Dental profile of patients with Gaucher disease

BACKGROUND: This study was conducted to determine whether patients with Gaucher disease had significant dental pathology because of abnormal bone structure, pancytopenia, and coagulation abnormalities. METHODS: Each patient received a complete oral and periodontal examination in addition to a routine hematological evaluation. RESULTS: Gaucher patients had significantly fewer carious lesions than otherwise healthy carriers. Despite prevalence of anemia, there was no increase in gingival disease; despite the high incidence of thrombocytopenia, gingival bleeding was not noted; and despite radiological evidence of bone involvement, there was no greater incidence loss of teeth or clinical tooth mobility. CONCLUSIONS: These data represent the first survey of the oral health of a large cohort of patients with Gaucher disease. It is a pilot study of a unique population and the results of the investigation are indications for further research. Based on our findings, we recommend regular oral examinations with appropriate dental treatment for patients with Gaucher disease as for other individuals. Consultation between the dentist and physician, preferably one with experience with Gaucher disease, should be considered when surgical procedures are planned

Evaluation of major depression in a routine clinical assessment

<p>Abstract</p> <p>Background</p> <p>Major depression is a disorder that significantly worsens a patient's morbidity and mortality. The association of depression and diabetes is well documented and has clinical impact in diabetes treatment's outcome. Patients usually aren't evaluated initially by a psychiatrist, so it is important that non-psychiatrists learn to evaluate major depression and its impact.</p> <p>Conclusions</p> <p>Major depression can and should be evaluated on a routine clinical assessment. Depression's impact on the patients' quality of life, productivity and social interactions is well documented. The initial diagnosis of depression should lead to its prompt treatment, and it has to be emphasized that the incorrect treatment can lead to worsening of the condition, relapses, recurrences or even chronification of major depression.</p

Endocytosis of Proteins by Salivary Gland Duct Cells

The ability of the intralobular duct cells of the rat parotid gland to take up protein from the lumen was examined by retrograde infusion of exogenous proteins and by immunogold localization of endogenous secretory proteins. Small amounts of native horseradish peroxidase (HRP) were taken up by intercalated and striated duct cells, and were present in small vesicles, multivesicular bodies, and lysosomes. In contrast, HRP modified by periodate oxidation was avidly internalized by the duct cells and was present in large apical vacuoles that ac-quired lysosomal hydrolase activity. Native and cationized ferritin were taken up in a similar manner when infused at a high concentra-tion (up to 10 mg/mL). At lower concentrations (0.3-1.0 mg/mL), endocytosis of cationizedferritin occurred mainly in small apical tu-bules and vesicles in striated duct cells. Little native ferritin was taken up at these concentrations. After stimulation of acinar cell secretion by isoproterenol, similar vacuoles were occasionally observed in both intercalated and striated duct cells. Labeling of thin sections with antibodies to amvlase and to a 26,000-dalton secretory protein (pro-tein B1), followed by protein A-gold, revealed the presence of these proteins in the vacuoles, indicating endocytosis of acinar secretory, proteins by the duct cells. Although uptake of acinar proteins by duct cells occurs at a low rate in normal animals, previous work suggests that extensive endocytosis may occur in certain pathological condi-tions. This may be a mechanism for removing abnormal or modified proteins from saliva before it reaches the oral cavity