Evidence-based Standard Operating Procedures FoR the Prevention and Management of Sodium Hypochlorite Accidents in Dentistry.

This article aims to reduce harm and improve patient safety in dentistry by providing evidence-based guidance on the prevention, recognition, management, and reporting of sodium hypochlorite injuries occurring in the course of endodontic dental treatment. In contrast to previous publications all types of sodium hypochlorite harm and near-harm events in the dental setting are considered, to offer the reader an all-encompassing clinical guide for reference.

Suprascapular nerve block for the treatment of adhesive capsulitis: a randomised double-blind placebo-controlled trial.

OBJECTIVE: Adhesive capsulitis is a common painful shoulder condition. Treatment for the condition remains unsatisfactory. Suprascapular nerve block (SSNB) shows promise as a treatment option for adhesive capsulitis but there are no randomised controlled trials that examine its effect on pain or duration of the condition. The objective of this study was to examine the efficacy of SSNB for the management of adhesive capsulitis. METHODS: A randomised double-blind placebo-controlled trial of SSNB and standard therapy versus placebo and standard therapy was performed. In total, 54 patients were enrolled in the study. 27 patients received a glenohumeral joint (GHJ) injection and physiotherapy plus a 3-month SSNB, and 27 patients received a GHJ injection and physiotherapy plus a 3-month placebo injection. Patients were followed to resolution of their symptoms as measured by a combination of range of movement, pain scores, Shoulder Pain and Disability Index (SPADI) scores and perceived recovery scores. The primary outcome measure was time to resolution of symptoms. RESULTS: Participants who received the SSNB reduced the duration of their symptoms of adhesive capsulitis by an average of 6 months (mean time to resolution 5.4 (95% CI 4.4 to 6.3) months vs 11.2 (95% CI 9.3 to 13) months) in the placebo group. They also had reduced pain scores, improved range of movement and lower SPADI scores compared with the placebo group across all time points. CONCLUSION: SSNB reduced the duration of adhesive capsulitis and resulted in improved pain and disability experience for patients. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ANCTRN 12615001378516).

Rural healthcare: how to recruit and retain health professionals.

A major challenge for healthcare in the United States is recruiting and retaining health professionals in rural areas of the country. There is a significant shortage of physicians and other health professionals in many of these areas. This article outlines some of the factors that go into recruiting health professionals to practice in rural communities, and what factors are influential in making sure they remain in service to those communities.

Comparison of Heat Resistance of Listeria monocytogenes in Milk as Determined by Two Methods.

The thermal resistance of 3 strains of Listeria monocytogenes was compared using test tube versus sealed tube methods of thermal inactivation. All L. monocytogenes strains were rapidly inactivated in milk when survival was measured using sealed tube thermal inactivation methods. Calculated D62°C values ranged between 0.1-0.4 min for the three strains tested. In contrast, total inactivation of L. monocytogenes populations using test tube methods of thermal inactivation could not be accomplished within 30 min at 62°C. Extensive tailing of survivor curves was consistently observed. When an initial population of 5 × 106 L. monocytogenes /ml was heated at 72, 82, or 92°C, consistent survival of a population of 102-103 L. monocytogenes /ml after 30 min was observed. The results prove that the test tube method for measuring thermal resistance of L. monocytogenes is inaccurate. Reports of extraordinary heat resistance based upon this method are correspondingly inaccurate. L. monocytogenes cells, dispersed freely in milk, will not survive pasteurization.

Psychrotrophic Growth and Thermal Inactivation of Listeria monocytogenes as a Function of Milk Composition.

Listeria monocytogenes strains 19111, 19113, 19115, F5027 and F5069 were grown in 11% nonfat milk solids, skim milk and whole milk at 4, 10, 22, and 37°C to determine the influence of temperature and milk composition on growth and thermal resistance. Milk composition affected cellular growth. The psychrotrophic growth of L. monocytogenes serotype 4b strains was enhanced in whole milk when compared to skim milk or 11% NFMS. This enhancement of psychrotrophic growth was not observed for serotype 1 or 3 strains. The stimulatory effect of whole milk on serotype 4b L. monocytogenes strains was most dramatic at 10°C where cells increased from 7.9 × 10° to 5.8 × 106 CFU/ml within 48 h. Milk composition did not affect the thermal resistance of L. monocytogenes . All strains used in this study had a D62.7°C value of 1.0 min or less, therefore, pasteurization as defined by current FDA guidelines should eliminate this organism from raw milk with a large margin of safety. Post-pasteurization contamination of dairy products with L. monocytogenes must be eliminated since the psychrotrophic nature of this organism ensures survival and proliferation during refrigerated storage.