Pit and fissure sealants: a review of the literature.

This article reviews the scientific literature regarding pit and fissure sealants for oral health care professionals interested in managing dental caries. Review topics include the development of sealant materials; their efficacy and use with incipient caries; the use of sealants in combination with restorative materials and orthodontic care; the utilization patterns of sealants; and professional and public awareness of and acceptance of sealants. While research findings overwhelmingly document the efficacy of sealants, their utilization has been limited. Recommendations to increase sealant use focus on the need to educate the public and increase the knowledge and acceptance of oral health care professionals about this caries-preventive technology.

Comparison of dose doubling with probenecid for sustaining serum cefuroxime levels.

Serum cefuroxime concentrations were measured over a 12 h period in ten healthy adults following three iv dosing regimens: 750 mg cefuroxime, 1.5 g cefuroxime, and 750 mg cefuroxime with 1 g of probenecid given orally 3 h before the cefuroxime infusion. Probenecid prolonged the serum cefuroxime half-life by 63% (P < 0.05) with a significant increase in the mean time for which serum cefuroxime concentrations exceeded the MIC90 for common respiratory pathogens (2 mg/L) compared with either 750 mg cefuroxime (2.2 h, P < 0.05) or 1.5 g of cefuroxime (0.9 h, P < 0.05) without probenecid. The cost of the 750 mg cefuroxime dose plus probenecid is approximately half that of a 1.5 g cefuroxime dose.

Occult pneumothorax in patients with abdominal trauma: CT studies.

Abdominal CT, which routinely includes the lower thorax, is an important adjunct to supine chest radiography in detecting chest injury in patients with blunt abdominal trauma. In 1,086 consecutive patients with blunt abdominal trauma, 223 of whom had both supine chest radiography and abdominal CT, 49 patients examined with both techniques had pneumothoraces, 28 of them occult (seen only on CT). To help guide management, we established three categories of occult pneumothorax, based on size and location: (a) minuscule (< 1 cm in greatest thickness, seen on four or fewer images); (b) anterior (> 1 cm in greatest thickness, but not extending beyond the midcoronal line); (c) anterolateral (extending beyond the midcoronal line). In our study four of six patients with minuscule pneumothorax, including one who required mechanical ventilation, were observed without complications; two of six patients had chest tube placement. Seven of 14 cases with anterior pneumothorax were observed and resolved without complication; seven had chest tube placement. All eight patients with anterolateral pneumothoraces underwent percutaneous tube thoracostomy, regardless of proposed management.

Vicarious contrast material excretion in patients with acute unilateral ureteral obstruction.

Radiographs of 45 patients with evidence of acute unilateral ureteral obstruction at intravenous urography, obtained at least 24 hours after injection of contrast material, were retrospectively studied. Vicarious contrast material excretion (VCME) as evidence by gallbladder opacification on delayed radiographs was seen in 19 patients (42%), 10 of whom also showed extravasation of contrast material. A total of 15 of the 45 patients developed spontaneous extravasation; 10 (67%) showed VCME, while only nine of the 30 patients (30%) who did not have spontaneous extravasation of contrast material showed VCME. The creatinine level was elevated (greater than 1.5 mg/dL [133 mumol/L]) in four patients with VCME and in six patients without. This series indicates that VCME is more common than previously appreciated in patients with acute unilateral ureteral obstruction and occurs with greater frequency when obstruction is associated with contrast material extravasation.

Stress-related symptoms among dental hygienists.

A sample of 49 practicing dental hygienists responded to a survey which included Derogatis and Spencer's 1982 Brief Symptom Inventory, a measure of stress-related symptoms, and a list of items considered stressful based on previous research with hygienists, arranged in six content categories. As hypothesized, in comparison with national norms, hygienists displayed significantly more symptoms on the over-all inventory and also on eight of nine subscales. Also as hypothesized, on the list of stressors, items pertaining to time pressure were rated as significantly more stressful than items from other behavioral domains. However, contrary to prediction, the correlation between over-all symptom level on the inventory and self-rated stress did not reach statistical significance. A variety of implications for stress reduction in dental hygiene practice are discussed.

Xerostomia: a review for dental hygienists.

The percentage of people over 65 years of age is increasing each year in the United States. Dental hygienists can play an important role in meeting the oral care needs of this growing population. The purpose of this paper is to further educate dental hygienists about xerostomia, one of the common oral symptoms of this age group. This paper contains a review of the literature regarding the etiology, clinical implications, prevention, and treatment related to xerostomia.