Trends in Scope of Practice for Oral Health Care: Future Transformative Effects.

KNOWLEDGE TRANSFER STATEMENT: The results of this study can help key stakeholders, such as health care facilities, educational and research institutions, insurance companies, and governmental bodies, plan future activities and policies on dental practice and education.

COVID-19 Has Clarified 2 Foundational Policy Questions in Dentistry.

KNOWLEDGE TRANSFER STATEMENT: This commentary can be used by governments, regulators, professional groups, and other stakeholders in their considerations of what constitutes essential or medically necessary dental care and how to best allocate dental care resources.

A new definition for oral health developed by the FDI World Dental Federation opens the door to a universal definition of oral health.

This article first published as an editorial in the Journal of the American Dental Association presents the FDI World Dental Federation's universal definition of oral health. This new definition was approved in September 2016 and developed as as part of the FDI's advocacy and strategic plan - Vision 2020.

Compound A, a selective glucocorticoid receptor agonist, inhibits immunoinflammatory diabetes, induced by multiple low doses of streptozotocin in mice.

BACKGROUND AND PURPOSE: Type 1 diabetes is a multifactorial inflammatory disease that develops as a result of deregulated immune responses, causing progressive autoimmune destruction of insulin-producing beta cells of pancreas. 2-((4-acetoxyphenyl)-2-chloro-N-methyl) ethylammonium chloride, compound A (CpdA), is a selective glucocorticoid receptor (GR) agonist that displays strong anti-inflammatory and immunomodulatory activities. We investigated the therapeutic effectiveness of CpdA in a pharmacological model of type 1 diabetes in mice. EXPERIMENTAL APPROACH: The utility of CpdA in diabetes prevention was evaluated in vivo through its prophylactic administration to male C57BL/6 mice that received multiple low doses of streptozotocin for immunoinflammatory diabetes induction. The effect of CpdA on disease development was studied by measuring blood glucose and insulin level, histopathological examination, determination of the nature of infiltrating cells, pro- and anti-inflammatory cytokine production, and signalling pathways. KEY RESULTS: Prophylactic in vivo therapy with CpdA conferred protection against development of immunoinflammatory diabetes in mice by dampening the M1/Th1/Th17 immune response and switching it towards an anti-inflammatory M2/Th2/Treg profile, thus preserving beta cell function. CONCLUSIONS AND IMPLICATIONS: Anti-diabetic properties of CpdA are mediated through modulation of immune cell-mediated pathways, but without triggering adverse events. These findings provide basic information for the therapeutic use of selective GR agonists in the amelioration of islet-directed autoimmunity.

Carbon monoxide-releasing molecule-A1 inhibits Th1/Th17 and stimulates Th2 differentiation in vitro.

Carbon monoxide (CO) is endogenously produced by haeme oxygenase-1 and has profound effects on intracellular signalling processes, generating anti-inflammatory, antiproliferative and antiapoptotic effects. A boron-containing compound CORM-A1 is capable of releasing CO in such a way to mimic physiological functions of haeme oxygenase-1. Considering the importance of Th1/Th17 versus Th2 balance in the final outcome of immune and inflammatory responses in this study we focused on immune-modulatory effects of CORM-A1 on murine lymph node-derived T cells in vitro and its influence on T-cell proliferation, activation and differentiation. Anti-CD3/CD28 antibody-triggered lymph node cells proliferation remained unaffected after 24-hour CORM-A1 treatment, as well as the expression of the early activation marker CD25. However, CORM-A1 successfully reduced the secretion of the two representative pro-inflammatory cytokines, IFN-γ and IL-17, while the secretion of anti-inflammatory cytokine IL-4 remained unchanged. Furthermore, CORM-A1 efficiently reduced the percentage of CD4(+) IFN-γ(+) and CD4(+) IL-17(+) cells, whereas CD4(+) IL-4(+) cell population increased after treatment. Also, CORM-A1 significantly reduced expression of transcription factor RORγT, necessary for Th17 development, but the expression of Th1-related and Th2-related transcription factors (T-bet and GATA-3, respectively) remained unchanged. In conclusion, our findings indicate that CO has anti-inflammatory role through the regulation of balance between pro-inflammatory Th1/Th17 and anti-inflammatory Th2 cells. Observed immunomodulatory effects of CORM-A1 could be useful for developing novel therapeutic approaches in managing Th1/Th17-mediated immune disorders.

The role of wages in the migration of health care professionals from developing countries

Several countries are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals. This trend has led to concerns that in many of the source countries - especially within Africa - the outflow of health care professionals is adversely affecting the health care system. This paper examines the role of wages in the migration decision and discusses the likely effect of wage increases in source countries in slowing migration flows. This paper uses data on wage differentials in the health care sector between source country and receiving country (adjusted for purchasing power parity) to test the hypothesis that larger wage differentials lead to a larger supply of health care migrants. Differences in other important factors affecting migration are discussed and; where available; data are presented. There is little correlation between the supply of health care migrants and the size of the wage differential between source and destination country. In cases where data are available on other factors affecting migration; controlling for these factors does not affect the result. At current levels; wage differentials between source and destination country are so large that small increases in health care wages in source countries are unlikely to affect significantly the supply of health care migrants. The results suggest that non-wage instruments might be more effective in altering migration flows

[Neuroradiologic diagnosis of space compression processes caused by orbital tumors or pseudotumors]. / Neuroradioloska dijagnostika spaciokompresivnih procesa orbite tumorske i pseudotumorske etiologije.

In thirty-year period are presented 110 patients with spatio-compressive orbital processes diagnosed by ophtalmoradiological methods. Out of those, 100 patients were surgically treated and histopathologically verified in our institution. All the entities of spatio-compressive processes are presented, benign and malignant tumors as well as pseudotumors of inflammatory and vascular nature. All the methods known in the world up to day are chronologically alleged, from classic to modern digital methods, as well as their diagnostic efficacy. The most efficacious algorhitm is established in the choice of radiological examination procedures on the basis of former experience. The collaboration of neuroradiologist, ophthalmologist and neurosurgeon was of the utmost significance in solving the spatio-compressive orbital processes.

A radiation hybrid map of human chromosome 5 with integration of cytogenetic, genetic, and transcript maps.

One of the major goals of the human genome project is to establish a physical map of each human chromosome with a density of sequence-tagged site (STS) markers exceeding one every 100 kb. We report here the generation of a human chromosome 5-specific radiation hybrid (RH) map that includes 556 markers. Of these markers, 132 loci are ordered with a maximum likelihood ratio of >1000:1 compared with the next most likely order. An additional 113 loci were ordered relative to these backbone markers with a maximum likelihood ratio of >10:1 but <1000:1. Together, these 245 loci form an ordered framework map for the chromosome. Using this framework, >300 more markers were localized based on two-point analysis with the ordered set. On average, there are 50 markers in common with the RH map presented here and other chromosome 5 maps included in the current whole genome cytogenetic, genetic, and physical maps. The accuracy of all the maps is evident in that there are no more than two discrepancies between any one of them and these data. All of the maps encompassing chromosome 5 complement each other providing excellent STS coverage with >2200 loci combined. The chromosome 5-specific RH map contains 20% of these independent loci. In addition, our RH map contains STSs derived from clones suitable for fluorescent in situ hybridization, allowing alignment to the cytogenetic map. Together, these maps will assist in the assembly of sequence-ready contigs and will aid in the identification of disease loci on chromosome 5 by positional cloning and positional candidate approaches.

[Closed intracranial extradural traumatic lesions of the internal carotid artery]. / Zatvorene traumatske intrakranijalne ekstraduralne lezije unutrasnje karotidne arterije.

Closed intracranial lesions of the internal carotid artery are severe complications of craniocerebral trauma. Intradural lesions of branches of this artery are common and well known while extradural lesions are less frequently found. This is illustrated also by a small number of lesions found in our patients within the twenty-year period, namely 8/1000 compared to intradural lesions of branches of the internal carotid artery. Traffic accidents are dominating in their etiology and the causative mechanism is transsphenoidal fracture of the skull base. Due to difficult surgical approach inadequate methods of ligature of the extracranial portion of the internal carotid artery have been used before but it has not led to cure. Contrarily to this, modern direct microsurgical approach or balloon embolisation successfully solve this problem.

[Transient ischemic attacks and coronary disease]. / Tranzitorni ishemicni atak i koronarna bolest.

Taking into consideration data from the literature that the most common cause of mortality of patients with transient ischemic attacks (TIA) is myocardial infarction, the aim of the study was to examine the state of coronary circulation in patients with TIA previously completely asymptomatic to coronary disease. There have been examined 40 patients with TIA previously asymptomatic to coronary disease and 14 patients with general characteristics similar to Parkinson's syndrome, also asymptomatic to coronary disease. All patients were subjected to neurological examination, echocardiography of carotid arteries, standard electrocardiography, X-ray of the heart and ergometry and, if indicated, coronarography. On the basis of the analysis of the results obtained it has been concluded that a significant number of patients with TIA, previously asymptomatic to coronary disease showed signs of coronary disease which imposes the necessity of correction of doctrinaire principles in prevention and follow up of these patients.

[Duplex sonography in the diagnosis of ischemic disease of the lower extremity. Comparative study with angiography]. / Dupleks sonografija u dijagnostici ishemicne bolesti donjih ekstremiteta. Komparativna studija sa angiografijom.

The aim was to study possibilities of duplex sonography in evaluation of ischemic diseases of the lower extremities. The results obtained were compared with angiographic findings and high correlation of the results was obtained. Duplex sonography is a simple, safe, noninvasive method in diagnosing the site and degree of stenotic changes on the arteries of the lower extremities.