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At least 469 records · Page 26Linked to original sources

Removable partial denture design by Canadian dental laboratories: a retrospective study.

Identical, unilateral, distal extension base (DEB) maxillary and mandibular casts with a posterior modification area were mailed to 15 Canadian commercial dental laboratories. Each cast was accompanied by a letter explaining the purpose of the study and a request for the laboratory to design a RPD-U and RPD-L framework. The package also included a questionnaire on the techniques commonly used by dentists in the construction of a removable partial denture prosthesis, as well as the laboratory procedures they requested from laboratory technicians. Compared to the findings of previous studies by McCracken and others, the results of this study indicate an improvement in the dentists' understanding of the fundamental principles of an RPD framework design. However, the questionnaire also revealed the need for improved communication between the dentist and the technician. The study suggests that the basic principles for the construction and design of removable partial dentures, as taught in dental schools across Canada, must be respected by dentists.

Communication↗

Blood collection and surgical procedures for the laboratory opossum (Monodelphis domestica).

Procedures have been developed for collecting blood samples from the laboratory opossum (Monodelphis domestica) and for conducting survival surgery on adults. Blood samples up to 1 ml were collected routinely by cardiac puncture of animals anesthetized by inhalation of methoxyflurane or halothane with minimal risk; however, halothane required more careful monitoring. Surgical procedures such as partial hepatectomy unilateral hysterectomy, and tail wound repair were safely accomplished on animals anesthetized with methoxyflurane. Other surgical procedures including enucleation and intra-abdominal vasectomy were carried out successfully with an inhalation/injection (pentobarbital-atropine-ketamine) protocol that was successful also for recipient surrogate females in embryo transfer experiments.

Anesthesia↗

Laboratory support for transplantation.

The clinical laboratory plays a major role in support of transplantation. Depending on the spectrum and number of transplants performed, such programs can consume up to 35% of all laboratory testing. This testing can be transplantation-nonspecific or -specific. The former constitutes routine laboratory procedures in various areas of laboratory medicine that are common to other categories of patients. Transplantation-specific testing includes tissue typing, procedures for assessment of graft viability/rejection, and measurement of immunosuppressive drugs. Because of the development of new immunosuppressive drugs such as FK506, cyclosporin G, and rapamycin, an increased burden will be placed on laboratories to establish new therapeutic monitoring programs. Preliminary guidelines for monitoring these drugs, similar to those previously established for cyclosporin A, are proposed herein. With the use of an increasing spectrum of immunosuppressive drug combinations, and the possible use of xenotransplantation on the horizon, new demands will be placed on the laboratory for the support of transplant programs.

Chemistry, Clinical↗

Filtered plasma as a potential cause of clinical misdiagnosis: inappropriate testing in a haematology laboratory.

We have identified situations in which filtered plasma is provided to the laboratory for combined assessment of lupus anticoagulant, as well as other diagnostic haemostasis laboratory procedures. On the basis of laboratory investigation, however, we report that significant errors in test result interpretation can arise should this occur and depending on the specimen processing procedure, and whether filtered plasma is used for multiple assays. Citrated plasma samples were obtained from 12 normal individuals and a portion of each sample filtered using a standard 0.22 micron filter. Small volumes were frozen for later analysis. We could detect a statistically significant difference (P < 0.01) between filtered plasma and non-filtered plasma in most test results. Most notable were changes in the APTT, fibrinogen, FVIII and vWF, where results often fell outside the normal reference range of the assay. Such assay results closely mimic those obtained with type 2 von Willebrand's disease (vWD) patients, thus should filtered plasma unknowingly be tested for vWF, a wrong conclusion of type 2 vWD could easily arise. Assay results for other parameters may similarly draw incorrect conclusions, such as mild haemophilia A and dysfibrinogenaemia. In summary, we report that following filtration not only are a variety of coagulation test results altered, but reduced plasma levels of some coagulation factors could potentially lead clinicians incorrectly to diagnose congenital or acquired deficiencies or defects. We recommend that laboratories note that (other than for lupus anticoagulant) filtered plasma is not appropriate for the coagulation laboratory, and that any abnormal haemostasis test result following such combined testing be considered a potential artifact and independently repeated to confirm any putative abnormality prior to drawing any clinical conclusions.

Blood Coagulation Disorders↗

Analysis of a practice management computer software program for owner compliance with recall reminders.

The purpose of this study was to describe clients' level of compliance with reminders that are computer generated and to identify factors associated with owner response to a recall. Client response to a recall notice revealed that clients responded to reminders for vaccination about 3 times less often than for the other recall codes combined (dental procedures, laboratory tests, medical progress examinations, and neutering). These results suggest that veterinarians need to move away from annual vaccination reminders and toward the promotion of preventive veterinary services, such as annual wellness examinations, screening laboratory testing, and routine dental procedures. Once a practice has committed to and set up the required computer systems to promote preventive veterinary care, the stage is set for the implementation and monitoring of recommendations and reminders. This type of practice philosophy and marketing coincides perfectly with an approach to maximizing compliance in all aspects of veterinary medicine.

Animals↗

Activated protein C resistance: the influence of ABO-blood group, gender and age.

We have evaluated the potential influence of ABO-blood group, gender and age, on laboratory procedures used for detection of Activated Protein C Resistance (APCR), using over 300 normal donor samples and two distinct laboratory test procedures, one based on an Activated Partial Thromboplastin Time (APTT) and the other on a Russell Viper Venom Time (RVVT). We observed a statistically significant influence of ABO-blood group on APTT test times, both in the presence and absence of Activated Protein C (APC), which was no longer evident when using assay ratios. This ABO effect was not observed using the RVVT-based assay procedure. We also observed a gender effect on the APTT-based procedure, such that females (compared to males) provided shorter APTT test times (both with and without APC). This effect was still evident when using APTT assay ratios, but was again not observed using the RVVT-based procedure. We also observed an age related increase in APTT ratios. Interestingly, some previous studies have reported some specific gender and age related effects on APTT-based testing, but reports using RVVT-based testing are lacking, as are ABO related studies. Such findings should be considered as potential variables when associating specific laboratory based findings of APCR to clinical thrombophilia conditions.

ABO Blood-Group System↗

Predicting severity of liver disease: twelve laboratory tests evaluated by multiple regression.

To determine the predictive value of laboratory procedures for severity of liver disease, twelve laboratory tests were evaluated in seventy-two patients with various liver disease and in nine non-liver disease hospitalized cases. A numerical score based on the number and extent of abnormal findings was developed for grading clinical and histological severity. Multiple linear regression, utilizing a forward stepwise selection procedure, was used to find the best combination of laboratory tests for prediction of disease severity. The best predictive model for both clinical and histological severity was found for lecithin cholesterol acyltransferase (LCAT), total plasma cholesterol, alkaline phosphatase and bile acids. Of the routine tests prothrombin time and albumin/globulin were useful if the four-test combination listed above was not used. There was a significant correlation (p less than 0.001) between the clinical and the histological score, confirming validity of clinical scoring. In conclusion, this study shows LCAT to rank as first in predicting severity of liver disease. Cholesterol metabolism appears to be affected by liver disease even more than prothrombin time, albumin and globulins. LCAT and bile acids have a place in routine testing of severity of liver disease.

Adult↗

Laboratory investigation of PRRS virus infection in three swine herds.

Late in 1991, an enveloped RNA virus (now called porcine reproductive and respiratory syndrome [PRRS] virus) was identified as the etiologic agent for mystery swine disease. In 1992, laboratory procedures for the diagnosis of this disease evolved rapidly, and veterinary diagnosticians started applying these tests to field cases. This report is written from the perspective of veterinary laboratory diagnosticians and utilizes 3 case studies to define the advantages and disadvantages of the various available diagnostic laboratory PRRS test procedures in different clinical situations. The diagnostic procedures currently used in our laboratory for investigating PRRS are pathologic examination, serologic testing, fluorescent antibody (FA) testing, and virus isolation. Interstitial pneumonia, characterized by mononuclear cell infiltration of alveolar walls with normal airway epithelium, is a hallmark lesion for the disease, especially in neonatal pigs with respiratory distress. Interstitial pneumonia is not a specific lesion and must be coupled with other tests to verify PRRS virus infection. Demonstration of seroconversion is helpful, especially in sows that have experienced reproductive failure. The indirect FA test detects antibody sooner than the serum neutralization test and will likely become the serologic test of choice. The direct FA test on fresh tissue utilizes monoclonal antibody and is useful for investigating PRRS virus-associated pneumonia. Virus isolation utilizing swine alveolar macrophages has also been a useful diagnostic procedure. All of the above tests have been universally unrewarding when applied to aborted, mummified, or stillborn piglets.

Animals↗

Precision technique for trimming dies using a magnification device.

This article described a technique for trimming a die under magnification. However, the microscope is also useful for checking (1) margins of wax patterns for completeness, (2) the internal surfaces of castings for imperfections, bubbles, or retained investment particles which could prevent proper seating of the castings on the dies, (3) for cracks or contamination in dental porcelain as well as porcelain flash on margins; and (4) precision attachment operation after casting or soldering procedures. Attention to detail in these laboratory procedures greatly improves the final fit of dental castings and saves subsequent chairside adjustments and remakes.

Dental Instruments↗

The use of a technical questionnaire in laboratory proficiency testing.

As an adjunct to laboratory improvement, a technical questionnaire concerning specific steps of the more commonly employed laboratory procedures was incorporated into three proficiency testing evaluations: syphilis serology, mycobacteriology, and parasitology. This addition to proficiency testing revealed some basic and detrimental procedural deviations which could affect the validity of reported clinical values. These procedural deviations were communicated to the laboratories in an attempt to improve performance.

Bacteriological Techniques↗

Customized implant abutment copings to achieve biologic, mechanical, and esthetic objectives.

Fixed restorations for patients with implant-supported abutments frequently produce an unsatisfactory mechanical, biologic, or esthetic compromise. Pure titanium transmucosal abutments have biologic advantages, and factory-milled abutments for the comparable implant interface have mechanical advantages. The ultimate restorative objective is to satisfy the patient's desire for an esthetic restoration. This can generally be accomplished with precisely positioned implants; however, compromised locations need to be corrected with modified abutments. The use of customized copings fabricated by casting to pure titanium abutments can satisfy all three criteria, and may in some situations be the restorative procedure of choice. The clinical and laboratory procedures involved in achieving these criteria are described in detail.

Dental Abutments↗