Faculty Bibliography

I knocked on the door, entered and found Tito Puente alone. He seemed comfortable, but nervous. I told him that I had been sent to see him by his manager, who was a patient of mine. Tito nodded. He'd been expecting me, he said. He looked healthy; sometimes it was a matter of subtle perception to differentiate who needed an operation from who didn't. I went downstairs to speak with his relatives. They were holding a vigil near the elevators where families traditionally waited for the surgeon to bring them the news. In Tito's case, the surgeon was still in there with him, trying to treat the unforeseeable bleeding disorder. For almost 10 hours he'd been there with his patient, unwilling to take a break. I arrived there at the same time as the pizza man, bringing the family more sustenance than I could. 'It doesn't look good,' I said, something they already knew. I recognized Tito's daughter from the TV and, as she jounced up to pay the pizza man, I could again see her father's energy. I drew a picture of the heart and showed Tito where the valve was that was damaged. It was a straightforward operation to repair it and, if the vessels that fed the heart its blood and oxygen were blocked, a bypass operation would be performed at the same time. Tito was nervous about the operation. He was used to exerting maximal control over his life, his music. Now he would be handing all this over to a stranger, a man who, in a different world, was also a control artist, working long hours with maximal attention and focus, a man who was also known for his great hands

PURPOSE: Previous studies have demonstrated that babies are at higher risk for mutans streptococci (ms) colonization if their mothers have dense salivary ms reservoirs relative to babies who have mothers with negligible salivary reservoirs. This communication provides data that identifies another potential risk factor (use of a nursing bottle at bedtime and/or naptime that contains a substrate other than water) for baby infection by ms. METHODS: The study population consisted of 60 babies (28 males/32 females; mean age 15 mos; age range 12-18 mos) who were all healthy, caries free, and slept with a nursing bottle that contained a substrate other than water (NB+). Pooled maxillary incisor plaque and saliva samples were obtained and immediately placed in Reduced Transparent Fluid (RTF); they were serially diluted and plated onto Mitis Salivarius Agar plus Bacitracin (MSB) and blood agar plates within 4 hours of collection; the plates were incubated in an anaerobic environment for 48 h at 37 C and then placed for 24 h under aerobiosis prior to examination; representative ms colonies were isolated and subjected to mannitol and sorbitol fermentation tests for taxonomic verification. Plates with colony counts between 20 and 300 were utilized to determine the % of ms in each sample. RESULTS: Fifty one of the 60(85%) babies harbored ms in at least 1 of the 2 samples. The 95% confidence interval for the proportion of subjects with detectable levels of ms was 73%-93%. Fisher's exact test showed that babies 16-18 mos age were more likely to have detectable levels of ms than babies 12-15 mos age (p = 0.01). Levels of ms in plaque and saliva were as follows: < 0.1% (plaque 27/51, mean age 15 mos, sd 1.77; saliva 28/51, mean age 15 mos, sd 1.76); 0.1%-1.0% (plaque 4/51, mean age 14 mos, sd 1.5; saliva 6/51, mean age 15 mos, sd 1.46); > 1.0% (plaque 14/51, mean age 16 mos, sd 2.1; saliva 11/51, mean age 16 mos, sd 1.91). The density of infection did not vary by age for plaque (P = 0.32) or saliva (P = 0.64). CONCLUSION: These findings support the concept that NB+ is a strong indicator for ms infection in Puerto Rican babies; that prevalence of infection increases with age; and that density of infection does not vary with age in this population.

"Trouble In Mind: Black Southerners in the Age of Jim Crow" by Leon F. Litwack is reviewed

Lamm and Couzens contend that many men take a "hands-off" approach to health, rarely seeking preventive care and making unhealthy choices regarding diet and exercise. However, women can help their husbands by communicating concern and becoming actively involved in their healthcare and life-style choices