Influence of Lactobacillus reuteri, Bifidobacterium animalis subsp. lactis, and prebiotic inulin on dysbiotic dental biofilm composition ex vivo.

Background: Probiotic bacterial supplementation has shown promising results in the treatment of periodontitis and the maintenance of periodontal health. The purpose of this investigation was to evaluate the influence of Lactobacillus reuteri or Bifidobacterium animalis subsp. lactis supplementation with and without prebiotic inulin on biofilm composition using an ex vivo biofilm model.

Toxic structures: Speculation and lead exposure in Detroit's single-family rental market.

Foreclosure sales permitted investors to purchase large volumes of low-cost residential properties after the last financial crisis, reshaping patterns of property ownership in low-income housing markets across the US. This study links post-foreclosure property acquisitions by investor landlords to subsequent lead poisoning cases among children under age six living in Detroit, Michigan. We find that the odds of exhibiting elevated blood lead levels (≥5 μg/dL) are higher for children living in investor-owned homes purchased through tax foreclosure sale.

COVID-19: Postmortem Diagnostic and Biosafety Considerations.

As a result of the 2019 novel human coronavirus (COVID-19) global spread, medical examiner/coroner offices will inevitably encounter increased numbers of COVID-19-infected decedents at autopsy. While in some cases a history of fever and/or respiratory distress (eg, cough or shortness of breath) may suggest the diagnosis, epidemiologic studies indicate that the majority of individuals infected with COVID-19 develop mild to no symptoms. Those dying with-but not of-COVID-19 may still be infectious, however.

Decisions Before Incisions: Technique Selection for the Distal Wedge Procedure.

Focused Clinical Question: What factors identify the optimal surgical technique when a distal wedge procedure is indicated at a terminal maxillary or mandibular molar site?

Summary: Incision design for the distal wedge procedure is based primarily on the dental arch (maxilla or mandible), the distance from the terminal molar to the hamular notch or ascending ramus, and the dimensions of the attached gingiva.

Conclusions: In most situations, favorable clinical results are achievable irrespective of the chosen distal wedge method, and technique selection is based more on operator preference than evidence. However, anatomic limitations can render distal wedge procedures challenging in some cases, and procedural advantages of specific techniques can simplify treatment.

Rational Prophylactic Antibiotic Selection for Sinus Elevation Surgery.

Focused Clinical Question: For a generally healthy patient with no risk indicators for postoperative infection, what is the most appropriate perioperative antibiotic regimen for sinus elevation surgery in terms of reducing postoperative infection risk and minimizing untoward effects?

Clinical Scenario: A 38-year-old female patient in good general and periodontal health presents missing tooth #14 (Fig. ). She reports no systemic conditions, no history of sinusitis, and no allergies.

Implementing a pharmacist-led in-home medication coaching service via community-based partnerships.

Objectives: To describe one independent pharmacy group's experience delivering and being reimbursed for in-home medication coaching, or home visits, to high-risk and high-complexity community-dwelling patients.

Setting: A nondispensing clinical division of an independent community pharmacy in Seattle, Washington.

Practice Innovation: A community pharmacist-led in-home medication coaching program delivered through partnerships with 3 community-based organizations for referrals and payment over a 4.

Implementing take-home naloxone in an urban community pharmacy.

Objective: Morbidity and mortality associated with opioid use have increased across the nation, growing into what can only be described as an epidemic.

Setting: In Washington State between 2002 and 2004, the statewide death rate attributed to any opioid was 6.6 per 100,000 people, but between 2011 and 2013 it increased to 8.

Dedifferentiated liposarcoma of the lower extremity with low-grade dedifferentiation and low-grade osteosarcomatous component.

Dedifferentiated liposarcoma can arise de novo or as a complication of a preexisting well-differentiated liposarcoma. We describe the radiologic and pathologic features of a long-standing liposarcoma with multiple recurrences in a 59-year-old male. Imaging demonstrated a heterogeneous fat-containing mass in the anterior thigh.