Vista Community Clinic

Dens invaginatus is a developmental dental anomaly characterized by the infolding of the enamel organ into the dental papilla during early odontogenesis. This process leads to a broad spectrum of anatomical variations, ranging from minor enamel-lined pits confined to the crown to deep invaginations extending through the root, occasionally communicating with periodontal or periapical tissues. The internal complexity of affected teeth presents diagnostic and therapeutic challenges, particularly in severe forms that mimic root canal systems or are associated with pulpal or periapical pathology. Maxillary lateral incisors are most frequently affected, likely due to their unique developmental timeline and morphological susceptibility. Although various classification systems have been proposed, Oehlers’ classification remains the most clinically relevant due to its simplicity and correlation with treatment complexity. Recent advances in diagnostic imaging, especially cone beam computed tomography (CBCT), have revolutionized the identification and classification of these anomalies. CBCT-based adaptations of Oehlers’ classification allow for the precise assessment of invagination extent and pulpal involvement, facilitating improved treatment planning. Contemporary therapeutic strategies now include calcium-silicate-based cement sealing materials, endodontic microsurgery for inaccessible anatomy, and regenerative endodontic procedures for immature teeth with necrotic pulps. Emerging developments in artificial intelligence, genetic research, and tissue engineering promise to further refine diagnostic capabilities and treatment options. Early detection remains critical to prevent complications such as pulpal necrosis or apical disease. A multidisciplinary, image-guided, and patient-centered approach is essential for optimizing clinical outcomes in cases of dens invaginatus.

BackgroundValid, reliable measures of psychosocial constructs are needed in oral health research. This study quantitatively evaluated the psychometric properties of nine new Oral Health Behavior Social Support (OHBSS) scales, which measured support for three oral health behaviors (brushing, flossing, dental care), queried for each of three sources (family, health providers, others/friends).MethodsYoung Mexican-origin adults in the southwestern United States-Mexico border region completed an online survey, in English or Spanish (N = 502). Survey items included: OHBSS scales, general social support scales, oral health behaviors, self-rated oral health status, dental anxiety, acculturation and socio-demographics. Subsample 1 participants also completed a dental exam (N = 41). Subsample 2 participants also completed a repeat OHBSS survey two-to-six weeks later (N = 56).Psychometric properties were tabulated, overall and by language preference (English or Spanish). Convergent and divergent validity were evaluated via correlations between the dental-specific OHBSS social support scales, scores from three validated general social support scales, and scales expected to be largely unrelated (acculturation, dental anxiety). Correlations examined predictive validity between the OHBSS scales and oral health behaviors, and self-reported and clinical outcomes. Test–retest reliability was assessed via intraclass correlation coefficients in Subsample 2.ResultsOf 502 participants, 60% preferred speaking English, 37% were single, and 21% were male. OHBSS scores indicated that health providers then family provided the most support for all three oral health behaviors, while others/friends did not provide much support. Spanish speakers tended to have higher OHBSS scores than English speakers.Correlations followed expected patterns and supported convergent and divergent validity, in the full sample and across languages. OHBSS scales exhibited many significant weak-moderate positive correlations (r = 0.10–0.38) with general social support scales. Few (11/108) significant correlations (< -0.16) were observed between OHBSS scales, acculturation, and dental anxiety. OHBSS scales exhibited some significant weak-moderate positive correlations with oral health-promoting behaviors. OHBSS scales were not associated with clinical outcomes. OHBSS scales exhibited good test–retest reliability overall and in Spanish.ConclusionPsychometric properties for the OHBSS scales were acceptable in both English and Spanish versions. The scales are valid and reliable tools for assessing social support for oral health-promoting behaviors from family, health providers, and others/friends.Trial registrationNot applicable.

The 2019 novel coronavirus disease (COVID-19) pandemic has dramatically impacted numerous health and economic fronts. Because of the stay-at-home mandate and practice of physical distancing, nearly all preventive care measures have been halted, including colorectal cancer (CRC) screening. The health consequences of this temporary suspension are of great concern, particularly for underserved populations, who experience substantial CRC-related disparities. In this commentary, we describe challenges and opportunities to deliver COVID-19–adapted CRC screening to medically underserved populations receiving care in community health centers (CHC). This perspective is based on key informant interviews with CHC medical directors, teleconference discussions, and strategic planning assessments. To address the unprecedented challenges created by the COVID-19 pandemic, we identify 2 broad calls to action: invest in CHCs now and support equitable and adaptable telehealth solutions now and in the future. We also recommend 4 CRC-specific calls to action: establish COVID-19–adapted best practices to implement mailed fecal immunochemical test programs, implement grassroots advocacy to identify community gastroenterologists who commit to performing colonoscopies for CHC patients, assess cancer prevention priorities among individuals in underserved communities, and assess regional CRC screening and follow-up barriers and solutions. The COVID-19 pandemic may further exacerbate existing CRC screening disparities in underserved individuals. This will likely lead to delayed diagnosis, a shift to later-stage disease, and increased CRC deaths. To prevent this from happening, we call for timely action and a commitment to address the current extraordinary CRC screening challenges for vulnerable populations.

Purpose and ObjectivesCollaboration across multiple sectors is needed to bring about health system transformation, but creating effective and sustainable collaboratives is challenging. We describe outcomes and lessons learned from the Hearts of Sonoma County (HSC) initiative, a successful multi-sector collaborative effort to reduce cardiovascular disease (CVD) risk in Sonoma County, California.Intervention ApproachHSC works in both clinical systems and communities to reduce CVD risk. The initiative grew out of a longer-term county-wide collaborative effort known as Health Action. The clinical component involves activating primary care providers around management of CVD risk factors; community activities include community health workers conducting blood pressure screenings and a local heart disease prevention campaign.Evaluation MethodsThe impact of the clinical improvement efforts was tracked using blood pressure data from the 4 health systems participating in HSC. Descriptive information on the community-engagement efforts was obtained from program records. Lessons learned in developing and maintaining the collaborative were gathered through document review and interviews with key informants.ResultsFavorable trends were seen in blood pressure control among patients with hypertension in the participating health systems: patients with controlled blood pressure increased from 58% in 2014 to 67% in 2016 (P < .001). Between 2017 and 2019, the community engagement effort conducted 99 outreach events, reaching 1,751 individuals, and conducted 1,729 blood pressure screenings, with 441 individuals referred to clinical providers for follow-up care. HSC scored highly on 6 essential elements of an effective coalition and achieved a degree of sustainability that has eluded many other collaboratives.Implications for Public HealthFactors contributing to the success of HSC include 1) starting small and focused to build trust among participants and demonstrate value, 2) working within the framework of a larger effort, and 3) providing long-term, open-ended backbone support.

The clinical case study was carried out in a cow having sign of ketosis, diagnosis based on owner history, clinical symptoms and laboratory findings (Urine and blood sample). Therapeutic management was carried out as per physiological conditions of animal. Cow was treated with Injection of dextrose, corticosteroid, vitamin B-complex parental along with oral gluconeogenic precursors and jaggery. Case was treated successfully and excellent recovery.

The growing possibilities of space travel are quickly moving from science fiction to reality. However, to realize the dream of long-term space travel, we must understand how these conditions affect biological and physiological processes. Planarians are master regenerators, famous for their ability to regenerate from very small parts of the original animal. Understanding how this self-repair works may inspire regenerative therapies in humans. Two studies conducted aboard the International Space Station (ISS) showed that planarian regeneration is possible in microgravity. One study reported no regenerative defects, whereas the other study reported behavioral and microbiome alterations post-space travel and found that 1 of 15 planarians regenerated a Janus head, suggesting that microgravity exposure may not be without consequences. Given the limited number of studies and specimens, further microgravity experiments are necessary to evaluate the effects of microgravity on planarian regeneration. Such studies, however, are generally difficult and expensive to conduct. We were fortunate to be sponsored by the Student Spaceflight Experiment Program (SSEP) to investigate how microgravity affects regeneration of the planarian species Dugesia japonica on the ISS. While we were unable to successfully study planarian regeneration within the experimental constraints of our SSEP Mission, we systematically analyzed the cause for the failed experiment, leading us to propose a modified protocol. This work thus opens the door for future experiments on the effects of microgravity on planarian regeneration on SSEP Missions as well as for more advanced experiments by professional researchers.