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Biomedical subjects

G Acs

Publications and source records attributed to G Acs.

141 records · Page 8Linked to original sources
PubMedDate not supplied

Glandular and squamous atypia and intraepithelial lesions in atrophic cervicovaginal smears. One institution's experience.

OBJECTIVE: To review the cytologic features and follow-up histologic findings in atrophic cervicovaginal smears with the diagnoses of glandular or squamous atypia or intraepithelial lesion. STUDY DESIGN: A total of 228 cases were included in the study. The selection criteria included: age > 48 years and a diagnosis of either atypical glandular cells (AGC) (51 cases), cellular changes suggestive of human papillomavirus (HPV) infection (S/O HPV, 97 cases), low grade squamous intraepithelial lesion (LSIL) (60 cases) or high grade squamous intraepithelial lesion (HSIL) (20 cases). Follow-up biopsy information was available for 103 cases (45%). RESULTS: From the AGC group, 35 (69%) cases had tissue studies; 14 (40%) cases showed glandular lesions; 5 (14%) showed squamous intraepithelial lesion (SIL) and atypical cells. Follow-up information was available for 32 (33%) cases classified as S/O HPV; significant lesions (glandular/squamous) were found in 11 (34%). In the LSIL category, 22 (37%) cases had follow-up; 16 (73%) showed SIL. In the HSIL category, 14 cases (70%) underwent biopsy, and all showed SIL (four LSIL and nine HSIL) or squamous cell carcinoma. CONCLUSION: Even though atrophy-related epithelial changes often pose diagnostic difficulties in the interpretation of postmenopausal smears, application of reproducible and established cytologic criteria in diagnosing SIL and/or glandular lesions can improve diagnostic accuracy and result in selection of patients for follow-up tissue studies.

Atrophy↗
PubMedDate not supplied

The effect of dental rehabilitation on the body weight of children with early childhood caries.

PURPOSE: The purpose of this study was to determine the effect of comprehensive dental rehabilitation on the percentile weight and percentile growth velocity of children with early childhood caries (ECC). METHODS: The percentile weight categories of children with noncontributory medical histories and ECC were compared to caries free comparison patients, before and after comprehensive dental treatment under general anesthesia. RESULTS: Prior to dental rehabilitation, test subjects' percentile weight categories were significantly less than that of comparison counterparts (P < 0.001). Of the ECC patients, 13.7% weighed less than 80% of their ideal weight, thereby satisfying one of the criteria for the designation of failure to thrive, while none of the comparison patients did so (P < 0.05). Following therapeutic intervention, ECC children exhibited significantly increased growth velocities through the course of the follow-up period (P < 0.001), reflecting the phenomenon of catch up growth. The average length of follow-up for the test and comparison groups were 1.58 and 1.36 years, respectively. At the end of the follow-up period there were no longer any statistically significant differences noted in the percentile weight categories of the test and comparison groups. CONCLUSION: Comprehensive dental rehabilitation resulted in catch-up growth, such that children with a history of nursing caries no longer differed in percentile weights from comparison patients.

Body Weight↗
PubMedDate not supplied

A 20-year perspective on the changing use of hand over mouth (HOM) and restraint in postdoctoral pediatric dental education.

PURPOSE: This study assessed the current teaching and utilization of the hand over mouth technique in advanced educational programs in pediatric dentistry and compared these results to previous surveys. METHODS: A survey, identical to those used in 1979 and 1989, was sent to pediatric dentistry program directors. Descriptive and comparative statistics evaluated the use of HOM, HOMAR, and restraint. Additionally, changing patterns of responses for programs and directors that responded to both the 1989 and 1999 surveys were assessed. RESULTS: Eighty-seven percent of directors returned surveys. There was a significant decrease in the number of programs utilizing the HOM technique in the past 10 years (P< 0.0001). Among respondents that returned surveys in 1989 and 1999, 50% of the previous HOM users discontinued its use (P<0.03). Technique non-users were significantly less likely to describe the technique consistent with AAPD guidelines (P<O.0001). Although the 1989 respondents expressed significantly decreased certainty that restraint techniques were free of psychological sequealae compared to 1979 respondents, the continuing decreasing trend observed between the 1989 and 1999 groups was not significant. CONCLUSIONS: With continuing uncertainty regarding psychological sequealae associated with HOM, there was a significant decrease in the number of programs advocating its use.

Attitude of Health Personnel↗
PubMedDate not supplied

Perceived outcomes and parental satisfaction following dental rehabilitation under general anesthesia.

PURPOSE: The objective of this study was to evaluate parents' perceptions of their child's quality of life following dental rehabilitation under general anesthesia and to assess their satisfaction with that treatment modality. METHODS: A survey was sent to 400 parents of patients who had undergone dental rehabilitation. Quality of life outcomes, such as continued presence of pain and inability to eat or sleep, were assessed. Additionally, parental satisfaction with outcomes and processes was evaluated, as was outcome expectation. Descriptive statistics were collected on outcome measures. Contingency testing was employed to compare outcomes by medical or developmentally compromising conditions, gender, or continued use of the initial treatment facility for routine care. RESULTS: Fifty seven percent of parents returned surveys. A descending hierarchy of improved treatment outcomes was noted, with improvement in pain the predominant outcome, followed by improved abilities to eat and sleep, reported by 86, 69, and 41% of parents, respectively, 72% perceived an improvement in their child's health. Children with medically or developmentally compromising conditions were significantly more likely to have improved abilities to eat and sleep, and had a significantly improved overall health status. Satisfaction and expectations were consistently achieved and were not related to continued use of the initial treatment facility. CONCLUSIONS: Children with early childhood caries receiving comprehensive treatment under general anesthesia achieved improvements in their quality of life as well as overall health. A hierarchy of improvement was noted, with the greatest improvement noted in pain experience followed by improved abilities to eat and sleep. Parents were overwhelmingly satisfied with outcomes and the process of care, and reported that their expectations had been met.

Anesthesia, Dental↗
PubMedDate not supplied

The influence of medical history on restorative procedure failure rates following dental rehabilitation.

PURPOSE: This study evaluated the association between patient medical history and the outcomes of restorative procedures performed under general anesthesia. METHODS: The dental records of patients who had dental rehabilitation under general anesthesia at Children's Hospital in Boston (1990-1992) and Children's National Medical Center in Washington, DC (1994-1998) were examined. Data regarding restorative outcomes and the association between patient medical history and restorative failures were assessed using chi-square tests with correction for continuity. T-tests were performed on parametric data. RESULTS: Significantly higher stainless steel crown failure rates were found in young patients diagnosed with developmental disabilities when compared to patients without such disabilities (p<0.025, x2 = 5.50). However, there was no difference in the failure rates of SSCs in young patients with significant medical histories compared to patients without significant medical histories. Regarding amalgam and composite restorations, there were no differences in failure rates among patients with and without significant medical histories, including developmental disabilities. CONCLUSIONS: SSC failures were higher in young children with developmental disabilities compared to children without these disabilities.

Adolescent↗
PubMedDate not supplied

Antibiotic prophylaxis for patients with hydrocephalus shunts: a survey of pediatric dentistry and neurosurgery program directors.

A survey of antibiotic prophylaxis recommendations for patients with hydrocephalus shunts was sent to directors of advanced programs in pediatric dentistry and neurosurgery. Recommendations were sought for patients with ventriculoperitoneal (VP) or ventriculoatrial (VA) shunts who were to receive dental care. Most respondents believed that shunt infection (SI) was related infrequently to dental procedures. Pediatric dentists believed that 5.2% of infected VA shunts were related to dental procedures, while neurosurgeons believed the rate to be 3.0% (P < 0.05). There was no difference in perceived risk for VP shunts. Except for the equal risk associated with extractions, pediatric dentists were significantly more likely than neurosurgeons to recommend chemoprophylaxis for patients with VA shunts undergoing invasive dental procedures (P < 0.05). They were more likely to agree with neurosurgeons when VP shunts were involved. Except for the equal risk associated with dental prophylaxis, pediatric dentists and neurosurgeons believed VA shunt patients were at greater risk for SI than VP shunt patients (P < 0.05). Pediatric dentists were significantly more likely to ascribe SI to streptococcal organisms, and recommended penicillin for prophylaxis for both VA and VP shunts (P < 0.01 and 0.025, respectively). Although neurosurgeons believed that staphylococcal organisms were most likely to be responsible for SI (P < 0.001), 60% still recommended using penicillin for shunt prophylaxis following dental procedures.

Anti-Bacterial Agents↗
PubMedDate not supplied

Effect of nursing caries on body weight in a pediatric population.

A review of anesthesia and sedation records of children with nursing caries was undertaken. The weights of these 115 children with otherwise noncontributory medical histories were compared to subjects matched for age, gender, race, and socioeconomic status. Nursing caries children were treated using either sedation or general anesthesia and received treatment for at least one pulpally involved tooth. Comparison subjects had no gross carious lesions. The average age for both the comparison and test groups was 3.2 years (SD = 1.01 and 0.98, respectively). While comparison patients weighed 16.2 +/- 3.08 kg, patients with nursing caries weighed only 15.2 +/- 2.66 kg. This difference was statistically significant (P < 0.005). Of the nursing caries patients, 8.7% weighed less than 80% of their ideal weight, compared with only 1.7% of the comparison patients (P < 0.02). Of nursing caries children, 19.1% were in the 10th percentile or less for weight, compared with only 7.0% of comparison subjects (P < 0.01). The mean age of "low weight" patients with nursing caries was significantly greater than for patients at or above their ideal weights, indicating that progression of nursing caries may affect growth adversely.

Age Factors↗
PubMedDate not supplied

The incidence of postoperative pain and analgesic usage in children.

The purpose of this study is to report the incidence of post-restorative dental pain and analgesic usage in children. A questionnaire completed by parents was employed. The mean age of the patients was 8.1 years; and all patients were in the six- to thirteen-year-old range. Pain following routine restorative procedures was reported by 31.5 percent of the patients. Additionally, 52.9 percent of these patients required analgesic relief.

Adolescent↗
PubMedDate not supplied

Current teaching of restraint and sedation in pediatric dentistry: a survey of program directors.

Directors of advanced educational programs in pediatric dentistry were surveyed to examine the usage patterns of various physical and pharmacological restraint techniques over the past five years. Results indicate that while the overall use of sedation has decreased, the use of oral sedative agents reportedly increased by 42.1%. The net decrease resulted from large decreases in parenteral administration. While the survey results showed large decreases in the use of hand-over-mouth and hand-over-mouth with airway restriction, the use of other physical restraint techniques continued to be employed at the same rate. Programs reporting changes in the use of nitrous oxide were divided equally between increased and decreased utilization. The usage pattern of general anesthesia, however, was clearly unidirectional. More than half (57.4%) of program directors reported an increased use of general anesthesia, while only 13.0% reported a decreased use.

Anesthesia, Dental↗
PubMedDate not supplied

An updated survey on the utilization of hand over mouth (HOM) and restraint in postdoctoral pediatric dental education.

A survey of directors of advanced educational programs in pediatric dentistry, identical to one conducted in 1979, was undertaken to examine the utilization of and indications for various physical restraint techniques. Updated results indicated that there is still a high acceptance of the hand-over-mouth (HOM) technique. Only 11.1% of programs never use the technique. However, the acceptance of airway restriction is significantly lower than in 1979. Program directors currently report increased situations in which other physical restraint techniques, such as the Papoose Board, are recommended. Despite the continued acceptance of physical restraint techniques, a significant number of directors report that they are less certain that these techniques do not induce psychological problems. Although the current survey data indicates that there may be a discrepancy between professional standards as espoused by program directors, and material standards, that discrepancy is greatest for those program directors with tenures in excess of 10 years. These directors were much more likely to believe that HOM was indicated in situations other than for the control of hysterical and tantrum-like behavior and were much less likely to tell the child why HOM was being used. Additionally, such directors were as likely to use airway restriction as were 1979 respondents, although directors with tenures of less than 10 years were significantly less likely to use airway restriction.

Child Behavior Disorders↗
PubMedDate not supplied

The incidence of post-extraction pain and analgesic usage in children.

A parentally completed questionnaire was used to investigate the incidence of post-extraction pain in children. Significantly more patients in the study group reported pain following dental extraction than did control patients. Increasing age was significantly associated with the report of pain, but not with the use of a pain medication, even when the degree of difficulty of the extraction procedure was standardized. These findings suggest that the report of pain represents a late learned response while medication usage represents an early learned response. Those patients that reported increased severity of pain were significantly more likely to require a pain medication, but the pain medication was most effective for only mild pain. Additionally, male patients were significantly more likely to report complete effectiveness when pain medication was used. Contrary to some popularly held beliefs, the results of this study indicate that children do experience post-extraction pain and some children experience pain of sufficient intensity to require an analgesic for relief of post-extraction pain. Additionally, for a small group of patients, neither aspirin nor acetaminophen are adequate in fully relieving post-extraction discomfort. For these patients other agents may be indicated to fully relieve pain.

Adolescent↗
PubMedDate not supplied

A constellation of dental anomalies in a chromosomal deletion syndrome (7q32): case report.

A case is reported of a patient with deletion of the long arm of chromosome 7 at a highly specific locus (7q32). In addition to significant craniofacial stigmata and global developmental delay, the patient presented with numerous clinical and radiographic dental anomalies observed over a 10-year period. Hypodontia, accessory roots, dens invaginatus, hypoplastic enamel, and numerous pulpal anomalies all were noted. Some of these dental findings suggest trichodentoosseous syndrome (TDO), although the other stigmata do not. The wide variety of dental findings in this patient may help to define the role of chromosome 7q32 in dental development.

Abnormalities, Multiple↗