Initiating change under the Pew National Dental Education Program at the University of California, San Francisco.
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Biomedical subjects
Publications and source records attributed to J C Greene.
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Both demographic patterns and disease distribution are changing rapidly in the United States. These developments have led to the recognition that the epidemiology of many conditions is poorly understood, and that other research has thus been hindered. Four areas of epidemiological study were chosen for detailed analysis of how new technology will affect the conduct of future research. These areas, selected because information about them will be increasingly needed in an aging society, were periodontitis, temporomandibular disorders (TMD) and other orofacial pain, salivary gland disturbances, and health services research. The potential effect of new technology was examined in the short, intermediate, and long term. While the nature of epidemiological study is unlikely to change with the advent of new technology, the scope of potential studies will become broader. Advances in diagnostic techniques from elsewhere will permit far more precise diagnosis than is possible at present. Computer technology will permit an efficient system of epidemiological surveillance to provide current data on trends in tooth loss, caries, and periodontitis--data which will complement the results of national surveys. Analytical studies to produce hypotheses on the etiology of oral conditions, especially in such poorly-understood areas as chronic pain and TMD, will help direct clinical research in those areas.
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The emergence of AIDS has alerted the nation's health care community to the dangers of occupational transmission of infectious disease. This article assesses the risk of occupational transmission in the health care setting and examines two prevention strategies: vaccination programs and infection control protocols. The implementation of these strategies by the School of Dentistry, University of California at San Francisco, is recounted to illustrate an institutional response to the issue of infection control in the dental setting.
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The World Health Organization's adoption in 1979 of 'health for all by the year 2000' as a worldwide target promoted the formulation of specific oral health goals by the Fédération Dentaire Internationale in 1981. Such goals are useful to governments and the private professional sector as a focus for programme planning and implementation and as a means of measuring progress. Recent evidence that caries prevalence is already declining in some industrialized nations, including the USA, suggests that most developed countries will meet or surpass the goals adopted by the FDI by the year 2000. However, keeping these trends moving in the right direction will require a sustained effort on the part of both the public and the private sector.
A 16-year-old male presented with a history of asthma and recurrent pneumonia. A diagnosis of ABPA was based upon the typical clinical presentation, peripheral eosinophilia, elevated IgE and positive immediate skin tests to Aspergillus. Sputum cultures grew A. terreus, a rare cause of human disease. Soluble and particulate antigens were prepared from this organism. Precipitins against A. terreus, but not against A. fumigatus, were detected in the patient's serum. His lymphocytes proliferated markedly in vitro when exposed to soluble A. terreus but not A. fumigatus antigen. The lymphocyte responses correlated with disease activity. Functional serum opsonic activity was measured using the technique of stimulated polymorphonuclear leucocyte chemiluminescence. The nonspecific opsonic activity of the patient's serum was within high normal range when zymosan was employed as an alternative pathway activator. Specific opsonic activity against particulate Aspergillus antigen was significantly increased in the patient's serum when compared with control sera. Despite the presence of specific antibody and opsonic activity against A. terreus, the patient's serum levels of C3, C4, and total hemolytic complement were normal. These findings are consistent with in vivo sequestration of the organism.
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