The Yad Sarah geriatric dental clinic, a different model

Introduction: There are not sufficient dental services for elderly people around the world. Yad Sarah is an Israel‐wide network of volunteers aiding sick, elderly, isolated and housebound people with an array of services aimed at making home care possible. It provides medical and social services to more than 380 000 elderly persons per year and in addition, lends medical equipment free of charge, has day rehabilitation centres, legal aid council for seniors, provides transportation for the disabled, meal deliveries and geriatric dental services. Materials and methods: The latter are equipped with five dental units (one mobile unit) and a dental laboratory. During the 5 years from 2000 to 2004 the dental services provided dental care for 3890 elderly patients with the main clinic located in Jerusalem. Patients pay an average of 70% of the cost price of their dental care, with the difference being subsidised by Yad Sarah. Of the 515 patients who applied for treatment in 2004, 54% possessed natural teeth in both jaws, 28% were fully edentulous, 12% were edentulous in the maxilla and 6% were edentulous in the mandible. Females applied for dental treatment more often than the male population. Older patients (75–101 years old) required oral care at their homes or at old age residences, more frequently than the younger age groups (60–74 years old). Conclusion: Dental treatment was administered by 70 volunteer dental surgeons, two certified dental hygienists and dental hygienist students. The clinical staff was provided with a comprehensive in‐service training in geriatric dentistry during the 3‐year service learning period. A survey in 2004 showed that 83% of the selected patients were satisfied, compared with 14% who were not. The reasons for satisfaction were, mainly, the personal relationship with the attending staff (41%) and the professional ability of the dental team (46%).     

Effects of two types of herbivores on the population dynamics of a perennial herb

The joint effects of multiple herbivores on their shared host plant have received increasing interest recently. The influence of herbivores on population dynamics of their host plants, especially the relative roles of different types of damage, is, however, still poorly understood. Here, we present a modelling approach, including both deterministic and stochastic matrix modelling, to be used in estimating fitness effects of multiple herbivores on perennial plants. We examined the effects and relative roles of two specialist herbivores, a pre-dispersal seed predator, Euphranta connexa, and a leaf-feeding moth, Abrostola asclepiadis, on the population dynamics and long-term fitness of their shared host plant, a long-lived perennial herb Vincetoxicum hirundinaria (Asclepiadaceae). We collected demographic data during 3 years and combined these data with the effects of natural levels of herbivory measured from the same individuals. We found that both seed predation and leaf herbivory reduced population growth of V. hirundinaria, but only very high damage levels changed the growth trend of the vigorously growing study populations from positive to negative. Demographic modelling indicated that seed predation had a greater impact on plant population growth than leaf herbivory. The effect of leaf herbivory was weaker and diminished with increasing level of seed predation. Evaluation of individual fitness components, however, suggested that leaf herbivory contributed more strongly to host plant fitness than seed predation. Our results emphasize that understanding the effects of a particular herbivore on plant population dynamics requires also knowledge on other herbivores present in the system, because the effect of a particular type of herbivory on plant population dynamics is likely to vary according to the intensity of other types of herbivory. Furthermore, evaluating herbivore impact from using individual fitness components does not necessarily reflect the long-term effects on total plant fitness.     

A novel mutation in a large family causes a unique phenotype of Mucolipidosis IV

Mucolipidosis type IV is a rare autosomal recessive lysosomal storage disorder reported among Ashkenazi Jews and to a lesser extent in other ethnic groups. Several mutations have been reported in MCOLN1 which is the only known gene associated with the disorder. Here we report the first Saudi patient with Mucolipidosis type IV from a consanguineous family with two branches having a total of five patients carrying a novel transition mutation, c.1307A > G (p.Y436C) in exon 11. The clinical course of the patient was nonspecific and a lysosomal storage disorder was not highly suspected due to lack of coarse facial features, organomegaly and skeletal findings of dysostosis multiplex. The detailed bioinformatics analysis on the deleterious effects of the mutation is discussed. Emphasis is made on the importance of brain magnetic resonance imaging (MRI) findings and serum gastrin level as key clues to the diagnosis of this often subtle neurodevelopmental disorder.     

用信息公示代替管理评审等制度的思考

管理年评审、重点专科评审存在很多问题,带来形式主义和不正之风,探讨信息公开制度代替管理年评审的必要性、可行性及存在的问题,具有重要意义。

     

开展临床指导教师对普通专科医师培训情况的调查结果分析

目的：调查我院专科医师培训开展的整体情况,为继续做好专科医师培训工作提供依据。方法：随机调查我院参与普通专科医师培训轮转科室的指导教师,发放自制调查表。结果：90％以上导师认为科室带教质量高;48．78％导师认为临床科室应为学员每月发放1000元以上生活补助;60．98％导师认为硕士研究生普通专科医师培训时间应为二年;60％以上导师认为应着重硕士研究生临床操作技能、医患沟通能力、病历书写能力及阅片能力等方面能力的培训;50％以上导师认为目前培训中存在的主要问题是生活无保障;图书馆国内外最新文献不足;监管力度不强;临床技能培训针对性不强等。结论：我院开展普通专科医师培训整体情况较好。但仍存在很多问题,在今后的培训过程中应继续为学员的生活提供更多保障,继续加强管理监督,保证培训按计划、按质量完成。     

上鼓室重建对慢性中耳炎开放式鼓室成形术作用的临床研究

目的:观察在开放式鼓室成形术中,重建上鼓室对慢性中耳炎治疗的临床疗效。方法:86例(86耳)慢性中耳炎患者随机均分两组:两组均行开放式鼓室成形术,其中实验组应用自体乳突骨粉联合耳后肌骨膜瓣缩窄乳突根治腔,并垫高上鼓室内壁;对照组不行乳突根治腔缩窄术。回顾性观察两组患者在鼓膜状态(内陷及穿孔)、干耳时间、听力提高,头晕头痛、肉芽增生等几个方面的恢复情况。结果:通过对两组病例进行随访和疗效分析,在鼓膜状态、干耳时间、头晕头痛等方面,其临床疗效差异有显著性(P<0.05);而在术后听力提高及肉芽增生方面无显著性差异(P>0.05)。结论:在慢性中耳炎开放式鼓室成形术中,自体材料的应用缩短了干耳时间、提高了手术疗效,减少了手术相关的并发症。     

The use of fluctuating asymmetry as a measure of farming practice effects in rodents: A species-specific response

The effects of agricultural intensification on vertebrate populations could vary depending on whether species are habitat specialists or habitat generalists. Organic farming practices are generally considered to be less intensive and more environmental friendly than conventional farming practices and, as a result, these two managements may impact on habitat specialists and habitat generalists in different ways. The effect of environmental and/or genetic stress on populations can be assessed using fluctuating asymmetry (FA) and body condition of animals. We predicted that populations of a specialist species, the Pampean grassland mouse (Akodon azarae) would have higher levels of FA and poorer body condition on conventional farms compared to populations of A. azarae on organic farms. In contrast, we predicted that populations of generalist species, the corn mouse (Calomys musculinus) and the small vesper mouse (Calomys laucha) would not show differences in FA or body condition between conventional and organic farms. We examined the expression of FA in the hind foot and used the scaled mass index as a surrogate for body condition. As predicted, we found higher FA in the habitat specialist (A. azarae) on conventional farms compared to organic farms, and found no differences in FA among the two generalist species (C. musculinus and C. laucha). However, we found no differences in body condition for the three studied species between the two managements. Our results suggest that the effect of farming practices on small mammals varies between habitat specialists and habitat generalists. The results of this study provide important insights for the study of asymmetries, both from biological and methodological perspectives. Our results support the idea that the level of FA may be used as an index to assess the effects of farming practices on vertebrate populations.     

Conservation implications of competition between generalist and specialist rodents in Mediterranean afforested landscape

Density dependent habitat selection at the community level is regarded as a major determinant of biodiversity at the local scale, and data on these processes and how they are affected by human activities is highly applicable to conservation. By studying the competitive relationships between a specialist and a generalist we can acquire valuable insights about how different environmental elements determine species abundance and distribution and consequently biodiversity. Here we describe a study of density dependent processes that determine the community structure of two rodents: a specialist—the broad toothed mouse (Apodemus mystacinus), and a generalist—the common spiny mouse (Acomys cahirinus) in a Mediterranean maqui habitat, and how this structure is impacted by anthropogenic planting of pine stands. We carried out two field experiments: The first, based on open field trapping, looking at how rodent communities change with habitat structure. The second experiment was an enclosure study aimed at validating the habitat preferences and competitive relationship between the specialist and the generalist. We identified asymmetric competition relationships in which the specialist was dominant over the generalist. Competition intensity was lower in maqui with >10% oak cover, although both species abundances were high. Competition was found only during the limiting season (summer). Based on these findings we produced management recommendations to keep indigenous small mammals’ biodiversity high. Density dependent habitat selection processes play a central role in determining biodiversity, and understanding the mechanisms motivating these processes is needed if alterations in biodiversity in response to human disturbance are to be understood.     

动态心电图中短阵室性心动过速的分析

为探讨短阵室性心动过速（简称VT）的临床意义和发生机制。分析52例VT的动态心电图（DCG）变化和临床特征。结果经测定绝大部分VT的提前指＞1,而易损指数＜1.4;因此,一般不会引起室颤,53例患者经随访1－3年,VT绝大部分消失,预后良好。     

Population dynamics of interacting predatory mites,Phytoseiulus persimilis and Neoseiulus californicus,held on detached bean leaves

The success of combined release of the predatory mitesPhytoseiulus persimilis and Neoseiulus californicus insuppression of spider mites may be related to the effects of the interactionsbetween the two predators on their population dynamics. We studied populationgrowth and persistence of the specialist P. persimilis andthe generalist N. californicus reared singly versus rearedin combination after simultaneous and successive predator introductions ondetached bean leaf arenas with abundant prey, Tetranychusurticae, and with diminishing prey. When reared singly with abundantprey, either predator population persisted at high densities to the end of theexperiment. In every predator combination system with abundant prey and variousinitial predator:predator ratios N. californicus displacedP. persimilis. When held singly with diminishing prey, thepopulation of P. persimilis grew initially faster than thepopulation of N. californicus but both species reachedsimilar population peaks. Irrespective whether reared singly or in combination,N. californicus persisted three to five times longer afterprey depletion than did P. persimilis. Regarding thecrucial interactions in the predator combination systems, we conclude thatintraguild predation was a stronger force than food competition and finallyresulted in the displacement of P. persimilis. Previousstudies showed that intraguild predation between the specialist P.persimilis and the generalist N. californicusisstrongly asymmetric favoring the generalist. We discuss the implications ofpotential interactions between P. persimilis andN. californicus to biological control of spider mites.