Behaviors of children with and without attention deficit hyperactivity disorder during a dental recall visit.

Many children are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), but the impact of this on behavior at a dental visit has not been examined. This study compared the behaviors of children with and without ADHD during a dental recall visit. Forty-two children with and forty-two without ADHD (fifty-six boys and twenty-eight girls, ages 6.0 through 10.6 years of age) were selected from a chart review at a hospital dental clinic. Every child was observed in the dental chair before and during the dental visit. Tell-show-do was utilized with every patient. Each child was evaluated for compliance or resistance and was rated using the Frankl behavior rating scale. Behavior ratings of children with and without ADHD were not statistically different. This could indicate that children with and without ADHD behave similarly in the dental setting. Use of Tell-show-do and presence of a pediatric dentist trained in child psychology could have contributed to this similarity.

Physician attitudes toward palliative care at a community teaching hospital.

The goals of the study were to explore physicians' attitudes and opinions about palliative care and its implementation. Four focus groups composed of attending physicians were conducted by a professional facilitator at a community teaching hospital. The audio-tapes of the groups were carefully transcribed and analyzed according to rigorous qualitative methodology. Physicians perceived palliative care and pain control as important. Problems they perceived were a lack of education for physicians, residents, other health care professionals, and the general public; a lack of hospital support systems to implement palliative care appropriately, and a lack of knowledge and support regarding legal considerations. They believed that a palliative care unit was a reasonable tool to overcome many obstacles to good end-of-life care.

Early adolescents' perceptions of cigarette smoking: a cross-sectional survey in a junior high school.

Most adult cigarette smokers start smoking during adolescence. Since youths' perceptions of cigarette smoking may influence their decision to smoke, it is important to understand early adolescents' feelings about, and information sources regarding, smoking. In the present study, a cross-sectional survey, conducted in an urban junior high school, asked students in grades six to eight about their attitudes toward cigarette advertising, their perception of the harmful effects of cigarette smoking, and their sources of information. One hundred students completed the questionnaire, 12 of whom were current or former smokers. Approximately 27% believed cigarette advertising significantly influenced their classmates or themselves. Ninety percent recognized that cigarette smoking was seriously harmful. The source of this information was mainly teachers and parents. While 53% of the students identified their parents as the ones who taught them not to smoke, 47.8% of these parents were smokers themselves. Only 2% of the students indicated that they received information about the effects of smoking from health providers.

Functional results of dynamic splinting after transmetacarpal, wrist, and distal forearm replantation.

The results of replantation at the wrist and distal forearm are reported to be better than at the metacarpal level, in part because the latter involve direct injury to the intrinsic muscles. This study evaluates a new post-operative protocol for replantation at the metacarpal, wrist and distal forearm levels. 3 days after replantation, the patient was placed in a dynamic crane outrigger splint with MP joint control, compensating for intrinsic muscle function loss. From 4 to 12 weeks, an anticlaw splint alternated with the outrigger splint. After 12 weeks, a dynamic wrist extension orthosis was added to the anti-claw splint. 11 patients (four replantations at the transmetacarpal level, three at the wrist and four in the distal forearm) had this protocol between 1988 and 1993. For distal forearm replantation, TAM of fingers averaged 216 degrees, grip strength 42 lb, and pinch strength 7.2 lb with 75% good or excellent results. For wrist replantations, TAM of fingers averaged 243 degrees, grip strength 37 lb and pinch strength 10.6 lb with 100% good or excellent results. For transmetacarpal replantations, TAM of fingers averaged 189 degrees, grip strength 37 lb and pinch strength 5.6 lb, with 75% good and excellent results. Early protected mobilization, as described here, preserves tendon gliding, muscle strength and excursion. Our results support this protocol for wrist and distal forearm replantation and especially for transmetacarpal replantation, the results of which tend to be poor according to the medical literature.

Perceptions of plagiarism in the use of other authors' language.

BACKGROUND AND OBJECTIVES: Some authors do not place quotation marks around words used verbatim from another source. The purpose of this study was to determine if physician faculty, English faculty, editors, and medical students would: 1) consider it plagiarism to use selected samples of verbatim or paraphrased text from a published medical journal article (without quotation marks but with citation of the original work) and 2) consider this an important type of plagiarism. METHODS: A questionnaire was circulated to medical school faculty, English faculty, health care and non-health care editors, and medical students. Respondents compared writing samples with an original article and determined if any samples displayed plagiarism. (All samples were plagiarism according to published guidelines). RESULTS: The majority of physicians did not perceive any of the samples as being plagiarism and did not consider this type of plagiarism important. The reverse was true of the majority of medical students, English faculty, and nonphysician editors. CONCLUSIONS: While perceptions varied widely within and among all groups studied, some physician faculty members and many other publishing professionals and medical students regard the use of verbatim text from another author without quotation marks as a serious form of plagiarism.

Primary extensor tendon reconstruction in dorsal hand defects requiring free flaps.

This study reports results in nine patients with extensive loss of soft tissue, extensor tendon, and bone, treated with an emergency free flap for skin cover, primary bone grafts, and tendon grafts passed through individual tunnels in the free flap. Four had a good result, four were fair and one poor. Six patients returned to work, two were not working and one was retired. In select patients, emergency reconstruction of severe extensor tendon injuries appears to produce better function, with fewer operations, a shorter hospital stay, minimal complications, and a shorter period of disability.

Degradation of metal-labeled collagen implants: ultrastructural and X-ray microanalysis.

Three different metal salts, silver nitrate, uranyl acetate and lead citrate, are mixed with a collagen gel to produce 3 metal/collagen sponges. These sponges were implanted subcutaneously in the rat and samples harvested after 5 days of implantation. TEM observation shows that sponges are degraded and digested by macrophages, polymorphonuclear cells (PMN) and fibroblasts. We have observed that the location of the precipitates differs according to the metal added to the collagen. Lead precipitates stay longer on the collagen mesh while silver precipitates, after 5 days, are soon digested and are found in phagosomes of macrophages. Uranium precipitates are digested with the collagen and uranium/collagen associated pictures are seen in phagolysosomes. Metal precipitates accumulated in phagolysosomes of macrophagic cells are recognized by X-ray microanalysis. The degradation process of implanted collagen is discussed.