A description of the new technologies used in transforming dental education

Information and communications technology (ICT) is a universal term describing the use of technology and media to disseminate and share knowledge and information. Educational media provide a means by which information can be communicated between teacher and learner. In this context, the aim of this digest is to summarise and describe the spectrum of tools available. All technologies used in education have their strengths and weaknesses. Variety needs to be balanced by economy. However, it must be remembered that technology is not the overriding issue. The design of the learning environment and the learning experience itself are far more important. Technologies are generally flexible and can be used in a variety of ways. Knowledge of these technologies will help guide appropriate selection. The following tools are described: 1. Telecommunications services; 2. Communications tools (social software) including email, newsgroups, weblogs and wikis; 3. Richmedia in interactive training and learning; 4. Compact discs (CDs) and digital video discs (DVDs); 5. Virtual learning environments (VLE); 6. Sophisticated communications - videoconferencing, webcasting and podcasts; 7. Interactive television; and 8. Virtual reality.     

Oncocytoid artifact of the parotid gland: A newly reported artifact

Electrocautery can induce significant alterations in the connective tissues and epithelium of specimens removed for diagnostic or therapeutic purposes. When electrocautery is used during parotid surgery, it can cause an oncocytoid artifact. The alterations described in this article are enlarged, tightly packed serous acinar cells with coarse to granular eosinophilic cytoplasm, distinct cell borders, and round basal nuclei that on cursory microscopic examination resemble oncocytes with respect to morphology. These changes are seen in conjunction with other, more recognized changes secondary to electrocautery and are believed to occur as a consequence of the electrothermal discharge. On the basis of our findings, this artifact is common in parotid surgical specimens and was misdiagnosed as benign oncocytic lesions in 5 cases.     

Management of Periodontal Tissues for Restorative Dentistry

Proper management of periodontal tissues is required to achieve predictable long-term success with restorative dental procedures. Forced eruption as well as several surgical techniques may be used to achieve and maintain adequate biologic width during restorative and esthetic dental procedures. The technique that will yield optimal results depends on the relationship between the restoration's margins and the surrounding periodontium. A classification system that describes these interrelationships and provides treatment recommendations is included.     

A survey of postgraduate (specialist) orthodontic education in 23 European countries

This paper reports on a survey of the duration, funding, and assessment of postgraduate specialist orthodontic training, the requirement for postgraduate training prior to entering specialist orthodontic training and registration of specialist orthodontists in Europe. A questionnaire and explanatory letter were mailed to all members of the EURO-QUAL BIOMED II project. Answers were validated during a meeting of project participants and by fax, when necessary. Completed questionnaires which were subsequently validated, were returned by orthodontists from 23 countries. The results indicated that a period of postgraduate training, prior to entering specialist orthodontic training was required in 12 of the responding countries. Specialist orthodontic training was reported as lasting 2 years in three countries, 3 years in 17, and for 4 years in three. Part-time training was reported as a possibility in four countries. In 21 of the 23 countries specialist training was reported to take place in full or part within universities, with some training taking place in government clinics in four countries. In five countries some or all training was reported to take place in specialist practices. Training was said to be funded solely or partially by governments in 15 of the 23 countries, to be solely self-funded in five countries, and partly or solely funded by universities in six countries. A final examination at the end of specialist training was reported to be held in 21 of the 23 countries. The nature of this examination varied widely and there was no such examination in two countries. Twelve of the 23 countries reported that they had a specialist register for orthodontics; 11 that they had no register. In none of the countries surveyed was there a requirement for those on a register to undergo periodic reassessment of competence once they are on the register. It was concluded that there was wide diversity in all aspects of specialist orthodontic training and registration within the countries surveyed.     

Detection of hyponatremia in the PACU.

Fluid and electrolyte management is an important part of PACU nursing care. Any alteration in fluid and electrolytes, especially in the vulnerable elderly population, can be catastrophic. An assessment of hyponatremia following transurethral resection of the prostate requires that the PACU nurse be diligent in discovering the etiology of unexpected mental status changes.     

Perioperative Breast MRI Is Not Associated with Lower Locoregional Recurrence Rates in DCIS Patients Treated With or Without Radiation

Introduction

For women with ductal carcinoma in situ (DCIS) undergoing breast-conserving surgery (BCS), the benefit of magnetic resonance imaging (MRI) remains unknown. Here we examine the relationship of MRI and locoregional recurrence (LRR) and contralateral breast cancer (CBC) for DCIS treated with BCS, with and without radiotherapy (RT).

Methods

A total of 2,321 women underwent BCS for DCIS from 1997 to 2010. All underwent mammography, and 596 (26 %) also underwent perioperative MRI; 904 women (39 %) did not receive RT, and 1,391 (61 %) did. Median follow-up was 59 months, and 548 women were followed for ≥8 years. The relationship between MRI and LRR was examined using multivariable analysis.

Results

There were 184 LRR events; 5- and 8-year LRR rates were 8.5 and 14.6 % (MRI), respectively, and 7.2 and 10.2 % (no-MRI), respectively (p = 0.52). LRR was significantly associated with age, menopausal status, margin status, RT, and endocrine therapy. After controlling for these variables and family history, presentation, number of excisions, and time period of surgery, there remained no trend toward association of MRI and lower LRR [hazard ratio (HR) 1.18, 95 % confidence interval (CI) 0.79–1.78, p = 0.42]. Restriction of analysis to the no-RT subgroup showed no association of MRI with lower LRR rates (HR 1.36, 95 % CI 0.78–2.39, p = 0.28). No difference in 5- or 8-year rates of CBC was seen between the MRI (3.5 and 3.5 %) and no-MRI (3.5 and 5.1 %) groups (p = 0.86).

Conclusions

We observed no association between perioperative MRI and lower LRR or CBC rates in patients with DCIS, with or without RT. In the absence of evidence that MRI improves outcomes, the routine perioperative use of MRI for DCIS should be questioned.