Automated hospital information system functions for dietetics.

Utilization of computer technology in health care is expanding, and managers need information regarding existing automated functions when making decisions relative to system design or acquisition. The Automated Hospital Information System (AHIS) Component Catalog, compiled by the Health Services Research Center/Health Care Technology Center (HSRC/HCTC) at the University of Missouri-Columbia, describes the features of software packages offered by vendors and utilized in hospitals. On the basis of an analysis of the contents of the Catalog relative to automated functions for dietetic departments, charge capturing and diet change notification were the functions used most frequently in hospitals. Although a stores inventory was not included as a component offered by any of the responding vendors, 23 of the hospital systems described in the catalog included a stores inventory component. Menu planning and meal scheduling were functions which were both available from vendors and utilized in hospitals. The nutrient analysis function was implemented in some of the larger hospitals. The information in the Catalog reflects the availability and adoption of automated hospital information system components for dietetic functions.

Surgical correction of Goldenhar's syndrome.

Goldenhar's syndrome is a variant of hemifacial microsomia - one of the more common congenital syndromes of the first and second arch. The Goldenhar's type is characterized by varying degrees of underdevelopment of craniofacial structures. The major deformities involve the mandible and the ear; but they also include the orbit and vertebral column, specific defects pathognomonic of this condition. Medical management requires reconstructive surgery of which treatment must take into consideration the timing of surgery and the effects of surgery upon the growth and development of the poorly formed structures. This paper presents a discussion of the pathogenesis and the favorable and unfavorable factors affecting the selection and timing of surgery. The literature is reviewed and two additional cases are added with an evaluation of the effects of early reconstruction. A single-stage procedure, utilizing rib autograft, is described for correction of the defective hemimandible, glenoid fossa, and zygoma. The results are evaluated by means of photographs and radiographs with a follow-up period of at least one and one-half years. The data suggest a remodeling of the grafts to resemble normal structures, and a downward growth of the maxilla to fill a space created by the reconstruction of the mandible and expansion of the lower portion of the face. Multiple stages of surgery as well as unnecessary delays in performing surgical procedures are challenged by the report.

The use of lag screws in mandibular fractures.

The use of screws and plates in the treatment of fractures and osteotomies of the facial bones promises the abandonment of intermaxillary fixation. For those who are adept with the instrumentation and have experience in applying the screws, such systems offer an approach to fracture treatment and osteotomy stabilization that is very much appreciated by patients.

Removing third molars: a review for the general practitioner.

The decision to extract a third molar should be made only after considering all possible outcomes of this treatment. If the practitioner decides to remove a third molar, then a meticulous course of surgery and postoperative care should be performed.

The efficacy of an intraosseous injection system of delivering local anesthetic.

This article describes the clinical testing of a new system for the intraosseous delivery of local anesthesia. The author concluded that the system delivered local anesthetic very effectively (in some situations more effectively than the traditional delivery method), thus offering a great potential advantage to both dentists and patients.

Whiplash and temporomandibular disorders: a critical review.

Some authors have hypothesized a relationship between rear-impact motor vehicle collisions and subsequent symptoms of neck pain and temporomandibular disorders, or TMD, despite no facial impact. This article examines the TMD aspect in terms of the physiological basis and cultural factors influencing the reporting of such symptoms.

An approach to some dilemmas and complications of office oral surgery.

This article reviews an eclectic collection of problems. There is no particular reason why any one of them was chosen other than that they are more likely to occur in the course of practice than some other complications such as an oro-antral fistula or trauma to the lingual nerve or tissue emphysema. These latter and some other predicaments were discussed in the course of the talks given by the author at the 28th Australian Dental Congress in March 1995. The problems discussed in this paper are: 1. Dentoalveolar abscess anaesthesia. 2. Inability to obtain effective anaesthesia. The complications: 1. Post-extraction haemorrhage. 2. Syncope. 3. Postoperative infection.

The maxillary frenum and surgical treatment.

This article reviews the role of the maxillary frenum in diastema formation and provides guidance on procedures to remove it in both dentate and edentate patients.