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This article reviews the use of nickel-titanium rotary files for root canal instrumentation in primary teeth. The pulpectomy technique is described and the advantages and disadvantages of using rotary files are discussed. Specific recommendations for the selection of materials and devices are made.
This article reviews the use of nickel-titanium rotary files for root canal instrumentation in primary teeth. The pulpectomy technique is described and the advantages and disadvantages of using rotary files are discussed. Specific recommendations for the selection of materials and devices are made.
Within public mental health services in Australia, community mental health nurses are often the first point of contact for people presenting with mental health problems. Community mental health nurses are responsible for determining appropriate triage and assessing need for treatment. Community mental health staff identified a need to improve skills in assessment and documentation of psychiatric symptoms. This collaborative study sought to develop an educational package, based on Present State Examination-9, for initial assessment, and a reliable file audit tool to evaluate the effectiveness of the education. Twenty initial mental health assessments completed by twenty different community mental health nurses were audited approximately one month prior to, and two months after, attendance at the education programme. The audit indicated that the documentation of assessments improved in all aspects, although the most significant differences were achieved in recording history, mental state and treatment plan. These items were the main items emphasised in the education programme. It is suggested that the Present State Examination-9 provides a useful base for teaching clinicians how to incorporate the documentation of comprehensive and precise information into assessment formats and treatment planning and that the file audit tool, when linked with an assessment format provides a useful way of evaluating self and peer assessment documentation.
Besides the well known signs of the ulnar palsy, there is a new sign, unknown till now: the "failing ulnar hook". It could be named the "nail file sign", because it was discovered from a woman who could not file the nail of her little finger. Practically, the patient is asked, in a first time, to roll his little and ring fingers around the index of the same hand of the examinator. As the patient is resisting, the other index of the examinator tries to extend these two fingers. If they cannot resist, there is an ulnar palsy at an upper level. The explanation is that the flexor profundus of the ring and the little fingers are commanded by the ulnar nerf, whereas those of the index and the middle finger are by the median nerve. So, when this sign is present, the block is located from the elbow to the brachial plexus. When it is absent, whereas other signs of ulnar palsy are present, it evoques a lower palsy. This sign is of great interest because it confirms the diagnosis of ulnar palsy and allows the localization of the block. It is very useful to search it in every neurologic examination of the hand. In a carpal tunnel syndrome, it allows to eliminate or not an ulnar participation without using of electrical tests.
Straightening of curved canals is one of the most common procedural errors in endodontic instrumentation. It can lead to ledging, perforation, and stripping of the canal. The problem is commonly encountered when root canal preparation is performed in curved molars. The purpose of this study was to compare the results of root canal preparation by undergraduate dental students using traditional stainless-steel 0.02 taper K files to results obtained using rotary nickel-titanium 0.04 taper files. One hundred ninety six extracted teeth comprising maxillary and mandibular first molars were used. Preoperative and postoperative radiographs of each tooth were taken. Graduate endodontic residents evaluated the radiographs according to the evaluation criteria used by the endodontic department. The presence of errors--such as stripping, perforation, ledging, transportation, zipping, and instrument breakage--was recorded by examining the radiographs.
This article explored the relationship among injured workers' perceptions of workplace justice (i.e., distributive, interactional, and procedural), perceptions of employers' disability-related policies, and the decision to file a workers' compensation claim. Using a 2-wave sample of 1,077 workers with repetitive motion injuries, the authors tested a structural equation model. Results revealed that Time 1 interactional justice was negatively related to filing a claim, whereas Time 1 distributive justice was positively related to perceptions of employer disability-related practices measured a year after the date of injury report. At Time 2, the claim decision was unrelated to perceptions of justice, yet perceptions of disability-related practices were significantly related to all 3 types of justice.
A test of the performance of an automatic indexing procedure based on the processing of the full text of medical journal articles shows results comparable to those achieved using Excerpta Medica and MEDLARS manual indexing. A file of nineteen documents was partitioned by sixteen questions, for each of which two search strategies in each indexing language were formulated. The results were compared to ideal answers chosen by a fourth-year medical student who read the entire file and posed the questions.
One of the most significant advancements in the field of endodontics has been the change in the endodontic file. The new files have different metallurgy, taper, cutting efficiency, and rotary capabilities. This article reviews and updates the advancements in endodontic instrumentation.
The author compares the 1986 population figures obtained through the Canadian census to figures from Quebec's health insurance file. The difference between the two "is very close to the one implied by the estimated rate of undercounting. This paper explains the functioning of the file and how it may be used for demographic purposes, and provides some results by age and sex as well as by region." (SUMMARY IN ENG AND SPA)
We examine the completeness of death reporting in the Social Security Administration's Death Master File (DMF) through comparison with deaths by year and age group reported in official U.S. vital statistics. For most years since 1973, results suggest that the DMF includes 93 percent to 96 percent of deaths of individuals aged 65 or older. Although studies have shown that the National Center for Health Statistics' National Death Index provides superior coverage of deaths, for many researchers the DMF may be a desirable choice. Some advantages of the Death Master File are discussed.
The development of Internet and the need for regular follow-up of patients often living a long way from hospital have led us to develop a follow-up dossier for patients with localized prostate cancer treated by laparoscopic radical prostatectomy. This feasibility study is based on 100 patients who agreed to test this system. After approval by the Commission Nationale d'Informatique et de Liberté (CNIL) (French Computers and Privacy Commission) ensuring medical secrecy and confidentiality of data, the website was opened on a server specifically devoted to this project and presenting all of the required computer securities. The website is composed of pages comprising the hospital discharge summary, and the operative and histology reports. A quality of life questionnaire based on assessment of urinary continence and sex life and a PSA assay form are also included. The patient is therefore able to enter his PSA level and complete the questionnaire at home and the results are then sent to the doctor who treated him. A contact page allows the patient and the doctor to exchange information by text. 92 of these 100 patients connected regularly to the site with a mean connection rate of 8 per patient (range: 1 to 22). 98% of patients were satisfied with the various sections of the site and 95% were satisfied with their medical file. 11% of patients encountered connection problems and 14% reported technical problems essentially attributed to incorrect PSA data entry or incorrect functioning of videos due to the absence of appropriate software. This type of Internet medical service for patients who have undergone a surgical operation requiring regular follow-up appears to be a useful approach for the future by allowing: maintenance of close contact between the patient and his doctors while avoiding the problems related to hospital visits, regardless of the patient's place of residence. It also provides general practitioners with access to the patient's file, with the patient's permission.
Knowledge about users and their information needs can contribute to better user interface design and organization of information in clinical information systems. This can lead to quicker access to desired information, which may facilitate the decision-making process. Qualitative methods such as interviews, observations and surveys have been commonly used to gain an understanding of clinician information needs. We introduce clinical information system (CIS) log analysis as a method for identifying patient-specific information needs and CIS log mining as an automated technique for discovering such needs in CIS log files. We have applied this method to WebCIS (Web-based Clinical Information System) log files to discover patterns of usage. The results can be used to guide design and development of relevant clinical information systems. This paper discusses the motivation behind the development of this method, describes CIS log analysis and mining, presents preliminary results and summarizes how the results can be applied.
This poster describes the feasibility of integrating an existing database driven teaching file with the Radiological Society of North America's (RSNA) Medical Imaging Resource Center (MIRC). MIRC is the product of an RSNA sponsored initiative to enable medical institutions to share their electronic medical content (images, text, and multimedia) by creating a distributed repository accessible from the Internet. A description of MIRC's query/storage service architecture is provided along with an overview of the author's experience with implementing a storage service front end for an existing, database driven teaching file system.
French regulations related to "genetic prints" and its later incorporation to an automatized file in the frame of the penal process, initially deserved (1998) a positive judgement due to the guarantees surrounding such techniques, considering that with its use an interference was made with the freedom and rights of the individual. This primary regulation is watching a legislative evolution that brings serious doubts about the current guarantee system. A couple of legal reforms with security as their main axis (2001 and 2003) give more importance to the "genetic print" file by extending the causes in which it starts functioning going against the proportionality that must be observed when freedoms and rights of the individual can be affected.
This final rule removes the written statement of intent (SOI) procedures, set forth in 42 CFR 424.45, used to extend the time for filing Medicare claims. In the absence of an SOI, providers and suppliers (and, where applicable, beneficiaries) have from 15 to 27 months (depending on the date of service) to file claims with Medicare contractors.
The aim of this study was to clinically evaluate the effect of immediate trauma from instrumentation after scaling and root planing with different instruments. Ten subjects with moderate chronic periodontitis, presenting probing depths of 3.5-6.5mm on anterior teeth, maxillary and/or mandibular, were selected. Teeth were randomly assigned to one of the following groups: PF group - scaled and planed with Hirschfeld periodontal files; CC group - scaled and planed with Gracey conventional curettes. The selected teeth were probed with a computerised electronic probe, guided by an occlusal stent and subjected to scaling and root planing. Immediately following instrumentation, teeth were probed again. The difference between relative attachment level (RAL) immediately before and after instrumentation was considered as trauma from instrumentation. Intra-group analysis revealed statistically significant differences between RAL immediately before and after instrumentation in both groups (1.28 +/- 1.13 for PF group; and 0.83 +/- 0.41 for CC group - p<0.05). However, inter-group analysis did not show statistically significant difference in trauma from instrumentation caused by the different instruments (p=0.063). Within the limits of this study, it was concluded that root instrumentation causes a mean immediate attachment loss of 1.06mm, with no differences between instrumentation with periodontal curettes or periodontal files.
INTRODUCTION: Disparities in asthma hospitalization by gender, age, and race/ethnicity are thought to be driven by a combination of 2 factors: disease severity and inadequate health care. Hospitalization data that fail to differentiate between numbers of admissions and numbers of individuals limit the ability to derive accurate conclusions about disparities and risks. METHODS: Hospitalization records for pediatric asthma patients (aged one to 14 years) were extracted from New Jersey Hospital Discharge Files (for the years 1994 through 2000) and then linked by patient identifiers using a probabilistic matching algorithm. The analysis file contained 30,400 hospital admissions for 21,016 children. Hospitalization statistics were decomposed into persons hospitalized and number of hospitalizations. Analysis of readmission within 180 days of discharge used additional records from 2001 to avoid bias due to truncated observation. RESULTS: Overall, 22.9% of children in our analysis had repeat asthma admissions within the same age interval, accounting for 30.9% of all hospitalizations. Also among all children, 11.7% had at least one readmission within 180 days of a prior discharge. The risk of hospitalization was higher for boys, decreased by age for both genders, was lowest for white children and highest for black children. Readmission rates were higher for black and Hispanic girls than boys in older age groups, but were otherwise relatively uniform by gender and age. CONCLUSION: Decomposition of ratios of total hospitalizations to population illuminates components of risk and suggests specific causes of disparity.
Forty stainless steel endodontic files were observed at scanning electron microscopy after being subjected to ten disinfection cycles of 10 minutes each one, immersed in different chemical disinfectants. Corrosion was not observed on the surface of the files in circumstances that this study was made.