Measurement of intraosseous pressures generated by the Wand, high-pressure periodontal ligament syringe, and the Stabident system.

Intraosseous pressure generated by the use of three anesthetic systems-the Wand; a hand-operated high-pressure periodontal ligament (PDL) syringe; and the Stabident system-were studied in fresh mandibles of 14 large swine. The mandibles were drilled and tapped in one area of both the right and left posterior molar regions. Pressure gauges were attached via threaded fittings. Pressures during injection were recorded for the Wand first, then the PDL syringe, and finally Stabident. Results showed averages of 8.3 mm Hg generated by the Wand, 16.3 mm Hg with the high-pressure PDL syringe, and 43.7 mm Hg from the Stabident system. Results were corroborated with data from three human cadaver mandibles.

Clearance of biofilms from dental unit waterlines through the use of hydroperoxide ion-phase transfer catalysts.

OBJECTIVES: The purpose of this research was to demonstrate the effectiveness of hydroperoxide ion-phase transfer catalyst (HPI-PTC) cleaners and disinfectants for maintaining dental unit waterlines free of planktonic organisms. METHOD AND MATERIALS: Water samples were taken from 117 sites, which included a variety of dental units and samples from the sink faucets of most operatories. Samples were plated on appropriate bacteriologic media and incubated. The presence or absence of biofilms was confirmed by scanning electron microscopy. Twenty-two of the dental units were retrofitted with independent water systems; the cleaning procedure involved an overnight application of an HPI-PTC cleaner followed by a 2-minute water rinse. RESULTS: Water from both the air-water syringe and the high-speed handpiece lines from all untreated units contained at least 6 x 10(2) colony-forming units per milliliter of planktonic or free-floating bacteria; the average was 1.4 x 10(5) CFU/mL. An initial 5% solution of HPI-PTC successfully cleared the lines of any apparent biofilm when applied for 3 consecutive days. Thereafter, once weekly use of the cleaner maintained the dental unit water supplies free of significant numbers of planktonic organisms. CONCLUSION: Routine weekly use of an HPI-PTC cleaner controlled dental unit waterline biofilm and reduced, with minimum effort, the microbial contamination level of water used for patient treatment to less than 200 CFU/mL.

Pain prevalence and pain treatments for residents in Oregon nursing homes.

The Client Care Monitoring Unit of Oregon's Senior and Disabled Services Division developed and conducted a study with survey-generated information to describe the prevalence of pain and the effectiveness of pain interventions for residents of Oregon nursing home facilities. Forty-four percent of sampled residents who were identified as having pain management needs were found to have problematic treatment regimens. Reports of surveyors' experiences during information collection and review of the Medicare/Medicaid recertification reports of the sampled facilities revealed that lack of assessment, and reevaluation of the effectiveness of treatment for pain were the chief contributing factors that led to these findings.

Recognition memory as a method of assessing intelligence of an infant with quadriplegia.

The authors demonstrate a test of visual cognitive abilities (Fagan Test of Infant Intelligence) in the assessment and management of a ventilator-dependent infant with quadriplegia. Assessment of visual recognition memory indicated that the infant's cognitive development progressed normally, despite severe physical limitations and a prolonged stay in hospital. The results suggested that the infant would benefit from age-appropriate auditory, visual and social stimulation and a specialized program of rehabilitation. The test may be particularly useful in assessing the intellectual abilities of infants whose motor dysfunction precludes effective response to traditional tests of sensorimotor intelligence.

Selective screening device for the early detection of normal or delayed cognitive development in infants at risk for later mental retardation.

The present study tested the predictive validity at 3 years of age of a screening device for the early identification of later cognitive delay. The screening device, administered between 3 and 7 months of age, is based on the infant's differential fixation "to novel" over previously shown pictures. The sample was composed of 62 infants suspected to be at risk for later mental retardation. The prevalence of delayed cognitive development (IQ less than or equal to 70) at 3 years of age was 13%. Novelty preference scores correctly identified six of eight (75%) of the delayed children. The test identified 49 of 54 (91%) of the normal children. Validity for predicting cognitive delay was 55%. Validity for the prediction of normality was 96%. The screening device proved to be equally sensitive, specific, and valid when the sample was divided into infants born at term or born preterm. The results of the present study and of a previous study indicate that detection of cognitive delay based on early novelty preferences is as easily accomplished for infants who will later be mildly delayed (IQ scores 60 to 70) as it is for those who will later be severely delayed (IQ scores less than or equal to 50). Moreover, such results are in contrast to those obtained with conventional tests tapping sensorimotor development.