The effect of a multimedia interactive tutorial on learning endodontic problem-solving

New technology may create additional opportunities for learning in dental education. One of these new features is a multimedia approach, courseware combining sound, text, stills and video with interactive learning. A multimedia program was developed to train dental students and dental practitioners in decision making and problem solving in endodontics. This study compared the effects of the multimedia program with a more traditional approach consisting of written information, without interaction. 28, 4th-year dental students at the University of Kentucky in Lexington, KY, USA were randomly assigned to the multimedia or the text-based groups. They were given a written pre-test using 2 cases of dental pain and were instructed to study independently using either the multimedia program (group A) or the written information (group B), No restrictions were imposed on the amount of time to be invested, and the total study time was recorded for each student. 3 weeks after the pre-test, the students completed the post-test. A total of 18 students completed both the pre-test and the post-test and their scores were included in the final data. Statistical analysis of the average scores using paired t-tests revealed no significant difference between the performance of the students in either group, indicating that the multimedia approach to learning endodontic problem solving may successfully replace traditional learning strategies.     

Ultrasonography of alcoholic liver disease with histological correlation

In alcoholic liver disease (fatty infiltration, alcoholic cirrhosis), the liver is diffusely abnormal on ultrasound. Changes in size, dilatation of the hepatic veins, and ascites may also occur. The authors conducted a histological correlation of these abnormalities in 22 alcoholic patients and 16 controls, grading the changes on a scale of 0 to 4+ for fat, fibrosis, and necrosis and noting tumor whenever present. Ultrasound detected abnormality in 21 cases (sensitivity = 95%) and correctly identified 15 controls (specificity = 94%). Of the 5 tumors seen, 4 hepatomas were detected and biopsied and 1 metastatic squamous-cell carcinoma was missed. Applications of commercially available A-scan module are considered and its limitations discussed. With the exception of minimal change (1+ fat or fibrosis), ultrasound detected many of the pathological changes seen in alcoholic liver disease.     

Topics in clinical dentistry. Trends in the Dutch dental literature

Aim of the study was to evaluate a method for selecting topics suitable for developing dental clinical practice guidelines in the Netherlands, based on an analysis of Dutch dental journals. A search for dental clinical topics was conducted by analysing Dutch dental journals, magazines and series over the period 1992-1997. The numbers of publications per topic were plotted against the publication years. The number of publications as well as the value of the slope of the linear regression were considered to be indicators of the importance of a topic. 'Dental implants (indication)' had the highest number of publications, followed by 'orthodontic treatment planning' and 'periodontology (indication)'. The topic 'practice hygiene' showed the highest value of the slope of the linear regression, followed by 'TMJ dysfunction' and 'dental implants (indication)'. With this method, it is feasible to detect changes and tendencies in the Dutch dental literature. It permits a selection of clinically relevant topics over a time span. It was concluded that this method may be very useful in the selection of a topic, but should probably be combined with other methods.     

Practice guidelines in dentistry. An insight into the Dutch situation

Practice guidelines provide opportunities for monitoring and improving dental health care. A survey was conducted among 78 departments at dental societies, scientific dental associations and health care insurance companies in the Netherlands to obtain insight into the number and quality of practice guidelines available. The response rate was 67%. Written materials were analysed and 21 practice guidelines were identified as such. The results of the analysis indicate that many initiatives to construct and implement practice guidelines have been taken. However, these initiatives were insufficiently coordinated and existing guidelines may be subject to improvement. Main improvement would be to demonstrate the validity and reliability of the existing guidelines and, more in general, to provide a sound scientific basis to the development and implementation of practice guidelines.     

Profile and competences for the European dentist

This paper presents the profile and competences for the European Dentist as approved by the General Assembly of the Association for Dental Education in Europe at its annual meeting held in Cardiff in September 2004. A task-force drafted the document, which was then sent to all European Dental Schools. Reactions received were used to amend the document. European dental schools are expected to adhere to the profile and the 17 major competences but the supporting competences may vary in detail between schools. The document will be reviewed in 5 years time. This paper will be disseminated to ministries of health, national dental associations and dental specialty associations or societies in Europe and these organisations will be asked to offer their comments. This information will be used in the reviewing process to be started in 2007. It is hoped that the availability of this document will assist dental schools in Europe to further harmonize and improve the quality of their curricula.     

Sources and sequelae of bacterial contamination of hematopoietic stem cell components: implications for the safety of hematotherapy and graft engineering

Background: It is important to compare the incidence of bacterial contamination of components collected from the peripheral blood or bone marrow (BM), as well as of components processed with or without cell selection or depletion, and to evaluate the sequelae of such contamination. Study Design and Methods: Bacterial contamination rates were compared in 1380 untreated autologous peripheral blood progenitor cells (PBPCs), 291 untreated autologous BM samples, 916 monoclonal antibody (MoAb)-treated autologous and allogeneic BM samples, and in 45 autologous PBPC components from which the CD34+ cells were selected. Bacterial cultures were performed at sequential time points during the processing of MoAb-treated BM. Results: Bacterial contamination was documented in 44 of 2632 components from 1593 patients (1.67% of components, 2.76% of patients) before cryopreservation. Although only 0.65% of untreated PBPCs were contaminated before cryopreservation, each patient was more likely to have given a contaminated PBPC component than a contaminated BM component (2.41% vs. 0%, p < 0.01). Bacterial contamination of MoAb-treated BM was greater during or after manipulation than it was before (2.33% vs. 0.77%, p < 0.05). At thawing, contamination was documented in 42 (1.97%) of 2136 components cultured. Ten (13.7%) of 73 patients who received hematopoietic progenitor cells that were contaminated before cryopreservation or at thawing developed fever or positive blood cultures within 48 hours of transfusion. Fever was associated with bacteremia in two cases, but no irreversible clinical sequelae were noted. Conclusion: These studies suggest that, despite careful attention to sterile procedures, low-level contamination of hematopoietic stem cell components can be introduced before or during manipulation as well as at thawing, and that standards for monitoring of the procedures for collection, processing, cryopreservation, thawing, and transfusion of hematopoietic progenitor cells are necessary.