[Show abstract][Hide abstract] ABSTRACT: Evidence is emerging that women's poor oral health and health practices during pregnancy are associated with poor oral health in their children and potentially an increased risk of pre-term or low-birth weight infants.
The Midwifery Initiated Oral Health-Dental Service (MIOH-DS) trial is a three arm multicentre randomised controlled trial which will recruit women from three metropolitan hospitals aimed at improving women's oral health and service access and indirectly reducing perinatal morbidity. All three arms of the trial will deliver oral health promotion material, although a midwife oral assessment and referral to private/public/health fund dental services pathway (Intervention Group 1) and the midwife oral assessment and referral to local free public dental services pathway (Intervention Group 2) will be compared to the control group of oral health promotional material only. Midwives will undergo specific oral health education and competency testing to undertake this novel intervention.
This efficacy trial will promote a new partnership between midwives and dentists focused on enhancing the oral health of women and their infants. Should the intervention be found effective, this intervention, with existing on-line educational program for midwives, can be easily transferred into practice for large metropolitan health services within and beyond Australia. Further cost-benefit analysis is proposed to inform national health policy.Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12612001271897.
BMC Oral Health 01/2015; 15(1):2. DOI:10.1186/1472-6831-15-2 · 1.13 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Cancer cells create a microenvironment that prevents tumor rejection by the host's immune system. The activation of pattern recognition receptors (PRRs) can elicit an innate immune response and guide the adaptive immune response to overcome this. dsRNA analogs can trigger TLR3, RIG-I, MDA5, NLRP3 and several other PRRs to induce not only robust immune response against cancer but also programmed cell death. This review focuses on the signal pathways activated by dsRNA and examines examples of their clinical application in cancer treatment.
Anti-Cancer Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry - Anti-Cancer Agents) 02/2014; 14(2):241-55. DOI:10.2174/18715206113136660373 · 2.47 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Aim:
The aim of this paper is to describe the factors that impact on the mental health of Australian and New Zealand (NZ) women in the perinatal period (pregnancy and the year following birth), and to determine the impact of perinatal mental health on women's subsequent health by summarising findings from prospective longitudinal studies conducted in Australia and NZ.
A systematic search was conducted using the databases, Scopus, Medline, PsychInfo and Health Source to identify prospective longitudinal studies focused on women's social and emotional health in the perinatal period. Forty-eight papers from eight longitudinal studies were included.
The proportion of women reporting depressive symptoms in the first year after birth was between 10 and 20% and this has remained stable over 25 years. The two strongest predictors for depression and anxiety were previous history of depression and poor partner relationship. Importantly, women's mood appears to be better in the first year after birth, when compared to pregnancy and five years later. Becoming a mother at a young age is by itself not a risk factor unless coupled with social disadvantage. Women report a high number of stressors in pregnancy and following birth and the rate of intimate partner violence reported is worryingly high.
Midwives have an important role in the identification, support and referral of women experiencing mental health problems. As many women do not seek help from mental health services, the potential for a known midwife to impact on women's mental health warrants further examination.
Women and Birth 04/2013; 26(3). DOI:10.1016/j.wombi.2013.02.006 · 1.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: Poor maternal oral health may be associated with adverse pregnancy and infant outcomes. Unfortunately women seldom seek dental care during pregnancy due to various patient barriers such as cost and lack of awareness. Provider barriers may also be contributing to the problem such as the misconceptions held by health professionals surrounding perinatal oral health. This study reviewed current knowledge, attitudes and behaviours of dentists and prenatal care providers towards perinatal oral health.
Method: All studies published in English that explored the perceptions of dentists, general practitioners, midwives and obstetricians regarding oral health care during pregnancy were reviewed. Relevant studies that met the inclusion criteria (n=9) were critically appraised for their methodological quality and their data was extracted and categorised under key outcomes. The nine studies reviewed originated from United States, Jordan, Brazil and Australia and contained responses from 2418 dentists, 714 obstetricians, 197 general practitioners and 15 midwives.
Result: Despite acknowledging the importance of maternal oral health many dentists are uncertain about the safety of dental procedures and are hesitant in treating pregnant women. General practitioners and midwives are poorly informed about the impact of poor maternal oral health and rarely initiate this topic during prenatal care. Many general practitioners also believe that dental procedures are unsafe during pregnancy. Obstetricians are well informed about perinatal oral health and are supportive of dental procedures. However, due to lack of training in this area and competing health demands obstetricians seldom focus on oral health during pregnancy.
Conclusion: There is no real consensus among dentists and prenatal care providers regarding oral health care during pregnancy. This issue poses a significant deterrent for pregnant women seeking dental care. Education, training and practice guidelines in perinatal oral health are needed for dental and health professionals to emphasise this important aspect of prenatal care.
[Show abstract][Hide abstract] ABSTRACT: Invading pathogens have unique molecular signatures that are recognized by Toll-like receptors (TLRs) resulting in either activation of antigen-presenting cells (APCs) and/or costimulation of T cells inducing both innate and adaptive immunity. TLRs are also involved in T-cell development and can reprogram Treg cells to become helper cells. T cells consist of various subsets, that is, Th1, Th2, Th17, T follicular helper (Tfh), cytotoxic T lymphocytes (CTLs), regulatory T cells (Treg) and these originate from thymic progenitor thymocytes. T-cell receptor (TCR) activation in distinct T-cell subsets with different TLRs results in differing outcomes, for example, activation of TLR4 expressed in T cells promotes suppressive function of regulatory T cells (Treg), while activation of TLR6 expressed in T cells abrogates Treg function. The current state of knowledge of regarding TLR-mediated T-cell development and differentiation is reviewed.
Cancer Vaccine: From Research to Clinical Practice, 1 edited by Adrian Bot, Mihail Obrocea, Francesco Marincola, 01/2011: chapter 17. Induction of innate immunity by nucleic acids: a potential adjuvant for cancer vaccines?: pages 232-249; Informa Healthcare.
[Show abstract][Hide abstract] ABSTRACT: Endoscopic variceal obturation with tissue adhesive is used to control gastric variceal bleeding. We investigated the prevalence of serious complications from this therapy.
We performed a retrospective analysis of complications that occurred in 753 patients with gastric variceal hemorrhages who were hospitalized in 2 tertiary referral hospitals. All patients received N-butyl-2-cyanoacrylate as therapy for endoscopic variceal obturation.
Complications occurred in 51 patients. Thirty-three patients experienced rebleeding because of early-onset (within 3 months) extrusion of the N-butyl-2-cyanoacrylate glue cast (4.4%), 10 patients developed sepsis (1.3%), and 5 patients developed distant embolisms (0.7%; 1 pulmonary, 1 brain, and 3 splenic). One patient had major gastric variceal bleeding after endoscopic variceal obturation (0.1%), 1 developed a large gastric ulcer (0.1%), and 1 had mesentery hematoma, hemoperitoneum, and infection in the abdominal cavity (0.1%). The complication-related mortality was 0.53% (3 deaths from sepsis and 1 death from rebleeding after early-onset glue cast extrusion).
The occurrence of complications after endoscopic variceal obturation with N-butyl-2-cyanoacrylate in gastric varices treatment is rare.
Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 09/2010; 8(9):760-6. DOI:10.1016/j.cgh.2010.05.019 · 7.90 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: dsRNA can be detected by pattern recognition receptors, for example, TLR3, MDA-5, NLRP3 to induce proinflammatory cytokines responsible for innate/adaptive immunity. Recognized by endosomal TLR3 in myeloid DCs (mDCs), dsRNA can activate mDCs into mature antigen presenting cells (mAPCs) which in turn present antigen epitopes with MHC-I molecules to naïve T cells. Coadministration of protein and synthetic dsRNA analogues can elicit an antigen-specific Th1-polarized immune response which stimulates the CD8+ CTL response and possibly dampen Th17 response. Synthetic dsRNA analogues have been tested as vaccine adjuvant against viral infections in animal models. However, a dsRNA receptor, TLR3 can be expressed in tumor cells while other members of TLR family, for example, TLR4 and TLR2 have been shown to promote tumor progression, metastasis, and chemoresistance. Thus, the promising potential of dsRNA analogues as a tumor therapeutic vaccine adjuvant should be evaluated cautiously.
BioMed Research International 07/2010; 2010(1110-7243):690438. DOI:10.1155/2010/690438 · 2.71 Impact Factor