of 3 months and externally extended ventrally involving the perineum and the dorsal aspect of the udder. Necropsy examination demonstrated a large primary squamous cell carcinoma of the vulva, perineum, and mammary gland with metastases to the supramammary, sublumbar, deep inguinal, and mediastinal lymph nodes. No gross renal lesions were observed and, histologically, there was only mild vacuolation of renal tubular epithelium. Based on the normal concentration of serum parathyroid hormone, the absence of evidence of hypervitaminosis D, and normal renal function, a diagnosis was made of hypercalcemia of malignancy or pseudohyperparathyroidism. The mechanism responsible for hypercalcemia was not determined, but the histologic type of the neoplasm and the clinical course suggested possible production of a humoral hypercalcemic factor by the neoplasm, similar to that demonstrated in certain types of human squamous cell carcinoma.