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Timmons Abel posted an update 6 months, 4 weeks ago
The most effective local anaesthetic for the extraction of impacted mandibular third molars appeared to be 4% articaine, with significant differences when compared with 2% lidocaine, 0.5% bupivacaine, and 1% ropivacaine. Lidocaine is the safest local anaesthetic, although all investigated solutions can be used safely.Introduction In Australia and Sweden, orthodontic treatments may be performed by either a general dental practitioner (GDP) or a specialist orthodontist. Evidence suggests that the public may easily confuse a GDP who provides orthodontic treatment with a specialist orthodontist. We conducted a survey of people in Australia and Sweden to assess their understanding of the differences between a specialist orthodontist and a GDP who provides orthodontic treatments. Methods The sample comprised 2006 Australian adults and 1010 Swedish adults who completed an online questionnaire. The survey examined the respondents’ understanding of the difference between a GDP and a specialist orthodontist. Demographic data and the respondents’ preference concerning future practitioner type were also collected. Results Although most of the responses between the countries were different with statistical significance (P less then 0.001), many similarities in the responses were observed. More than 90% of the respondents in both countries did not know the difference between a GDP who provides orthodontic treatment and a specialist orthodontist. Almost 75% believed that a specialist orthodontist was the most qualified practitioner to perform orthodontic treatment. Fewer than 10% of the respondents preferred to see a GDP for orthodontic treatment over a specialist. These people tended to be male, have less education, and be younger. Cost was identified as an important factor in choosing an orthodontic practitioner, particularly in the Australian sample. Conclusions The clear majority of both Australian and Swedish respondents were unable to identify the difference between a specialist orthodontic and a GDP who provides orthodontic treatments.Introduction One factor that can affect treatment outcomes is the treatment provider, and this factor has not been extensively studied. This research aimed to evaluate orthodontic treatment quality, length, and efficiency when 2 orthodontists collaborated on treatment, compared with the treatment provided solely by either orthodontist. Methods A total of 150 consecutively treated subjects were divided into 3 equal groups based on the treating clinician. Patients in group A were treated by orthodontist A, group B by orthodontist B, and group C by both orthodontists in collaboration. The Peer Assessment Rating (PAR), Index of Complexity, Outcome, and Need (ICON), American Board of Orthodontics-Discrepancy Index, and American Board of Orthodontics-Cast and Radiographic Evaluation were used to assess the pretreatment and posttreatment status. Patient age, gender, type of malocclusion, extraction treatment, orthognathic surgery, treatment length, number of visits, and treatment efficiency index were assessed. Results Posttreatment PAR and ICON indices showed excellent results in all 3 groups. American Board of Orthodontics-Cast and Radiographic Evaluation was significantly higher in group C (25.3 points) than in group A (21.5 points) or group B (22.0 points) (P = 0.014). Patients in group A had significantly shorter treatment time (23 months) than those in either group B or C (26 months) (P = 0.011). Patients in group C required more appointments (27 visits) than those in either group A or B (23 and 25 visits, respectively). The treatment efficiency index showed no statistically significant difference among the 3 groups. Conclusions There was no difference in treatment quality among the 3 groups, as assessed by the PAR index and ICON. Jointly treated cases required 2 to 4 more visits and had higher American Board of Orthodontics-Cast and Radiograph Evaluation scores than those treated by either orthodontist. Complex cases required 6 to 7 more months when they were treated collaboratively.Background We assessed the impact of an evidence-based neuroprotection care bundle on the risk of brain injury in extremely preterm infants. Methods We implemented a neuroprotection care bundle consisting of a combination of neuroprotection interventions such as minimal handling, midline head position, deferred cord clamping, and protocolization of hemodynamic and respiratory managements. These interventions targeted risk factors for acute brain injury in extremely preterm infants (born at gestational age less than 29 weeks) during the first three days of birth. Implementation occurred in a stepwise manner, including care bundle development by a multidisciplinary care team based on previous evidence and experience, standardization of outcome assessment tools, and education. We compared the incidence of the composite outcome of acute preterm brain injury or death preimplementation and postimplementation. Results Neuroprotection care bundle implementation associated with a significant reduction in acute brain injury risk factors such as the use of inotropes (24% before, 7% after, P value less then 0.001) and fluid boluses (37% before, 19% after, P value less then 0.001), pneumothorax (5% before, 2% after, P value = 0.002), and opioid use (19% before, 7% after, P value less then 0.001). Adjusting for confounding factors, the neuroprotection care bundle significantly reduced death or severe brain injury (adjusted odds ratio, 0.34; 95% confidence interval, 0.20 to 0.59; P value less then 0.001) and severe brain injury (adjusted odds ratio, 0.31; 95% confidence interval, 0.17 to 0.58; P less then 0.001). Conclusions Implementation of neuroprotection care bundle targeting predefined risk factors is feasible and effective in reducing acute brain injury in extremely preterm infants.Background Acupuncture anesthesia was used instead of intubation anesthesia in the 1970s and 1980s in West Germany and West Berlin. In East Germany acupuncture played no decisive role. Sources Different articles and papers in journals, in daily press, statements of contemporary witnesses, films, records in archives. Results As in other Western countries, acupuncture was hugely popular in the Federal Republic of Germany in the 1970s. Chief triggers were the state visits to China of the American President Richard Nixon in 1972 and shortly thereafter of West German Foreign Minister Walter Scheel and his wife Mildred, an x-ray technician. Epigenetic inhibitor During that period observation of an operation under acupuncture anesthesia was an obligatory element in the agenda of a foreign delegation. Following this showcasing, acupuncture was widely adopted in Western surgery as an alternative to the previously exclusive employment of intubation anesthesia. While the alternative method was soon abandoned in the frontline city of West Berlin, it continued to prevail in other West German cities, e.
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