Do buffered local anesthetics provide more successful anesthesia than nonbuffered solutions in patients with pulpally involved teeth requiring dental therapy?: A systematic review

Background

The authors conducted a systematic review that addresses the following population, intervention, comparison, outcome question: “In adults requiring dental therapy with pulpally involved teeth, what is the comparative efficacy of buffered local anesthetics (LAs) compared with that of nonbuffered LAs in achieving anesthetic success?”

Simulation of medical emergencies in dental practice: development and evaluation of an undergraduate training programme

Background: The evidence available suggests that many dentists on graduation do not feel competent managing medical emergencies; a problem requiring improved undergraduate training. This study developed a comprehensive simulation based training programme for final year undergraduate dental students and assessed student attitudes towards training. Methods: Final year dental students (n = 52) from The University of Melbourne were required to complete simulation training incorporating an interactive tutorial and realistic, simulated emergency scenarios conducted in the students’ real clinical environment. A post‐participation questionnaire utilizing a 5‐point Likert scale (1 = strongly disagree, 5 = strongly agree) assessed student attitudes. Results: Student responses supported simulation training, evidenced by the following selected questionnaire responses: achieved greater confidence in managing emergencies 4.65 ± 0.48 (n = 52); prefer lecture to simulation 1.46 ± 0.74 (n = 52); simulation training is important in undergraduate teaching 4.86 ± 0.35 (n = 43). Conclusions: Realistic simulation training in management of medical emergencies for dental students is an effective adjunct to traditional lecture style teaching. Given the importance of this subject, this mode of training would benefit students if incorporated into undergraduate dental courses.     

Fluoride profiles in different sites of approximal surfaces of second primary molars after topical application of acidulated phosphate fluoride gel in vivo

Thirty-four (17 paired) extracted second primary molars were obtained from 17 individuals (9 boys and 8 girls) aged from 9 yr 2 months to 12 yr 7 months. A tooth on one side was extracted as a control, and an acidulated phosphate fluoride (APF) gel was then applied to the paired contralateral second primary molar. Three months later, the experimental tooth was extracted. Nine sites were assayed by a microsarapling technique from small areas of the approximal enamel surface. The fluoride and phosphorus concentrations were determined by a fluoride electrode and by colorimetric procedure, respectively. Fluoride concentrations were higher in the teeth treated with the APF gel than in the control teeth. The highest fluoride uptake was observed in the central area of the approximal surfaces. Deeper areas (>10 μm) had a marked uptake of fluoride as compared with surface areas (< 3 μm). It was concluded that the APF gel application increased the fluoride levels of approximal tooth surfaces, particularly the mid-central site, of second primary molars, even at 3 months after application.     

心肌细胞损伤模型构建及应用的研究进展

心肌细胞损伤模型目前被广泛应用于心血管疾病的分子机制及药物作用的研究,因各种模型的形成机制不 同,选择合适的模型非常重要。临床心血管疾病的病理变化相对复杂,根据其特点采用的心肌细胞损伤模型主要有过 氧化氢心肌细胞损伤模型、缺氧/复氧心肌细胞损伤模型、阿霉素心肌细胞损伤模型、高糖/高脂心肌细胞损伤模型、异 丙肾上腺素心肌细胞损伤模型等。几种模型均有优缺点,需要根据研究内容选择相对合适的心肌细胞损伤模型。     

基于“木郁达之”探讨化肝煎之临证运用

“木郁达之”意指肝气郁结当疏泄通达。化肝煎出自明代医学家张景岳的《景岳全书》,由青皮、陈皮、山栀子、牡丹皮、泽泻、芍药、土贝母7味中药组成,可疏肝畅达清热,为治肝郁化火之证的代表方,也是“木郁达之”治法的具体体现。现代临床可用于胃痛、胁痛、腹痛、头痛、烦热、咳吐痰血、妇女月经不调、目赤眼胀等多种病症的治疗。临证之时应抓住肝郁化火之辨证要点,基于“木郁达之”的原则,灵活化裁,以使肝气条畅,气血冲和,病症得除。     

质量管理工具在基层医院难免性压疮管理中的应用

目的探讨将质量管理工具应用到难免性压疮管理中的效果。方法采用质量管理工具中的查检表对难免性压疮高危患者上报及发生例数进行统计、绘制特性要因图(鱼骨图)后进行原因分析,确定和解决难免性压疮管理中的问题。结果质量管理工具应用前后难免性压疮发生率比较,差异有统计学意义(P0.05)。结论将质量管理工具应用到难免性压疮管理中可有效减少难免性压疮的发生,达到护理质量与安全的持续改进。     

Categorical or Dimensional: How Do Attachment Measures Inform Clinicians in Couple Therapy?

Self-report measures of adult romantic attachment have been widely used in research but their application in clinical practice has not been adequately examined. One important issue is the selection of a practical and reliable attachment measure that therapists can rely on in couple therapy. In the present study, the three-category Attachment Style Prototype (Hazan & Shaver, 1987) representing the original classic conceptualization of attachment, and the Experiences in Close Relationships (Brennan, Clark, & Shaver, 1998), a more recent scale with two dimensions representing a new conceptualization, were compared. Experiences in Close Relationships data were also used to establish four clusters based on the scores of the two dimensions. The Experiences in Close Relationships and Attachment Style Prototype categories were related in meaningful ways; however, Attachment Style Prototype was less effective in detecting a group of insecurely attached individuals who tended to self-identify as securely attached. Experiences in Close Relationships clearly shows an advantage over Attachment Style Prototype in clinical application, and therefore was recommended. Examples of the clinical utilization of Experiences in Close Relationships in couple therapy were provided using Experiences in Close Relationships scores from couples seeking therapy.     

Is There a Relation between AOFAS Ankle-Hindfoot Score and SF-36 in Evaluation of Achilles Ruptures Treated by Percutaneous Technique?

The percutaneous technique of Achilles tendon repair seems to offer satisfactory clinical and functional results, although these results have been evaluated mainly using objective rating scales. Recently, some “subjective” rating scales have been combined to evaluate the results of various surgical treatments. The purpose of the present study was to compare the results of a percutaneous Achilles tendon repair evaluated objectively using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and subjectively using the Medical Outcomes Study, short-form, 36-item questionnaire (SF-36) questionnaire. A total of 17 consecutive patients were treated for acute Achilles tendon rupture using the modified percutaneous Ma and Griffith technique. We reviewed all patients with a follow-up of 24 to 64 months (mean 45.5). At the final follow-up visit, the AOFAS ankle-hindfoot score of each patient was compared with each 1 of the 8 domains of the SF-36 questionnaire, using the parametric Pearson correlation coefficient and the equivalent nonparametric Spearman rho correlation coefficient. The relation between the objective (AOFAS) and subjective (SF-36) results showed a significant correlation (Pearson's correlation coefficient) between the physical functioning (r = 0.597, p = .011) and bodily pain (r = 0.663, p = .004) SF-36 domains, and a nonstatistically significant correlation with the other SF-36 domains. Very similar results were found using the nonparametric Spearman rho correlation coefficient. These results suggest that regarding pain and function, the AOFAS ankle-hindfoot score and SF-36 provide complementary information; therefore, we believe that the SF-36 questionnaire should be used with the AOFAS ankle-hindfoot score for a more complete evaluation of the outcome.