Occupational hazards in dentistry.

Professional risk factors in dentistry may harm the dentist and the dental team. It is essential for the dentist to recognize these risk factors and protect against them. Among the various organs that are vulnerable in the dental situation are (in a nut-shell): The eyes, the ears, the respiratory system, the palm of the hand, and the back and the vertebrae. In addition, the dentist and the dental team must recognizes the potential for Hepatitis (A, B, C, D, E), and for the acquired immune deficiency syndrome due to the HIV virus. The primary means for protecting against these potential hazardous factors is meticulously keeping proper working conditions such as good ventilation of the operating room, using face masks which are capable of blocking even small particles, using eye protection and gloves, and proper seating at the chair. It is reasonable to adopt a routine of taking a vaccine against Influenza and Hepatitis B, and to routinely check the level of antibodies for Hepatitis B. Personal accidents- and severe-diseases-insurances, as well as insurance against losing the ability to work are advised for every dentist.

[Bilateral deep vein thrombosis as presenting symptom of malignancy].

In 1865 Trousseau first described the association between venous thrombosis and malignancy. We now know that unprovoked deep vein thrombosis of the legs precedes the diagnosis of malignancy in more than 7% of the cases. In bilateral deep vein thrombosis the risk of occult malignancy exceeds 40%. We describe a patient with bilateral deep vein thrombosis as presenting symptom of pancreatic cancer.

Using the automated biopsy gun with real-time ultrasound for native renal biopsy.

BACKGROUND: The use of an automated biopsy system for renal biopsy has recently gained popularity, but its safety in single functioning kidneys is unclear. OBJECTIVE: To report our experience with the automated system for closed renal biopsy during a 5 year period. METHODS: Eighty-five patients underwent percutaneous native renal biopsy with the automated biopsy gun (16G needle) under real-time ultrasound. They were chronologically divided into two groups: 41 patients (group A), using an older ultrasound machine; and 44 patients (group B), using a newer ultrasound machine. Nine patients biopsied with a manual 14G Tru-cut needle served as the control (group C). RESULTS: The number of "attempted" passes at the kidney was 4.0 +/- 0.1 in group B, 4.7 +/- 0.3 in group A (P < 0.05 vs. group B), and 5.8 +/- 0.5 in group C (P < 0.01 vs. group B). The number of successful passes did not differ (3.3 +/- 0.1, 3.3 +/- 0.1, 3.1 +/- 0.2). The ratio of "attempted/successful" was 1.28 +/- 0.07 in group B, 1.95 +/- 0.38 in A, and 1.90 +/- 0.21 in C (P < 0.01 vs. B). The number of glomeruli obtained was similar in the three groups. Adequate tissue was obtained in 95%, 98%, and 100%, respectively. Hemoglobin decreased by 4.3 +/- 1.1% in group B, 6.9 +/- 1.3% in group A, and 11.3 +/- 1.8% in group C (P < 0.05 vs. B). Perinephric/subcapsular hematoma occurred in 5 patients (11.4%) in group A (2 taking aspirin), in 2 patients (4.9%) in group B, and in none in group C. The necessity for blood transfusion post-biopsy was similar in all groups. Four of five patients with single functioning kidneys (one in group A and four in group B) had uneventful biopsies, and adequate tissue was obtained in three. CONCLUSIONS: The use of the automated biopsy gun is effective, safe and has a low rate of major complications. It may be used safely in single functioning kidneys.