Given the dramatic changes presently occurring in the practice of dentistry, it was the purpose of this research to examine the outlook held by practicing dentists toward their profession. Through use of a mailed questionnaire, a national sample of general and pediatric dentists was surveyed. A 12-item Likert scale was used to measure dentist outlook. Additionally, dentists responded to questions dealing with conditions of their practice. Respondents were most positive about the professions' accomplishment in reducing caries by promoting the use of fluorides. The majority also felt that decreased time spent providing restorative services would lead to increased time spent providing other services, that greater use of auxiliaries would produce increased income, that the ADA's proposed marketing plan would have a positive effect on the public, and that research findings were relevant to the private practice of dentistry. Three items received negative responses. These items related to the oversupply of dental manpower, the detrimental effects of the increase in competition among dentists, and the decrease in professional autonomy. Additionally, four practice variables were found to be related to dentist outlook. Outlook became more favorable with increasingly more positive income change over the prior year, with increasing numbers of employees, and with increasing practice business. Finally, the longer a dentist had been out of dental school, the more positive his or her outlook was likely to be.

Attitude of Health Personnel↗

PubMedDate not supplied

[Treatment of critical pulmonary valvular stenoses in newborn infants using percutaneous valvuloplasty. Study of 28 cases].

Twenty-eight neonates aged 1 to 21 days with critical pulmonic stenosis were treated by percutaneous valvotomy consisting of balloon dilatation of the stenotic valve by percutaneous catheterization. The right ventricular systolic pressure (RVP) was either the same or higher than the systemic pressure in all cases but 3. In those it was somewhat lower (80%) than the left ventricular systolic pressure (LVP) so that, on the whole, the RVP/LVP ratio, here called rP ranged from 0.8 to 2 (m = 1.41 +/- 0.36). The procedure failed 5 times because of failure to introduce the balloon through the valve (4 cases) or because of an accident (1 case). All failures occurred during the initial phase of our experience with this procedure as the last 20 trials were successful. The procedure was inefficacious in 3 cases (13%) but immediately successful in the other 20 (87%) with a drop in the mean rP to 0.59 +/- 0.17. During the follow-up period, one neonate continued to present with an important degree of cyanosis, due to a poor right ventricular compliance. He had to be operated on. Pulmonic stenosis reappeared in 6 cases who underwent for a second time a percutaneous valvotomy. The procedure was successful in 3 and failed in 3 who eventually required surgery. Overall, the satisfactory results observed after the procedure persisted over time in 13 cases. In conclusion, interventional catheterization has become almost always possible in neonates with critical pulmonic stenosis. If performed under vigorously controlled conditions including an infusion of prostaglandin E1 in cases with severe cyanosis and the use of large diameter balloons, this method is relatively safe and generally efficacious since in 70% of cases it circumvents the need for surgery.

Angioplasty, Balloon↗

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