Background and Purpose-Chronic infectious diseases may increase the risk of stroke. We investigated whether periodontal disease, including periodontitis and gingivitis, is a risk factor for cerebral ischemia. Methods-We performed a case-control study with 303 patients examined within 7 days after acute ischemic stroke or transient ischemic attack, 300 population controls, and 168 hospital controls with nonvascular and noninflammatory neurological diseases. All subjects received a complete clinical and radiographic dental examination. The individual mean clinical attachment loss measured at 4 sites per tooth served as the main indicator for periodontitis. Results-Patients had higher clinical attachment loss than population (PϽ0.001) and hospital (Pϭ0.010) controls. After adjustment for age, sex, number of teeth, vascular risk factors and diseases, childhood and adult socioeconomic conditions, and lifestyle factors, the risk of cerebral ischemia increased with more severe periodontitis. Subjects with severe periodontitis (mean clinical attachment loss Ͼ6 mm) had a 4.3-times-higher (95% confidence interval, 1.85 to 10.2) risk of cerebral ischemia than subjects with mild or without periodontitis (Յ3 mm). Severe periodontitis was a risk factor in men but not women and in younger (Ͻ60 years) but not older subjects. Periodontitis increased the risk of cerebral ischemia caused by large-artery atherosclerosis, cardioembolism, and cryptogenic etiology. Gingivitis and severe radiologic bone loss were also independently associated with the risk of cerebral ischemia, whereas caries was not. Conclusions-Our study indicates that periodontal disease, a treatable condition, is an independent risk factor for cerebral ischemia in men and younger subjects.

During the last two decades, northern European retirement residence in the southern European sunbelt has grown strongly and its forms have rapidly changed, but standard demographic and social statistical sources provide no information about the flows, the migrants or their increasingly mobile and complex residential patterns. Considerable primary research has however recently been undertaken into the causes, conditions, experiences and consequences of international retirement migration (IRM) by investigators from Germany, Spain, Switzerland and the United Kingdom. Many collaborated when designing their studies and instruments, and all have subsequently worked together in a European Science Foundation Scientific Network. This paper compares the findings of six systematic social surveys in (to be more precise than the title) eight regions of southern Europe and the Canary Islands: all that have tackled similar research questions with similar methods and instruments. It presents interpretations of several comparative tables compiled from their original data, with a focus on the socio-economic backgrounds, motivations and behaviour of the various migrant groups and their relationship with the host and home countries. The paper presents new findings about the typical and variant forms of IRM, and additional understanding of the heterogeneity of the retirees of different nations and in the several regions.

Periodontitis is an independent risk factor for cerebral ischemia and acute exacerbation of inflammatory processes in the periodontium might be a trigger for the event of cerebral ischemia.

Background: The needs of patients feeling severely affected by multiple sclerosis (MS) have rarely been investigated. However this is essential information to know before care can be improved, including adding palliative care (PC) services where helpful. Since it remains unclear at what point specialized palliative care should begin for this patient group, this study focuses on needs in general. Objective: The objective was to explore the subjectively unmet needs of patients feeling severely affected by MS. Methods: The study used a qualitative cross-sectional approach for needs assessment. Fifteen patients selfreporting feeling severely affected by MS were recruited and interviewed using a combination of purposive and convenience sampling (five were accompanied by a caregiver relative). Interviews were recorded and transcribed verbatim, followed by qualitative content analysis. Results: Unmet needs were identified in the main categories ''support of family and friends,'' ''health care services,'' ''managing everyday life,'' and ''maintaining biographical continuity.'' Patients expressed the desire for more support from their families and to be viewed as distinct individuals. They see a substantial deficit in the physician-patient relationship and in the coordination of services. A decrease in expressed unmet needs was found for patients more severely affected and less socially integrated. Conclusions: To address the unmet needs of severely affected MS patients, health care services need to be improved and linked with existing PC services. Special attention is required to form supporting professionalpatient relationships. Multiprofessional services should be accessible for patients, while integrating relatives. All services should have an individual approach to provide needs-tailored support.