Practices and opinions of pediatric and general dentists in Connecticut regarding the age 1 dental visit and dental care for children younger than 3 years old.

PURPOSE: This study aimed to determine the percentage of general and pediatric dentists in Connecticut that were aware of, and practice, the current AAPD guidelines for the age one dental visit and to determine the services they provide to 0-2-yr-old patients. METHODS: A survey was mailed to Connecticut general and pediatric dentists seeking information on practice type, years in practice, training, ages of children seen, procedures performed and opinions regarding the age one dental visit. RESULTS: The response rate was 42% for general dentists and 84% for pediatric dentists, giving a sample of 113 and 60 dentists, respectively. All responding pediatric dentists reported seeing 0-2-yr-olds as compared to 42% of general dentists. Although not statistically significant, general dentists who were female or in practice less than 10 years were more likely to see 0-2-yr-olds. The majority of pediatric dentists reported performing all procedures surveyed, however, only just over half of general dentists provided topical fluoride or restorative care. Among pediatric dentists, 98% were aware of the AAPD guidelines and 92% agreed with them compared to 41% and 45% of general dentists respectively. CONCLUSIONS: Nearly all Connecticut pediatric dentists are caring for 0-2-yr-olds compared to 42% of Connecticut general dentists.

Molecular characterization of Trypanosoma cruzi sylvatic isolates from Rio de Janeiro, Brazil.

Trypanosoma cruzi, the etiologic agent of Chagas disease, presents considerable heterogeneity between isolated populations within the wild and domestic cycles. By using multiplex polymerase chain reaction based on the mini-exon gene, characterization was performed on seven samples isolated from specimens of Triatoma vitticeps that had been collected from the locality of Triunfo in the municipality of Santa Maria Madalena, state of Rio de Janeiro, Brazil. The samples SMM10, SMM53, SMM88, and SMM98 (area A) and SMM36 and SMM82 (area B) revealed the presence of 150 base pairs, corresponding to the zymodeme III (Z3). Our study suggested that one isolate (SMM1) presents a mixed genotype associated with Z3 and TcII. The typing of isolates of T. cruzi has the main aim of identifying strains with different epidemiological and/or clinical characteristics of Chagas disease. Our results corroborate other descriptions in the literature and contribute towards the knowledge and records of the profile of some additional wild isolates of T. cruzi in regions not yet affected by the disease.

Failure to harvest sentinel lymph nodes identified by preoperative lymphoscintigraphy in breast cancer patients.

Selective sentinel lymphadenectomy dissection has been demonstrated to have high predictive value for axillary staging in breast cancer patients. Preoperative lymphoscintigraphy can localize and facilitate the harvesting of sentinel lymph nodes (SNLs) with a high success rate. The failure rate of selective sentinel lymphadenectomy ranges between 2% and 8%. Details of the failures were seldom addressed. This study analyzes the causes of failure to harvest SLNs in spite of positive preoperative lymphoscintigraphy. From November 1997 through November 2000, 201 female patients with histologically confirmed and operable breast carcinoma underwent selective sentinel lymphadenectomy at the University of California, San Francisco (UCSF) Carol Franc Buck Breast Care Center. Among these patients, 183 (91%) received preoperative lymphoscintigraphy to identify axillary lymph nodes. The causes of failure to harvest the SLNs in this group of patients despite successful preoperative lymphoscintigraphy were analyzed. In our series, the failure rate of SLN identification was 7.0% (14/201). The failure rate for our first year was 11.1% (6/54), second year 9.1% (7/77), and third year 1.4% (1/70). The incidence of failure in spite of positive preoperative lymphoscintigraphy was 3.5% (6/170). The shine-through effect of the primary injection site and failure to visualize a blue lymph node were the main reasons for technical failure. Most of these cases occurred during our learning curve of the procedure. The possibility of failure to get the SLN should be explained to patients before surgery. Axillary lymph node dissection (ALND) should be done if selective SLN dissection is not successful.