The influence of sequence of impressions on children's anxiety and discomfort.

PURPOSE: Laboratory studies with adults and children have found lower pain reports when pain proceeds from high to low rather than from low to high. However, pediatric dentists often ease children into difficult procedures (from easiest to most difficult). This study investigated the influence of order during a clinical procedure that involved taking maxillary and mandibular alginate impressions. METHODS: Subjects were 24 children aged 5 to 6 years (preoperational stage) and 24 children aged 9 to 10 years (concrete operational stage). Children were randomly assigned to either start with the mandibular (presumed to be easier) or start with the maxillary (presumed to be harder) impressions. Discomfort during the sequence of impressions was measured using the "Affective Facial Scale." A telephone interview was conducted 2 weeks later to evaluate the memory of discomfort. RESULTS: The results indicated that the older children who started with the mandibular (easier) impression and ended with the maxillary (more uncomfortable) impression reported significantly lower discomfort than older children who started with the maxillary impression and ended with the mandibular (Mann-Whitney U, Z = -2.08; P < .037). The same tendency was noted 2 weeks later on a telephone interview. By phone, 92% of the older children who started with the mandibular impression rated the sequence of impressions as "not at all bad," while only 58% of the older children who started with the maxillary impression rated the overall experience as "not at all bad" (chi2 = 3.56, P < .059). The younger children did not show any significant difference in their ratings of discomfort at either of the assessment periods. CONCLUSIONS: Consistent with clinical practice, this study observed that older children benefit from beginning an appointment with an easier procedure and working up to a more difficult one.

Resistance to serum killing may contribute to differences in the abilities of capsulate and non-capsulated isolates of lactococcus garvieae to cause disease in rainbow trout (Oncorhynchus mykiss L.).

Three capsulated and two non-capsulated isolates of Lactococcus garvieae were investigated in terms of their wall proteins, virulence and interactions with rainbow trout immunoglobulin (Ig). All isolates were similar in integral membrane protein profile, and all were able to bind non-immune rainbow trout Ig, although different proteins appeared to be involved in Ig binding. However, whilst capsulated isolates were highly virulent, non-capsulated isolates were avirulent. This appeared to correlate with susceptibility of the non-capsulated isolates to rainbow trout normal serum. In contrast, the capsulated isolates were resistant to both normal and immune serum killing. In spite of this, passive immunisation of rainbow trout with specific anti-serum to L. garvieae was able to protect against challenge by capsulated isolates of L. garvieae. This suggests the antibody may have some other role in protection against disease caused by this important Gram-positive bacterial fish pathogen.

Antibody increases phagocytosis and killing of Lactococcus garvieae by rainbow trout (Oncorhynchus mykiss, L.) macrophages.

The present study reports that specific antibody increased the bactericidal activity of rainbow trout head-kidney macrophages against virulent capsulated Lactococcus garvieae in the absence of complement. The observed increased bactericidal activity appeared to result from increased phagocytosis of capsulated L. garvieae in the presence of specific antibody and may in part explain the protective effect of antibody previously reported against this disease.