Patients' awareness of the potential benefit of smoking cessation. A study evaluating self-reported and clinical data from patients referred to an oral medicine unit

The present study analyzed history of smoking and willingness to quit smoking in patients referred for diagnosis and treatment of different oral mucosal lesions. Prior to the initial clinical examination, patients filled in a standardized questionnaire regarding their current and former smoking habits and willingness to quit. Definitive diagnoses were classified into three groups (benign/reactive lesions, premalignant lesions and conditions, and malignant diseases) and correlated with the self-reported data in the questionnaires. Of the 980 patients included, 514 (52%) described themselves as never smokers, 202 (21%) as former smokers, and 264 (27%) as current smokers. In the group of current smokers, 23% thought their premalignant lesions/conditions were related to their smoking habit, but only 15% of the patients with malignant mucosal diseases saw that correlation. Only 14% of the smokers wanted to commence smoking cessation within the next 30days. Patients with malignant diseases (31%) showed greater willingness to quit than patients diagnosed with benign/reactive lesions (11%). Future clinical studies should attempt (1) to enhance patients' awareness of the negative impact of smoking on the oral mucosa and (2) to increase willingness to quit in smokers referred to a dental/oral medicine settin

Rate of Transmission of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae Without Contact Isolation

The estimated rate of spread of extended-spectrum beta-lactamaseproducing Enterobacteriaceae was low in a tertiary care university-affiliated hospital with high levels of standard hygiene precautions, challenging the routine use of contact isolation in a non-epidemic settin

Methicillin-resistant Staphylococcus aureus (MRSA) among dental patients: a problem for infection control in dentistry?

We assessed the frequency of carriers of methicillin-resistant Staphylococcus aureus (MRSA) among 500 dental patients of a university clinic. From each participant, two specimens were taken from the anterior nares and the pharynx and analysed by culture. The participants completed a questionnaire on possible risk factors of MRSA infection. Two hundred ten individuals carried S. aureus, 90 in the nares only, 51 in the throat only and 69 in nares and throat. Isolates of 208 patients were methicillin-sensitive; two isolates were methicillin-resistant, both carried in the throat exclusively. In conclusion, the frequency of nasal and/or throat carriers of MRSA among dental patients was low and suggests few opportunities of exposure in the dental clinic assesse

Diffuse swelling of the buccal mucosa and palate as first and only manifestation of an extranodal non-Hodgkin ‘double-hit' lymphoma: report of a case

Background: Most of the lymphomas arising in the oral cavity are of B-cell origin. Among these, diffuse large B-cell lymphomas are the most common. Diffuse large B-cell lymphomas may exhibit more than one chromosomal rearrangement and are then referred to as ‘double-hit' or ‘triple-hit' lymphomas. Case report: We present a case of an intraoral ‘double-hit' lymphoma in a 76-year-old male who had been referred by an oral surgeon in private practice. Intraoral examination exhibited a firm, exophytic lesion in the region of the right hard palate and buccal mucosa with extension to the soft palate. Radiographic examination exhibited a massive thickening of the right sinus membrane, and arrosion of the lateral and basal cortical sinus walls in the right maxilla. After diagnosis of the lesion, the patient was treated with six cycles of chemotherapy. Discussion: Lymphomas arising within the oral cavity account for less than 5% of all oral malignancies and typically affect the palatine tonsils and the palate. ‘Double-hit' lymphomas are associated with older age, usually present with an advanced stage of disease, and show an aggressive clinical behaviour. They normally have a poor prognosis, even when treated with intensive chemotherapy regimens. Nevertheless, in the case presented, the patient was free of symptoms 1year after initial diagnosi

T Cell Migration from Inflamed Skin to Draining Lymph Nodes Requires Intralymphatic Crawling Supported by ICAM-1/LFA-1 Interactions.

T cells are the most abundant cell type found in afferent lymph, but their migration through lymphatic vessels (LVs) remains poorly understood. Performing intravital microscopy in the murine skin, we imaged T cell migration through afferent LVs in vivo. T cells entered into and actively migrated within lymphatic capillaries but were passively transported in contractile collecting vessels. Intralymphatic T cell number and motility were increased during contact-hypersensitivity-induced inflammation and dependent on ICAM-1/LFA-1 interactions. In vitro, blockade of endothelial cell-expressed ICAM-1 reduced T cell adhesion, crawling, and transmigration across lymphatic endothelium and decreased T cell advancement from capillaries into lymphatic collectors in skin explants. In vivo, T cell migration to draining lymph nodes was significantly reduced upon ICAM-1 or LFA-1 blockade. Our findings indicate that T cell migration through LVs occurs in distinct steps and reveal a key role for ICAM-1/LFA-1 interactions in this process

Sonication for Diagnosis of Catheter-Related Infection Is Not Better Than Traditional Roll-Plate Culture: A Prospective Cohort Study With 975 Central Venous Catheters

This prospective randomized controlled study with 975 nontunneled central venous catheters (CVCs) showed that the semiquantitative roll-plate culture technique (SQC) was as accurate as the sonication method for diagnosis of catheter-related infections. Sonication is difficult to standardize, whereas SQC is simpler, faster, and as reliable as the sonication method for culturing CVC

Bias-corrected nonparametric correlograms for geostatistical radar-raingauge combination

Geostatistical methods have been widely used for quantitative precipitation estimation (QPE) based on the combination of radar and raingauge observations. They are flexible and accurate and allow for radar-raingauge combination in real-time. Even within the area of geostatistical methods, however, a wide range of choices have to be made when planning for a particular application. These choices regard, for example, the actual combination method (e.g., kriging with external drift, cokriging), the kriging neighbourhood (global vs. local), the technique used to estimate the parameters of the geostatical model (e.g., least-squares, maximum-likelihood estimation), and the transformation of the precipitation variable. In addition to these issues, there are a number of options for modeling spatial dependencies in the precipitation data. Correlograms (variograms) for kriging are customarily one-dimensional, but two- or higher-dimensional correlation maps are also used and are one way of taking spatial anisotropy into account. Furthermore, correlograms can be parametric or nonparametric, they can be obtained from the radar or the raingauge data, and they can be estimated flexibly on a case-by-case basis or with data from a longer period of time. Recently, nonparametric correlograms based on spatially complete radar rainfall fields have been used in combining radar and raingauge data [1]. Here, we compare the estimation of nonparametric correlograms with the estimation of parametric semivariogram models conventionally used in geostatistical applications. We identify and explain a bias of the nonparametric correlograms towards too low ranges, and suggest a correction for this bias.Postprint (published version

Additive Effect of Enterococcus faecium on Enterococcal Bloodstream Infections: A 14-Year Study in a Swiss Tertiary Hospital

We investigated whether an increase in enterococcal bloodstream infections (BSIs) depends on the emergence of Enterococcus faecium in an area with low vancomycin-resistant enterococci prevalence. From 1999 to 2012, a linear increase in E. faecium BSI rates (0.009 per 1,000 patient-days per year; P<.001) was noted. Enterococcus faecalis BSI rates remained stabl

G-SINC: Global Synchronization Infrastructure for Network Clocks

Many critical computing applications rely on secure and dependable time which is reliably synchronized across large distributed systems. Today's time synchronization architectures are commonly based on global navigation satellite systems at the considerable risk of being exposed to outages, malfunction, or attacks against availability and accuracy. This paper describes a practical instantiation of a new global, Byzantine fault-tolerant clock synchronization approach that does not place trust in any single entity and is able to tolerate a fraction of faulty entities while still maintaining synchronization on a global scale among otherwise sovereign network topologies. Leveraging strong resilience and security properties provided by the path-aware SCION networking architecture, the presented design can be implemented as a backward compatible active standby solution for existing time synchronization deployments. Through extensive evaluation, we demonstrate that over 94% of time servers reliably minimize the offset of their local clocks to real-time in the presence of up to 20% malicious nodes, and all time servers remain synchronized with a skew of only 2 ms even after one year of reference clock outage