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Sample records for clinical caries diagnostic

  1. Implications of caries diagnostic strategies for clinical management decisions

    DEFF Research Database (Denmark)

    Baelum, Vibeke; Hintze, Hanne; Wenzel, Ann;

    2012-01-01

    in a low-caries population. METHODS: Each of four examiners independently examined preselected contacting interproximal surfaces in 53 dental students aged 20-37 years using a visual-tactile examination and bitewing radiography. The visual-tactile examination distinguished between noncavitated......OBJECTIVES: In clinical practice, a visual-tactile caries examination is frequently supplemented by bitewing radiography. This study evaluated strategies for combining visual-tactile and radiographic caries detection methods and determined their implications for clinical management decisions......-specificity) were calculated for each diagnostic strategy. RESULTS: Visual-tactile examination provided a true-positive rate of 34.2% and a false-positive rate of 1.5% for the detection of a cavity. The combination of a visual-tactile and a radiographic examination using the lesion in dentin threshold...

  2. The relative diagnostic yields of clinical, FOTI and radiographic examinations for the detection of approximal caries in youngsters

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    Mialhe Fabio

    2009-01-01

    Full Text Available Background: The detection of carious lesions in the initial stages of development is very important in order to prevent the occurrence of cavitation. Aims and Objectives: The aim of the present study was to compare three methods-visual examination, FOTI, and bitewing radiographic examination-for the detection of noncavitated and cavitated approximal carious lesions. Materials and Methods: Seventy students (mean age 14 years with low caries prevalence were examined by three examiners. The tooth surfaces judged as having caries by at least one examiner or one diagnostic method were scheduled for tooth separation. Results: The results showed that the incorporation of FOTI and radiographic examination represented an additional diagnostic yield of 50% and about 110%, respectively, compared to clinical examination alone. Conclusion: We conclude that FOTI or radiographic examination, or both, used as adjuncts to clinical examination, could improve the detection of noncavitated and cavitated approximal carious lesions. Although FOTI should not replace bitewing radiographic examination, it does seem to have additional value for the detection of carious lesions on approximal surfaces of the posterior teeth in school children with low caries prevalence.

  3. Laser diagnostic and therapy of dental caries: the clinic point of view; Laser diagnostico e tratamento da carie dental: uma visao clinica

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    Paiva, Priscila Faria

    2001-07-01

    Dental caries's diagnosis is a major dentistry problem from the clinic point of view. The laser beam on the region of 655 nm induces the fluorescence of the compounds present in the hard tissue, quantifying differences between sound and carious enamel and dentine. Diagnodent (Kavo, Germany), showed to be effective regarding dental caries's diagnosis in the present research sampling. The Er:YAG laser (Kavo Key Laser 2, Germany) performed efficient cavity preparations in caries lesions of I and V class type, using up energies that ranged from 300 mJ to 350 mJ with 4 Hz repetition rate for the enamel; and from 250 mJ to 300 mJ with 4 Hz repetition rate for the dentine, and with 80 mJ with 6 Hz of repetition rate for laser conditioning. In the Er:YAG laser preparations no patient was anesthetized even when there were deeper cavities, and the maximum degree of pain ( which ranged from 0 to 10) was 4. In the control group with conventional high-speed drill two patients were anesthetized and the maximum degree of pain was 7. Restorations performed by conventional method of composite were equally satisfying both in caries groups of I and V class type and in the control group. The laser application in the operative dentistry office as a new method of diagnosis and dental preparations should be a good alternative to the use of the conventional dental drill. Nevertheless, dentistry practice has a lot to improve from technology progress, as well as new researches on laser dentistry are necessary in a long term. New types of lasers will come about and will increasingly improve the dental practice assistance and procedures quality. (author)

  4. A Review on Traditional Caries Diagnostic Systems and Introduction of New International Caries Detection and Assessment System (ICDAS

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    Malek Mohammadi T.

    2011-04-01

    Full Text Available Dental caries is a chronic infection disease that manifests itself through demineralization of dental tissues and cavitations in the tooth structure. The diagnosis of dental caries poses challenges due to the complex interaction of multiple endogenous causal factors. Naturally, visual and visual-tactile examinations have been the most commonly used diagnostic aids in caries examination for many years. A major drawback in common dental examination was the use of varied diagnostic criteria by various authors. Some extensive reviews regarding this have emphasized the need for a unique system for the diagnosis of such caries. Thus, International Caries Detection and Assessment System (ICDAS emerged as a benchmark for detection and assessment of dental caries. The main objective of the new system is to improve the level of information to help make informed decision about diagnosis, prognosis, and clinical management of caries at both individual and public health levels.This study aimed to review traditional caries diagnosis methods and also describe the philosophy of the new ICDAS system for diagnosis and assessment of caries and also demonstrate how it can serve as a basis and benchmark for clinical and epidemiological research.

  5. Diagnostic Methods for Dental Caries Used by Private Dental ...

    African Journals Online (AJOL)

    2017-03-06

    Mar 6, 2017 ... types of diagnostic tools and methods used by private dental practitioners in. Ankara for .... and treatment approaches, and patient records. ..... detection aids. ... approximal and occlusal dental caries in a low risk population.

  6. New diagnostic technology and hidden pits and fissures caries

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    Fabrizio Guerra

    2015-10-01

    Full Text Available The accuracy in pits and fissures caries detection is of paramount importance in dental caries primary and secondary prevention. A combination of visual examination and probing is currently the mainstay of occlusal caries diagnosis. Unfortunately, these types of inspection alone may leave a certain number of pit and fissure caries undetected. The Vista Cam iX fluorescence camera (Durr Dental, Bietigheim-Bissingen, Germany is a novel dental diagnostic tool for quantitative assessment of dental caries with high specificity for carious lesions detection. In the presented cases photographic images, representing the visual diagnostic approach, are applied as integration to VistaCam iX Proof images. A step-by-step sequence of inspection and assessment of operative treatment need is presented in a case of hidden pit and fissure caries on a permanent molar. Based on the reported case, it could be observed that VistaCam iX Proof shows promising results in hidden pits and fissures caries detection and could be considered a non-invasive examination method that facilitate the detection of early lesions and a potential diagnostic aid.

  7. Diagnosis of occlusal caries: Part II. Recent diagnostic technologies.

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    Tam, L E; McComb, D

    2001-09-01

    Accurate diagnosis of the presence or absence of disease is a fundamental requirement in health care. The diagnosis of non-overt occlusal decay is challenging and can be highly subjective, and its inherent uncertainties can lead to widely differing treatment decisions. The purpose of this 2-part paper is to review current knowledge concerning conventional and new diagnostic methods for occlusal caries. Part I looked at established methods for diagnosing occlusal decay. These methods have several limitations, particularly in their ability to diagnose early carious lesions. Part II examines new and emerging technologies that are being developed for the diagnosis of occlusal decay. Electrical conductance measurements and quantitative laser- or light-induced fluorescence represent significant improvements over conventional diagnostic methods, especially for in vitro applications and particularly with regard to sensitivity and reproducibility. Proponents of the DIAGNOdent laser fluorescence system claim that it evaluates the fluorescence that develops when laser light is incident on areas of demineralization. This noninvasive device is simple to use and provides quantitative data. Studies supporting its validity are limited but do suggest good sensitivity and excellent reproducibility. However, the DIAGNOdent system requires more scientific scrutiny. Although it offers a high rate of disease detection, it has little ability to indicate the extent of decay. In all treatment decisions, clinicians must be aware of the limitations of the diagnostic methods that have been used. Clinical judgment based on the patient s case history, visual cues, review of radiographs and probability of disease is still the most important aspect of optimum patient care. New technologies may provide supplemental information, but they cannot yet replace established methods for the diagnosis of occlusal caries.

  8. Diagnostic and Preventive Approaches for Dental Caries in Children: A Review

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    Shahryar Karami

    2017-04-01

    Full Text Available Context Oral health status plays an essential role in human health. Recently, enhancement in oral health caries has been noted in both developed and developing countries. Dental caries is still very common among children. Screening and preventive interventions is necessary. The aim of this study was to review the diagnostic and preventive approaches for dental caries in children. Evidence Acquisition Searching PubMed, Medline, the Cochrane Library (for 5 recent years from 2011 - 2016, and reference lists for keywords and phrases such as “dental caries in children” and prevention and diagnosis, we included trials and controlled observational studies regarding the diagnosis and preventive techniques for dental caries in children. Results We found no study demonstrating the effects of screening by primary care providers on clinical outcomes. In a cohort study, pediatrician examination associated with a sensitivity of 0.76 was reported to identify dental caries in children. The results of the new randomized trials that were confirmed by previous studies showed that the efficacy of fluoride varnish is more than no varnish in reduction of dental caries from 18% to 59%. Some of the trials regarding xylitol had no results regarding the effects on dental caries. New observational studies have shown an association between early childhood fluoride use and enamel fluorosis. There is no evidence on the accuracy of prediction instruments in primary care settings. Conclusions We found no direct evidence that reveals that screening by primary care clinicians can decrease early childhood caries. Previous evidences reviewed by the United State Preventive Services Task Force demonstrated that oral fluoride supplementation is effective in decreasing caries incidences, and recent evidences supported the effectiveness of fluoride varnish in higher-risk children.

  9. Specifics of proximal caries and their diagnostics in posterior teeth

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    Wojcik-Checinska Ilona

    2015-06-01

    Full Text Available Proximal surfaces are the second in turn after the occlusal surfaces, as being the most exposed places to the carious process. The specificity of changes and location makes the diagnostic of approximal cavities difficult. The aim of the study was to collect information on possibilities of detection, monitoring and assessment of carious lesions located on proximal surfaces, starting from the early stage. On the base of current literature, chosen methods of diagnosis, from conventional, to advanced technologies were presented. Current literature also suggests that none of the diagnostic methods exclude the possibility of misdiagnosis of proximal caries. Therefore, during the diagnosing of doubtful cases, it is advisable to employ several methods of assessment, with simultaneous individual appraisal of caries risk factors, such as oral hygiene, frequency of eating sweets or the number of active caries foci.

  10. A Review on Traditional Caries Diagnostic Systems and Introduction of New International Caries Detection and Assessment System (ICDAS)

    OpenAIRE

    Malek Mohammadi T.; Hajizamani A.

    2011-01-01

    Dental caries is a chronic infection disease that manifests itself through demineralization of dental tissues and cavitations in the tooth structure. The diagnosis of dental caries poses challenges due to the complex interaction of multiple endogenous causal factors. Naturally, visual and visual-tactile examinations have been the most commonly used diagnostic aids in caries examination for many years. A major drawback in common dental examination was the use of varied diagnostic criteria by v...

  11. Diagnostic accuracy of insight intraoral film on dental caries

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    Yoon, Young Nam; Lee, Byung Do [Wonkwang University College of Medicine, Iksan (Korea, Republic of); Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    2004-03-15

    To compare the diagnostic accuracy of Kodak Insight film with other intra-oral films in the detection of dental caries. Periapical radiographs of 99 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were made on Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Kodak Insight films and automatically processed. Six dentists examined the presence of dental caries using a five-point confidence rating scale and compared the diagnostic accuracy by ROC (Receiver Operating Characteristic) analysis and ANOVA test. The sensitivity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.84, 0.77, 0.75 and 0.79 respectively. The specificity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.97, 0.95, 0.96 and 0.94 respectively. The mean ROC areas (Az) of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.917, 0.910, 0.894, 0.909 respectively. There was no significant differences between Az of Insight film and other films (p = 0.178). Theses results suggested that Kodak Insight film have the comparative diagnostic accuracy of dental caries with Ultraspeed and Ektaspeed films. (77)

  12. Clinical diagnosis of dental caries: a European perspective.

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    Pitts, N B

    2001-10-01

    The aim of this paper is to provide a broad international perspective on aspects of the RTI/UNC systematic review, to introduce relevant literature not cited, and to make recommendations for clinical practice education and research suggested by the evidence. Clinical caries diagnosis represents the foundation on which the answers to most of the consensus questions will be based. This paper highlights needs for being clear about definitions and nomenclature; understanding the importance of the concepts underlying the D1 and D3 diagnostic thresholds used widely within the RTI/UNC Review; and appreciating that the diagnostic challenge now faced by clinicians is significant and is becoming more complex as the presentation and distribution of the disease changes over time and the range of preventive and operative treatment options expands. A series of recommendations informed by the evidence are made, including a rather contentious issue for many clinicians concerning the lack of evidence supporting the continued use of a sharp explorer as a diagnostic tool for primary caries diagnosis. This practice should be discontinued as it may cause some harm to the patient and yet fails to provide a significant balancing diagnostic benefit. Finally, it is suggested that dentistry should learn from the developing evidence base in medicine on how best to disseminate the findings of reviews and promote appropriate changes in clinical practice.

  13. PUFA - an index of clinical consequences of untreated dental caries

    NARCIS (Netherlands)

    Monse, B.; Heinrich-Weltzien, R.; Benzian, H.; Holmgren, C.J.; Palenstein Helderman, W.H. van

    2010-01-01

    RATIONALE: Dental caries is a global public health problem, especially in children. Most caries in developing countries remains untreated. Only limited data are available on the clinical consequences of untreated dental caries because there is no measure to quantify the prevalence and severity of or

  14. Dental biothermophotonics: How photothermal methods are winning the race with X-rays for dental caries diagnostic needs of clinical dentistry

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    Mandelis, A.; Jeon, R.; Matvienko, A.; Abrams, S. H.; Amaechi, B. T.

    2008-01-01

    Recent trends in biothermophotonics of teeth are presented. The presentation is centered on the development of clinical-level frequency-domain photothermal radiometry and modulated luminescence to address issues associated with the early diagnosis of demineralization caries in human teeth. Biothermophotonic principles and applications to the detection of the carious state in human teeth as embodied by laser photothermal radiometry are presented and further supported by modulated luminescence. The emphasis is on recent developments with regard to abilities of these techniques to diagnose interproximal lesions between teeth, etching with phosphoric acid and with an artificial demineralization gel in order to simulate early demineralization, as well as demineralization and remineralization of dental crown enamel and root dentin. These are lesions which normally go undetected by X-ray radiographs. Comparisons with X rays, Micro-Computed Tomography (μ-CT) and Transverse Micro-Radiography (TMR) are discussed. A theoretical model involving coupled diffuse photon density and thermal-wave fields is developed and applied to frequency scans from demineralized artificial lesions to produce quantitative values for optical and thermophysical parameters of teeth as well as the thickness of the induced lesion.

  15. Histological evaluation of pulp tissue from second primary molars correlated with clinical and radiographic caries findings

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    Vellore Kannan Gopinath

    2014-01-01

    Full Text Available Background: Managing dental caries in young children is demanding due to the elusions present on the right diagnostic criteria for treatment. The present study evaluated the histological status of pulp tissues extracted from primary second molar with caries involvement. Histological findings are correlated with clinical and radiographic assessment. Materials and Methods: Simple experimental study was conducted on upper or lower second primary molars with occlusal (22 teeth or proximal (22 teeth dental caries. Selected children were below 6 years of age. Percentage of caries involvement, residual dentin thickness (RDT, radiographic assessment of interradicular and periapical areas, clinical caries depth and signs and symptoms are the parameters considered for comparing with the histological findings. The specimens were grouped based on the nature of the inflammatory process as acute or chronic. The data were analyzed by Student t-test to compare histological types of inflammation with clinical parameters. P value < 0.05 was considered as significant. Results: Four cases revealed severe acute inflammation in coronal and relatively mild acute inflammation in radicular pulp. In the rest of the specimen coronal and radicular pulp had similar acute or chronic inflammatory changes. Histological evidence of pulpitis correlated with dental caries depth of ≥80%, RDT of ≤1 mm, radiographic rarefactions in the interradicular regions and symptoms of pain. Conclusion: Primary second molars with more than two-third caries involvement with symptoms of pain histologically showed inflammation of both coronal and radicular pulp tissues in all cases.

  16. Clinical evaluation of three caries removal approaches in primary teeth

    DEFF Research Database (Denmark)

    Phonghanyudh, A; Phantumvanit, P; Songpaisan, Y

    2012-01-01

    To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques.......To evaluate the clinical performance and radiographic outcome of glass ionomer cement (GIC) restoration in primary molars using three caries removal techniques....

  17. Early dental caries detection by method of PNC-diagnostics: comparison with visual and x-ray methods

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    Masychev, Victor I.; Sokolovsky, Alexander A.; Kesler, Gaby; Alexandrov, Michail T.

    2000-03-01

    In this research results of approbation of the optical PNC- method in dental clinic are presented. The PNC-method was used for diagnostics stages of caries (initial, moderate and deep). The variant of the PNC-method adapted for dental diagnosis is based on simultaneous analyses the following parameters by special algorithms: backscattering and probing radiation, stimulated (endogenous) autofluorescence of caries induced batteries. Analyze of informational signals show good correlation with tooth morphological structure and concentration of anaerobic microflora in hearth of caries lesion. Investigation was performed in vivo on 101 tooth in conditions of typical dental clinic. Comparison of the PNC- method with visual and X-ray ones, which are widely used in clinical practice was made. Preliminary results showed high potential of usage the PNC-method in clinical practice and more high probability of initial caries detection (up to 100%) in comparison with X-ray method (approximately 75%). In cases when X-ray diagnosed absence of initial caries, more sensitive the PNC-method detected initial caries in stage 'white lesion.'

  18. Clinical randomized controlled trial of chemomechanical caries removal (Carisolv).

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    Lozano-Chourio, M A; Zambrano, O; González, H; Quero, M

    2006-05-01

    The purpose of this study was to compare the chemomechanical caries-removal system (Carisolv) with high-speed excavation in cavitated occlusal caries of primary molars. Design and setting. The study was a randomized controlled, clinical trial in which the two techniques were compared in each subject. Participants were chosen from public schools, in Maracaibo County, Zulia State, Venezuela. The sample consisted of 80 primary molars selected from 40 children (mean age 7.7+/-0.7 years). Each patient had at least two contralateral primary molars with cavitated occlusal caries and approximately equal-size access to lesions. The outcome variables were: clinically complete caries removal, size of the opening of the cavity, volume of carious tissue removed, pain during caries removal, anaesthesia requested by the patient, caries-removal time, and behaviour and preference of patients. All treated molars were clinically caries free whichever caries-removal procedure was used. When Carisolv' was used the final cavity entrance sizes were smaller (Premoved was less (Premoval was three times longer (7.51+/-1.83 min, Premoval of occlusal dentinal caries in cavitated primary molars; it is more conservative of dental tissue and appeared to be more comfortable for most patients, although the clinical time spent is longer than when using high-speed excavation.

  19. Clinical evaluation of sodium flouride chewable tablets in dental caries.

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    Maddi, S S; Tandon, S; Aithal, K S

    1999-01-01

    Chewable tablets containing low dosage flouride content were prepared using two varities of celluloses and their in vitro parameters were evaluated. An eighteen month clinical trial revealed that both these formulations were effective in controlling the caries. However, ethyl cellulose is proved to be superior to methylcellulose as a controlled release matrix material in controlling caries. Thus this study recommends ethylcellulose matrix tablets containing low flouride content is an efficacious and cost effective drug device in controlling dental caries.

  20. An In Vitro Comparison of Different Diagnostic Methods in Detection of Residual Dentinal Caries

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    Nimet Unlu

    2010-01-01

    Full Text Available The aim of this study was to investigate the efficiency of different diagnostic methods in detection of residual dentinal caries in excavated cavities. Fifty extracted molar with deep dentinal carious lesions were excavated using a slow-speed handpiece. All cavities were assessed by laser fluorescence(LF device, electronic caries monitor(ECM, and caries detector dye(CDD by three independent observers blindly. The measurements were repeated after two weeks. Specimens containing dentin slices 150 μm in thickness were prepared for histological analyses. The existence and absence of carious dentin was determined using a lightmicroscope. The average intraobserver accuracy was 1.00 (perfect agreement for CDD, 0.86 (excellent agreement for ECM, and 0.50 (good agreement for LF. The average interobserver accuracy values were 0.92 (excellent agreement, (0.36 marginal agreement and 0.48 (good agreement, for CDD, ECM, and LF, respectively. The average specificity was 0.60 for CDD, 73% for ECM, and 0.50 for LF. The average sensitivity was 0.55 for CDD, 0.85 for LF, and 0.47 for ECM. The average accuracy values were 0.53, 0.51, and 0.81 for CDD, ECM, and LF, respectively. LF had the greatest sensitivity and accuracy values of any of the methods tested. As a conclusion, LF device is appeared to most reliable method in detection of remain caries in cavity. However, because of its technical sensitivity it may susceptible to variations in measurements. To pay attention to the rule of usage and repeated measurements can minimize such variations in clinical practice. It was concluded that LF is an improvement on the currently available aids for residual caries detection.

  1. Clinical evaluation of Krimidanta Pratishedha (anti-caries) activity of Triphaladi Gandusha in high risk dental caries patients

    OpenAIRE

    Atara, Achyuta G.; Manjusha, R.; Shukla, Vinay J.; Vaghela, Dharmendra B.; Rooparalia, Brijesh

    2014-01-01

    Background: Dental caries is the most common complaint encountered in clinical practice. Virtually every adult in the world has experience of dental caries. It affects almost 80% of the population. It is now being viewed in dual perspective- “caries as a disease” and “caries as a lesion”. Aims: To evaluate the efficacy of Triphaladi Gandusha for its anti-caries activity and improvement in Oral Hygiene Index in high risk patients of dental caries and to compare the efficacy of prevalent method...

  2. Chemomechanical caries removal--a clinical evaluation.

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    Zinck, J H; McInnes-Ledoux, P; Capdeboscq, C; Weinberg, R

    1988-01-01

    The aim of this investigation was to evaluate the efficacy and convenience of decayed dentine removal with N-monochloro-DL-2 aminobutyrate (CARIDEX) in all classes of cavities. Fifty-seven patients, each with two teeth having similarly sized carious cavities, participated in this study. One cavity in each patient was treated with the chemomechanical CARIDEX technique and the other cavity was treated with conventional mechanical drilling. The cavities were restored with either amalgam, composite or glass ionomer restorative materials. The time taken for access and caries removal was noted and the efficacy of caries removal with each technique was evaluated. The chemomechanical caries removal technique was effective in removing 90-100% of decayed dentine in 98% of the cavities treated. Multiple regression adjusted access and caries removal time to account for volume of caries removed. This adjusted time was operator dependent, and ranged from 4 to 10 minutes longer for CARIDEX than for the conventional technique. Ninety-three per cent of patients preferred the chemomechanical method of caries removal over the conventional technique (highly significant P less than 0.001). Even though the chemomechanical removal of caries is slower than the conventional technique, the efficacy of CARIDEX and its high patient acceptance provides a viable alternative method for dentinal caries removal in all classes of cavities.

  3. [Validity of self-perceived dental caries as a diagnostic test and associated factors in adults].

    Science.gov (United States)

    Haikal, Desirée Sant'Ana; Roberto, Luana Leal; Martins, Andréa Maria Eleutério de Barros Lima; Paula, Alfredo Maurício Batista de; Ferreira, Efigênia Ferreira E

    2017-08-21

    This study aimed to analyze the validity of self-perceived dental caries and associated factors in a sample of 795 adults (35-44 years). The dependent variable was self-perceived dental caries, and the independent variables were combined in blocks. Three logistic models were performed: (1) all adults; (2) adults with a formal diagnosis of caries; and (3) adults without such caries. Self-perceived dental caries showed 77.7% sensitivity, 58% specificity, 65% accuracy, 52% positive predictive value, and 81% negative predictive value. In Model 1, self-perceived dental caries was associated with time of use of dental services, access to information, flossing, formal diagnosis of caries, self-perceived need for treatment, toothache, and dissatisfaction with oral health and general health. In Model 2, self-perceived dental caries was associated with time of use of dental services, self-perceived need for treatment, and dissatisfaction with oral health and general health. In Model 3, self-perceived dental caries was associated with time of use of dental services, access to information, flossing, self-perceived need for treatment, and dissatisfaction with oral health. Self-perceived dental caries showed limited utility as a diagnostic method.

  4. The Clinical, Environmental, and Behavioral Factors That Foster Early Childhood Caries: Evidence for Caries Risk Assessment.

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    Fontana, Margherita

    2015-01-01

    Caries risk assessment, an essential component of targeted health care delivery for young children, is of paramount importance in the current environment of increasing health care costs and resource constraints. The purpose of this manuscript was to review recent best available evidence behind the factors that influence caries risk assessment and the validity of strategies to assess the caries risk of young children. Moderate to weak evidence supports the following recommendations: (1) Children should have a caries risk assessment done in their first year (or as soon as their first tooth erupts) as part of their overall health assessment, and this should be reassessed periodically over time. (2) Multiple clinical, environmental, and behavioral factors should be considered when assessing caries risk in young children, including factors associated with the primary caregiver. (3) The use of structured forms, although most may not yet be validated, may aid in systematic assessment of multiple caries risk factors and in objective record-keeping. (4) Children from low socioeconomic status groups should be considered at increased risk when developing community preventive programs.

  5. Consistency of DIAGNOdent instruments for clinical assessment of fissure caries.

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    Astvaldsdóttir, Alfheidur; Holbrook, W Peter; Tranaeus, Sofia

    2004-08-01

    DIAGNOdent (KaVo, Biberach, Germany) has shown high diagnostic accuracy and intra-operator agreement for caries detection, both in vitro and in vivo. The aims of this study were to compare DIAGNOdent with visual examination (VI) and bitewing radiographs (BW) for clinical assessment of occlusal fissures, and to evaluate inter-device consistency of clinical recording using four different DIAGNOdent instruments; secondly, to correlate DIAGNOdent readings with microbial culture of the measured site. The subjects were young adults, the material comprising 34 occlusal fissures, scheduled for restorative treatment at the Dental School Clinic of the University of Iceland. Two examiners conducted visual and radiographic assessments. One examiner measured each site with four DIAGNOdent instruments in random order. The fissure was then opened and lesion depth was classified on a 4-point scale. Bacterial samples were taken from the fissure before and after opening. Intra-operator agreement was high (r = 0.85-0.98). Inter-device correlation for the four DIAGNOdent instruments was significant in all cases (r = 0.81-0.92). However, a common cut-off point could not be determined. There was weak but significant correlation between DIAGNOdent readings and all three classes of lesion depth. Level of infection showed very weak correlation with the DIAGNOdent readings. It was concluded that DIAGNOdent is more reliable in detecting dentinal caries if a proper cut-off point is used than in indicating actual lesion depth. Readings from the different instruments were not directly comparable, however, owing to the lack of a common cut-off point.

  6. An in vivo comparison of two diagnostic methods in secondary caries detection.

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    Kazem Saber Hamishaki

    2014-02-01

    Full Text Available The aim of this study was to compare the level of agreement between four operators with different levels of experience for two methods of detecting secondary enamel and dentin carious lesions in composite restored teeth.Sixty teeth of 40 patients with with secondary carious lesions in the composite resin were selected. The teeth were examined by two methods; visual inspection and a laser fluorescence device (DIAGNO dent pen 2190 by four operators including an undergraduate student, a dentist with 5 years of clinical experience, a general dentist with 12 years of clinical experience and an oral and maxillofacial radiologist. Cohen's kappa statistic was applied in order to assess the agreement between the diagnoses performed by the four operators with each diagnostic method.The diagnosis performed by different operators achieved an excellent agreement with high ICC.DIAGNOdent can be a useful device for secondary caries detection in posterior teeth as an adjunct to visual examination.

  7. An In Vivo Comparison of Two Diagnostic Methods in Secondary Caries Detection

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    Hamishaki, Kazem Saber; Chiniforush, Nasim; Monzavi, Abbas; Khazarazifard, Mohammad Javad

    2014-01-01

    Objective: The aim of this study was to compare the level of agreement between four operators with different levels of experience for two methods of detecting secondary enamel and dentin carious lesions in composite restored teeth. Materials and Methods: Sixty teeth of 40 patients with with secondary carious lesions in the composite resin were selected. The teeth were examined by two methods; visual inspection and a laser fluorescence device (DIAGNO dent pen 2190) by four operators including an undergraduate student, a dentist with 5 years of clinical experience, a general dentist with 12 years of clinical experience and an oral and maxillofacial radiologist. Cohen's kappa statistic was applied in order to assess the agreement between the diagnoses performed by the four operators with each diagnostic method. Results: The diagnosis performed by different operators achieved an excellent agreement with high ICC. Conclusion: DIAGNOdent can be a useful device for secondary caries detection in posterior teeth as an adjunct to visual examination. PMID:24910672

  8. A comparative clinical study on the Carisolv caries removal method.

    Science.gov (United States)

    Kakaboura, Afrodite; Masouras, Costas; Staikou, Olga; Vougiouklakis, George

    2003-04-01

    Carisolv is a relatively new chemomechanical method for caries removal. The aim of this clinical study was to compare Carisolv with the conventional drilling technique. Forty-five volunteers, ages 18 to 55 years, each with two contralateral primary coronal mesio-occlusal or disto-occlusal carious lesions, similar in extent, participated in the study. Two calibrated operators treated all lesions. One operator treated both lesions in one visit (one lesion with Carisolv and the other with conventional drilling). Following the filling procedure, the opinion of each patient regarding each caries removal method was recorded. The need for drilling in addition to the Carisolv application, the time required for caries removal, the need for anesthesia, and the gingival reaction to the Carisolv gel were recorded by each operator for each case. The patients found Carisolv treatment more pleasant (82%) and preferable (88%) to drilling. Of the patients treated with drilling, 40% required anesthesia compared to the 8% treated with Carisolv. Additional drilling for complete caries removal was needed in 10% of Carisolv-treated lesions. Carisolv induced no gingival reaction. Significantly longer times were required for caries removal with Carisolv (12.2 +/- 4.1 minutes) compared to drilling (6.8 +/- 2.8 minutes). The Carisolv technique was: (a) accepted by the majority of patients, (b) efficient for caries removal, (c) considered a time-consuming technique for the dentists, and (d) considered less dependent on local anesthesia.

  9. Caries assessment: establishing mathematical link of clinical and benchtop method

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    Amaechi, Bennett T.

    2009-02-01

    It is well established that the development of new technologies for early detection and quantitative monitoring of dental caries at its early stage could provide health and economic benefits ranging from timely preventive interventions to reduction of the time required for clinical trials of anti-caries agents. However, the new technologies currently used in clinical setting cannot assess and monitor caries using the actual mineral concentration within the lesion, while a laboratory-based microcomputed tomography (MCT) has been shown to possess this capability. Thus we envision the establishment of mathematical equations relating the measurements of each of the clinical technologies to that of MCT will enable the mineral concentration of lesions detected and assessed in clinical practice to be extrapolated from the equation, and this will facilitate preventitive care in dentistry to lower treatment cost. We utilize MCT and the two prominent clinical caries assessment devices (Quantitative Light-induced Fluorescence [QLF] and Diagnodent) to longitudinally monitor the development of caries in a continuous flow mixed-organisms biofilm model (artificial mouth), and then used the collected data to establish mathematical equation relating the measurements of each of the clinical technologies to that of MCT. A linear correlation was observed between the measurements of MicroCT and that of QLF and Diagnodent. Thus mineral density in a carious lesion detected and measured using QLF or Diagnodent can be extrapolated using the developed equation. This highlights the usefulness of MCT for monitoring the progress of an early caries being treated with therapeutic agents in clinical practice or trials.

  10. Are fluoride releasing dental materials clinically effective on caries control?

    Science.gov (United States)

    Cury, Jaime Aparecido; de Oliveira, Branca Heloisa; dos Santos, Ana Paula Pires; Tenuta, Livia Maria Andaló

    2016-03-01

    (1) To describe caries lesions development and the role of fluoride in controlling disease progression; (2) to evaluate whether the use of fluoride-releasing pit and fissure sealants, bonding orthodontic agents and restorative materials, in comparison to a non-fluoride releasing material, reduces caries incidence in children or adults, and (3) to discuss how the anti-caries properties of these materials have been evaluated in vitro and in situ. The search was performed on the Cochrane Database of Systematic Reviews and on Medline via Pubmed. Caries is a biofilm-sugar dependent disease and as such it provokes progressive destruction of mineral structure of any dental surface - intact, sealed or restored - where biofilm remains accumulated and is regularly exposed to sugar. The mechanism of action of fluoride released from dental materials on caries is similar to that of fluoride found in dentifrices or other vehicles of fluoride delivery. Fluoride-releasing materials are unable to interfere with the formation of biofilm on dental surfaces adjacent to them or to inhibit acid production by dental biofilms. However, the fluoride released slows down the progression of caries lesions in tooth surfaces adjacent to dental materials. This effect has been clearly shown by in vitro and in situ studies but not in randomized clinical trials. The anti-caries effect of fluoride releasing materials is still not based on clinical evidence, and, in addition, it can be overwhelmed by fluoride delivered from dentifrices. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  11. An in vitro comparison of a combined FOTI/Visual examination of occlusal caries with other caries diagnostic methods and the effect of stain on their diagnostic performance

    DEFF Research Database (Denmark)

    Ekstrand, K.R.; Côrtes, D.F.; Ellwood, R.P.

    2003-01-01

    Occlusal caries, detection, fibre optic transillumination, visual inspection, DIAGNOdent, laser fluorescence, electrical caries monitor, electrical resistance, stain......Occlusal caries, detection, fibre optic transillumination, visual inspection, DIAGNOdent, laser fluorescence, electrical caries monitor, electrical resistance, stain...

  12. Detection of early stages of dental caries by optical PNC diagnostics: comparison with visual inspection, dental probe, and x-ray methods

    Science.gov (United States)

    Masychev, Victor I.; Sokolovsky, Alexander A.; Kesler, Gaby

    2000-11-01

    In this research results of approbation of the optical PNC-method in dental clinic are presented. The PNC-method was used for diagnostics stages of caries (initial, moderate and deep). The variant of the PNC-method adapted for dental diagnosis is based on simultaneous analyses the following parameters by special algorithms: probing radiation, stimulated backscattering and autofluorescence of caries induced batteries. Analyze of informational signals show good correlation with tooth morphological structure and concentration of anaerobic microflora in hearth of caries lesion. Investigation was performed in vivo on 101 tooth in conditions of typical dental clinic. Comparison of the PNC-methods with visual inspection, dental probe and X-ray ones, which are widely used in clinical practice was made. Preliminary results showed high potential of usage of the PNC-method in clinical practice and more high probability of initial caries detection (up to 100%) in comparison with X-ray method (approximately 75%). In cases when X-ray diagnosed absence of initial caries, more sensitive the PNC-method detected initial caries in stage white lesion.

  13. Modernisation of the design of clinical trials for caries preventive agents

    NARCIS (Netherlands)

    Huysmans, M.C.

    2006-01-01

    In January 2002 the International Consensus Workshop on Caries Clinical Trials was organised in Scotland. The meeting was an initiative of both academic and industrial partners, in order to arrive at a consensus about ways to modernise the design of clinical trials for caries preventive agents (Cari

  14. Treatment protocols: nonfluoride management of the caries disease process and available diagnostics

    DEFF Research Database (Denmark)

    Twetman, Svante

    2010-01-01

    This article reviews the evidence for saliva diagnostics and some antibacterial concepts with potential to interfere with the caries process. It concludes that there is incomplete evidence to evaluate the role of chair-side tests and to recommend general topical applications of antibacterial agen...

  15. Chemomechanical caries removal method versus mechanical caries removal methods in clinical and community-based setting: A comparative in vivo study.

    Science.gov (United States)

    Kumar, K V K Santosh; Prasad, M Ghanashyam; Sandeep, R Venkata; Reddy, S Pavani; Divya, D; Pratyusha, K

    2016-01-01

    To compare the effectiveness of various caries removal techniques in mandibular primary molars using Smart Burs, atraumatic restorative technique (ART) (mechanical caries removal) and Carie-care (chemomechanical caries removal [CMCR]) among primary school children in clinical and community-based settings. A total of 80 carious primary mandibular molars were selected for the study from the dental clinic and community. They were equally assigned to four groups according to caries removal technique and also by the operating site. In Group 1, caries was removed using Carie-care in the dental clinic and in Group 2, with Smart Burs in the dental clinic. In Group 3, caries was removed using Carie-care in the field and in Group 4, with the ART in the field. The time taken for caries removal, the efficacy of caries removal and patient acceptance were evaluated with different caries removal techniques. The obtained data were subjected to statistical analysis by ANOVA test. In clinical settings, Carie-care was time-consuming but was more efficient with increased acceptance than Smart Burs and the result was found to be significant statistically (P removal technique in primary teeth among school children in terms of time, efficacy, and acceptance in both clinical- and community-based settings.

  16. Diagnostic Value of Senior Dental Students in Yazd About of Detection the Proximal Caries on Panoramic Radiographs Compared to Detection of Experts in 1394

    Directory of Open Access Journals (Sweden)

    E Romoozi

    2016-08-01

    Full Text Available Introduction: Tooth decay is the most common chronic disease of man in the world and dentists should receive the capability to accurately diagnose of tooth decay during the training courses. In addition to clinical examination, the panoramic view and intraoral radiography is usually used for the caries detection. Therefore, the detection of caries on X-ray images can have a role in treatment planning. Methods: In this analytical study, 10 panoramic radiographies that randomly selected, separately given to 30 senior dental students and 2 professors (in order to determine the gold standard. Data were analyzed using SPSS 17 software, diagnostic tables and indexes were prepared and the results were analyzed by Kappa test. Moreover, in order to determine the agreement between the professors and students about the depth of the decay the weighted kappa coefficient was used. Results: The kappa value about detection of presence or absence of proximal caries between professors and students's diagnosis was 0.428 (P value=0.001. Diagnostic sensitivity, specificity, positive predictive value and negative predictive value obtained by students in caries detection were %47, %91.9, %63 and %85.3, respectively. Coefficient of agreement in detection of depth diagnosis obtained by professors and students was 0.361(p value=0.000. Conclusion: The diagnostic capability of senior dental students about caries detection was fair and depth diagnosis was slight.

  17. Diagnostic Performance of the Intraoral Radiographs on the Interproximal Dental Caries

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Ji; Kang, Byung Cheol [Faculty of Dental Science, Graduate School, Department of Oral and Maxillofacial Radiology, College of Dentistry, Chonnam National University, Kwangju (Korea, Republic of)

    1998-02-15

    The purpose of this study was to evaluated the diagnostic performance of the senior dental students for the proximal dental caries in intraoral radiographs and to compare it with the dental hospital residents, the reference group. It was also investigated the diagnostic performance according to the carious lesion depth. Thirty-five intraoral periapical and bitewing radiographs with 213 proximal surface included in this study were selected from the dental patients at Chonnam National University Hospital. The observers were 181 senior dental students from 5 dental schools and 40 dentists who were second year resident from 5 dental hospitals. They were asked to evaluate the presence ro the absence of the proximal dental caries. The results were as follows : 1. The mean of the hitting rate for the overall observers was 184.51 surfaces and the diagnostic accuracy was 86.62%. 2. The diagnostic performance of the sound proximal tooth surfaces was very high, i.e., 91.5% true negative rate and 8.5% false positive rate. 3. The diagnostic performance of the dentist group was higher than the student group (P<0.05). 4. The proximal dental caries perceptibility increased as the lesion depth increased significantly (P<0.001) except no difference between the carious lesion depth III and IV (P>0.001).

  18. Early diagnosis and minimally invasive treatment of occlusal caries--a clinical approach.

    Science.gov (United States)

    Brostek, Andrew

    2004-01-01

    This report summarizes the clinical experiences and recommendations for use of the KaVo DIAGNOdent laser fluorescence device and of air abrasion (Kinetic cavity preparation). A major diagnostic problem facing clinicians today is the difficulty of achieving accurate occlusal caries diagnosis. Diagnostic accuracy is important because it determines the quality of the treatment decisions made, particularly with regard to the possibility of unnecessary operative intervention. The decrease in incidence of cavitated caries in Western countries, followed by the change in common presentation to non-cavitated caries, has made this accurate diagnosis more difficult. The deficiencies of using traditional methods of occlusal diagnosis are discussed and examined, along with the need for new, more accurate techniques. The use of the new technology of laser fluorescence is explained in detail with a discussion of the advantages and limitations of a commercial device: the KaVo DIAGNOdent. A minimal cavity outline philosophy is suggested for operative intervention, with particular emphasis on the advantages of using Kinetic cavity preparation (KCP) non-rotary method of tooth cutting. It should be noted that treatment options such as operative intervention should never precede adequate diagnosis and the use of preventive treatments such as sealants, should be utilized where indicated.

  19. Diagnostic accuracy of digital images for detection of artificial chemical proximal caries

    Energy Technology Data Exchange (ETDEWEB)

    Park, Geum Mee; Nah, Kyung Soo [Pusan National University College of Medicine, Busan (Korea, Republic of)

    2003-06-15

    To compare the diagnostic accuracy of proximal caries detection between Kodak Insight film and the Biomedisys CDX2000HQ digital (CCD) sensor. 156 proximal surfaces of extracted teeth, 78 of which had chemical artificial caries, were used in this study. Four observers interpreted the radiographs using a five-point confidence rating scale to record their diagnoses. The results were analyzed by receiver operating characteristic curves, ANOVA and Kappa values. Analysis using receiver operating characteristic curves revealed the areas under each curve which indicated a diagnostic accuracy of 0.951 in Insight and 0.952 in CDX2000HQ digital sensor. ANOVA revealed no significant differences between the two images with respect to caries detection. Kappa values indicated that the mean intra-observer agreement was 0.85 and inter-observer agreement 0.71 in conventional radiography. In digital radiography, the mean intra-observer agreement was 0.84 and inter-observer agreement 0.72. The results suggest that no significant difference exists between the two modalities for artificial caries detection and that CDX2000HQ was as good as Insight film for this purpose.

  20. Chemomechanical caries removal method versus mechanical caries removal methods in clinical and community-based setting: A comparative in vivo study

    Science.gov (United States)

    Kumar, K. V. K. Santosh; Prasad, M. Ghanashyam; Sandeep, R. Venkata; Reddy, S. Pavani; Divya, D.; Pratyusha, K.

    2016-01-01

    Objective: To compare the effectiveness of various caries removal techniques in mandibular primary molars using Smart Burs, atraumatic restorative technique (ART) (mechanical caries removal) and Carie-care (chemomechanical caries removal [CMCR]) among primary school children in clinical and community-based settings. Materials and Methods: A total of 80 carious primary mandibular molars were selected for the study from the dental clinic and community. They were equally assigned to four groups according to caries removal technique and also by the operating site. In Group 1, caries was removed using Carie-care in the dental clinic and in Group 2, with Smart Burs in the dental clinic. In Group 3, caries was removed using Carie-care in the field and in Group 4, with the ART in the field. The time taken for caries removal, the efficacy of caries removal and patient acceptance were evaluated with different caries removal techniques. Statistical Analysis: The obtained data were subjected to statistical analysis by ANOVA test. Results: In clinical settings, Carie-care was time-consuming but was more efficient with increased acceptance than Smart Burs and the result was found to be significant statistically (P < 0.05). In community-based settings, Carie-care was more efficient, less time consuming, and showed an increased acceptance when compared to atraumatic restorative treatment and the result was found to be significant statistically (P < 0.05). Conclusions: The CMCR technique was superior to the mechanical caries removal technique in primary teeth among school children in terms of time, efficacy, and acceptance in both clinical- and community-based settings. PMID:27403059

  1. [Clinical aspects of the evolution of dental caries and periodontal disease in patients treated with corticosteroids].

    Science.gov (United States)

    Lăcătuşu, St; Ghiorghe, Angela

    2004-01-01

    Patients treated with adrenal glucocorticoids may run a higher risk of dental caries, both as a result of their medical condition and of the physical and physiological effects of their pharmacotherapy. Our clinical study reports about patients treated with glucocorticoids who were also having an odonto-periodontal condition. They were examined and we found rampant caries and periodontal diseases. The slow evolution of asymptomatic periodontal disease encouraged destruction of teeth in root caries. The rampant caries were correlated with immunodeficiency and treatment of these caries must take into account the general treatment.

  2. Diagnostic Criteria for the Treatment of Caries-Induced Pulpitis.

    Science.gov (United States)

    1981-03-01

    filling". Seltzer and Bender (3) advocate maintenance of pulp vitality if there is no evidence of severe pathosis, even though a chronic pulp...34. Seltzer and Bender (3) maintain that the dentist is generally unable to make an accurate pathologic diagnosis of the state of the pulp by clinical means...described as "transitional stage" by Seltzer and Bender (3). Specimens with minimal inflammatory or atrophic changes in the pulp are also included in

  3. Photon undulatory non-linear conversion diagnostic method for caries detection: a pilot study.

    Science.gov (United States)

    Kesler, G; Masychev, V; Sokolovsky, A; Alexandrov, M; Kesler, A; Koren, R

    2003-08-01

    The objective of this study was to evaluate a new optical method - photon undulatory non-linear conversion (PNC)--for use in different stages of caries detection. Caries should be considered an infectious disease managed by risk assessment, early detection, and preventive therapies, rather than simply "drilling and filling." Fluorescence emission spectroscopy was performed in vitro on 90 extracted teeth, with intact occlusal surfaces. This system differs from the basic Diagnodent unit in its ability to distinguish between different tissue components with respect to their spectrums. Histological analysis served as the gold standard for verification. The teeth sections correspond to the specific point with the highest reading of the detector. The system was compared to visual inspection, probing, and x-ray methods. The system tested (helium-neon [He-Ne], lambda = 633 nm) has a fiber optic device that delivers radiation to the tooth and a spectrophotometer device that detects bacterial porphyrins fluorescence, allowing detection of caries, fillings, and calculus by simultaneous measurement of backscattering and fluorescence intensity. The system tested provides quantitatively reproducible measurements and detection even through sound enamel of more than 1 mm in thickness. The PNC method detects different stages of caries lesions in real time, and it exceeds x-rays in sensitivity, without any ionizing radiation. Preliminary results showed a high potential of using the PNC method in clinical practice (98% accuracy) in comparison to the other methods.

  4. Dental caries among children visiting a mobile dental clinic in South Central Kentucky: a pooled cross-sectional study

    OpenAIRE

    2013-01-01

    Background Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Methods Study...

  5. Evaluation of diagnostic ability of CCD digital radiography in the detection of incipient dental caries

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Wan; Lee, Byung Do [Wonkwang University College of Medicine, Iksan (Korea, Republic of)

    2003-03-15

    The purpose of this experiment was to evaluate the diagnostic ability of a CCD-based digital system (CDX-2000HQ) in the detection of incipient dental caries. 93 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were radiographed using 4 imaging methods. Automatically processed No.2 Insight film (Eastman Kodak Co., U.S.A.) was used for conventional radiography, scanned images of conventional radiograms for indirect digital radiography were used. For the direct digital radiography, the CDX-2000HQ CCD system (Biomedisys Co. Korea) was used. The subtraction images were made from two direct digital images by Sunny program in the CDX-2000HQ system. Two radiologists and three endodontists examined the presence of lesions using a five-point confidence scale and compared the diagnostic ability by ROC (Receiver Operating Characteristic) analysis and one way ANOVA test. The mean ROC areas of conventional radiography, indirect digital radiography, direct digital radiography, and digital subtraction radiography were 0.9093, 0.9102, 0.9184, and 0.9056, respectively. The diagnostic ability of direct digital radiography was better than the other imaging modalities, but there were no statistical differences among these imaging modalities (p>0.05). These results indicate that new CCD-based digital systems (CDX-2000HQ) have the potential to serve as an alternative to conventional radiography in the detection of incipient dental caries.

  6. Dental caries induction in experimental animals by clinical strains of Streptococcus mutans isolated from Japanese children.

    Science.gov (United States)

    Hamada, S; Ooshima, T; Torii, M; Imanishi, H; Masuda, N; Sobue, S; Kotani, S

    1978-01-01

    Oral implantation and the cariogenic activity of clinical strains of Streptococcus mutans which had been isolated from Japanese children and labeled with streptomycin-resistance were examined in specific pathogen-free Sprague-Dawley rats. All the seven strains tested were easily implanted and persisted during the experimental period. Extensive carious lesions were produced in rats inoculated with clinical strains of S. mutans belonging to serotypes c, d, e, and f, and maintained on caries-inducing diet no. 2000. Noninfected rats did not develop dental caries when fed diet no. 2000. Type d S. mutans preferentially induced smooth surface caries in the rats. Strains of other serotypes primarily developed caries of pit and fissure origin. Caries also developed in rats inoculated with reference S. mutans strains BHTR and FAIR (type b) that had been maintained in the laboratories for many years. However, the cariogenicity of the laboratory strains was found to have decreased markedly. All three S. sanguis strains could be implanted, but only one strain induced definite fissure caries. Two S. salivarius strains could not be implanted well in the rats and therefore they were not cariogenic. Four different species of lactobacilli also failed to induce dental caries in rats subjected to similar caries test regimen on diet no. 200. S. mutans strain MT6R (type c) also induce caries in golden hamsters and ICR mice, but of variable degrees.

  7. The classic caries clinical trial: constraints and opportunities.

    Science.gov (United States)

    Stamm, J W

    2004-01-01

    The history of clinical trials would include events in 1747 on board the Salisbury, a British Navy vessel at sea with 12 seamen critically ill with scurvy. Involving these 12 sailors in a study, an officer on board by the name of Lind evaluated six potential treatments for scurvy, and rapidly reached the conclusion that daily consumption of citrus fruits returned the men fit for duty in approximately six days (Bull, 1959). The concept of experimental randomization was first developed by Sir R.A. Fisher (1925, 1926), and the method was introduced to medical research via a study of tuberculosis treatment by Amberson and co-workers (1931), who randomized 24 TB patients into two groups, one to receive the experimental therapy, the other serving as the control. Amberson et al. also incorporated the concept of blinding into their study. Sir Austin Bradford Hill codified and built on the principles of scientific experimentation developed by Fisher, and introduced the use of random numbers in the allocation of patients in the British Medical Research Council (1948) study of the effect of streptomycin in the treatment of tuberculosis (Daniels and Hill, 1952; Hill, 1952). The first applications of clinical trial methodology for testing interventions on dental, oral, and maxillofacial diseases and conditions are more difficult to determine. For dental caries prevention, however, Chilton and Fertig (1958) and Slack and Martin (1964) were certainly among the early caries clinical trial pioneers. As clinical trials have come into the mainstream of clinical research in medicine and dentistry, a great deal of developmental work has focused on their methodological enhancement. The most successful of these efforts have come from fruitful, ongoing collaborations among clinician investigators, biostatisticians, data management specialists, biomedical ethicists, and others with an academic interest in clinical trial design and utilization. During the past 25 years, the emergence of

  8. Clinical evaluation of Er:YAG laser caries treatment

    Science.gov (United States)

    Dostalova, Tatjana; Jelinkova, Helena; Kucerova, Hana; Krejsa, Otakar; Hamal, Karel; Kubelka, Jiri; Prochazka, Stanislav

    1997-05-01

    To prepare the enamel, the energy used was mainly 345 mJ and repetition rate 2 Hz, for dentine the optimal energy of Er:YAG drilling machine was 200 mJ and repetition rate from 1 to 2 Hz, depending on cavity depth. Subject of treatment were caries of enamel and dentine and it was possible to remove the old insufficient fillings. The average number of pulses was 111.22, ranging from 16 to 489. During preparation, vibrations of microexplosions were felt by 8 patients, however, neither pain or unpleasant sensations were experienced. The filling materials used were composite resins and glassionomer cements. Their clinical evaluation 6 months post insertion was similar to that of the classical drilling system.

  9. Best clinical practice guidance for management of early caries lesions in children and young adults

    DEFF Research Database (Denmark)

    Kühnisch, J; Ekstrand, K R; Pretty, I

    2016-01-01

    statements were agreed upon and, furthermore, gaps in our knowledge were identified. RESULTS: Following the systematic reviews and outcomes of the seminars, it was concluded that visual and radiographic caries detection should be utilised as a basic diagnostic approach to locate, assess and monitor non...... is an essential aspect of preventive dentistry. Therefore, the EAPD encourages oral health care providers and caregivers to implement preventive practices that can arrest early caries and improve individual and public dental health....

  10. Diagnostic Values of Laser Fluorescence Device with Other Techniques in Occlusal Caries Detection

    Directory of Open Access Journals (Sweden)

    A. Chehresaz

    2009-06-01

    Full Text Available Objective: The aim of the present study was to compare the performance of laser fluorescence (LF method with other conventional diagnostic techniques in detection of smallocclusal caries in permanent teeth.Materials and Methods: Prior to this in vitro diagnostic study, a pilot study assessed intra-examiner reliability and reproducibility. The occlusal surfaces of 90 extracted human premolars were examined with four diagnostic methods: probing, visual inspection, bitewing(BW radiographs, and LF. The teeth were then sectioned for the purpose of histological examination. The data were analyzed using SPSS 15 software, and sensitivity,specificity and other diagnostic criteria of the techniques were calculated.Results: The intra-examiner reproducibility for probing and also radiographic techniques was 100%. The corresponded figure for LF (88% was more than visual inspection (82%.The highest level of validity of the examiner turned out to be in probing technique(76.9%. Sensitivity of visual inspection, probing, and LF methods was 54.5% and that of BW radiography was 27.5%. Specificity and efficiency of LF method were 84.8% and 81.1%, respectively. Probing and visual inspection showed the highest specificity (97.5% and 94.9, respectively and efficiency (92.2% and 90%, respectively among the methods.Conclusion: Specificity and efficiency of LF method were lower compared to those of other methods. Among all the investigated methods, the most efficient methods in the diagnosis of small occlusal caries in permanent teeth were probing and visual inspection,respectively.

  11. Examiner training and reliability in two randomized clinical trials of adult dental caries.

    Science.gov (United States)

    Banting, David W; Amaechi, Bennett T; Bader, James D; Blanchard, Peter; Gilbert, Gregg H; Gullion, Christina M; Holland, Jan Carlton; Makhija, Sonia K; Papas, Athena; Ritter, André V; Singh, Mabi L; Vollmer, William M

    2011-01-01

    This report describes the training of dental examiners participating in two dental caries clinical trials and reports the inter- and intra-examiner reliability scores from the initial standardization sessions. Study examiners were trained to use a modified International Caries Detection and Assessment System II system to detect the visual signs of non-cavitated and cavitated dental caries in adult subjects. Dental caries was classified as no caries (S), non-cavitated caries (D1), enamel caries (D2), and dentine caries (D3). Three standardization sessions involving 60 subjects and 3,604 tooth surface calls were used to calculate several measures of examiner reliability. The prevalence of dental caries observed in the standardization sessions ranged from 1.4 percent to 13.5 percent of the coronal tooth surfaces examined. Overall agreement between pairs of examiners ranged from 0.88 to 0.99. An intra-class coefficient threshold of 0.60 was surpassed for all but one examiner. Inter-examiner unweighted kappa values were low (0.23-0.35), but weighted kappas and the ratio of observed to maximum kappas were more encouraging (0.42-0.83). The highest kappa values occurred for the S/D1 versus D2/D3 two-level classification of dental caries, for which seven of the eight examiners achieved observed to maximum kappa values over 0.90. Intra-examiner reliability was notably higher than inter-examiner reliability for all measures and dental caries classifications employed. The methods and results for the initial examiner training and standardization sessions for two large clinical trials are reported. Recommendations for others planning examiner training and standardization sessions are offered. © 2011 American Association of Public Health Dentistry.

  12. [Modernisation of the design of clinical trials for caries preventive agents].

    Science.gov (United States)

    Huysmans, M C D N J M

    2006-04-01

    In January 2002 the International Consensus Workshop on Caries Clinical Trials was organised in Scotland. The meeting was an initiative of both academic and industrial partners, in order to arrive at a consensus about ways to modernise the design of clinical trials for caries preventive agents (Caries Clinical Trials or CCTs). All presentations delivered at the workshop and the consensus statements formulated at the end of the workshop were published last year in a special issue of the Journal of Dental Research. In this paper some important aspects are highlighted and the workshop conclusions are presented.

  13. Systematic Review and Meta-Analysis of Randomized Clinical Trials on Chemomechanical Caries Removal.

    Science.gov (United States)

    Hamama, H H H; Yiu, C K Y; Burrow, M F; King, N M

    2015-01-01

    The aim of this review was to assess the methodologies used in previously published prospective randomized clinical trials on chemomechanical caries removal and to conduct a meta-analysis to quantify the differences in the excavation time between chemomechanical and conventional caries removal methods. An electronic search was performed using Scopus, PubMed, EBSCO host, and Cochrane Library databases. The following categories were excluded during the assessment process: non-English studies published before 2000, animal studies, review articles, laboratory studies, case reports, and nonrandomized or retrospective clinical trials. The methodologies of the selected clinical trials were assessed. Furthermore, the reviewed clinical trials were subjected to meta-analysis for quantifying the differences in excavation time between the chemomechanical and the conventional caries removal techniques. Only 19 randomized clinical trials fit the inclusion criteria of this systematic review. None of the 19 reviewed trials completely fulfilled Delphi's ideal criteria for quality assessment of randomized clinical trials. The meta-analysis results revealed that the shortest mean excavation time was recorded for rotary caries excavation (2.99±0.001 minutes), followed by the enzyme-based chemomechanical caries removal method (6.36±0.08 minutes) and the the hand excavation method (atraumatic restorative technique; 6.98±0.17 minutes). The longest caries excavation time was recorded for the sodium hypochlorite-based chemomechanical caries removal method (8.12±0.02 minutes). It was found that none of the current reviewed trials fulfilled all the ideal requirements of clinical trials. Furthermore, the current scientific evidence shows that the sodium hypochlorite-based (Carisolv) chemomechanical caries removal method was more time consuming when compared to the enzyme-based (Papacarie) chemomechanical and the conventional caries removal methods. Further prospective randomized

  14. A Study on the Diagnostic Detection Ability of the Artificial Proximal Caries by Digora

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Kyung Ran; Choi, Eui Hwan; Kim, Jae Duck [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1998-08-15

    Digora system is an intraoral indirect digital radiography system utilizing storage phosphor image plate. It has wide dynamic range which allows it to decrease the patient's exposure time and may increase diagnostic ability through image processing (such as edge enhancement, grey scale conversion, brightness change, and contrast enhancement). And also, it can transmit and storage image information. The purpose of this study was to evaluate the diagnostic ability of artificial proximal caries between Conventional radiograph and Digora images (unenhanced image, brightness and contrast controlled image, and edge enhanced image). ROC (Receiver Operating Characteristic) analysis, paired t-tests, and F-tests were done for the statistical evaluation of detectability. The following results were acquired: 1. In Grade I lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.953, 0.933, 0.965, 0.978 (p>0.05). 2. In Grade II lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.969, 0.964, 0.988, 0.994. Among theses areas, there was just statistical significance between Diagnostic abilities of Digora edge enhanced image and Conventional radiograph (p<0.05). 3. In the Interobserver variability, the ROC curve areas of Digora edge enhanced image was lowerest in these areas, regardless of the Carious lesion depths. In conclusion, intraoral indirect digital system, Digora system, has the potential possibility as an alternative of Conventional radiograph in the diagnosis of proximal caries.

  15. Evaluation of Diagnostic Tests Using Information Theory for Multi-Class Diagnostic Problems and its Application for the Detection of Occlusal Caries Lesions

    Science.gov (United States)

    Arslan, Umut; Karaağaoğlu, Ergun; Özkan, Gökhan; Kanlı, Aydan

    2014-01-01

    Background: Several methods are available to evaluate the performance of the tests when the purpose of the diagnostic test is to discriminate between two possible disease states. However multi-class diagnostic problems frequently appear in many areas of medical science. Hence, there is a need for methods which will enable us to characterize the accuracy of diagnostic tests when there are more than two possible disease states. Aims: To show that two information theory measures, information content (IC) and proportional reduction in diagnostic uncertainty (PRDU), can be used for the evaluation of the performance of diagnostic tests for multi-class diagnostic problems that may appear in different areas of medical science. Study Design: Diagnostic accuracy study. Methods: Sixty freshly extracted permanent human molar and pre-molar teeth suspected to have occlusal caries lesions were selected for the study and were assessed by two experienced examiners. Each examiner performed two evaluations. Histological examination was used as the gold standard. The scores of the histological examination were defined as sound (n=11), enamel caries (n=22) and dentin caries (n=27). Diagnostic performance of i) visual inspection, ii) radiography, iii) laser fluorescence (LF) and iv) micro-computed tomography (M-CT) caries detection methods was evaluated by calculating IC and PRDU. Results: Micro-computed tomography examination was the best method among the diagnostic techniques for the diagnosis of occlusal caries in terms of both IC and PRDU. M-CT examination supplied the maximum diagnostic information about the diagnosis of occlusal caries in the first (IC: 1.056; p<0.05), (PRDU: 70.5%) and second evaluation (IC: 1.105; p<0.05), (PRDU: 73.8%) for the first examiner. M-CT examination was the best method among the diagnostic techniques for the second examiner in both the first (IC:1.105; p<0.05), (PRDU:73.8%) and second evaluation (IC:1.061; p<0.05), (PRDU:70.8%). IC and PRDU were

  16. Immunosensors in Clinical Laboratory Diagnostics.

    Science.gov (United States)

    Justino, Celine I L; Duarte, Armando C; Rocha-Santos, Teresa A P

    2016-01-01

    The application of simple, cost-effective, rapid, and accurate diagnostic technologies for detection and identification of cardiac and cancer biomarkers has been a central point in the clinical area. Biosensors have been recognized as efficient alternatives for the diagnostics of various diseases due to their specificity and potential for application on real samples. The role of nanotechnology in the construction of immunological biosensors, that is, immunosensors, has contributed to the improvement of sensitivity, since they are based in the affinity between antibody and antigen. Other analytes than biomarkers such as hormones, pathogenic bacteria, and virus have also been detected by immunosensors for clinical point-of-care applications. In this chapter, we first introduced the various types of immunosensors and discussed their applications in clinical diagnostics over the recent 6 years, mainly as point-of-care technologies for the determination of cardiac and cancer biomarkers, hormones, pathogenic bacteria, and virus. The future perspectives of these devices in the field of clinical diagnostics are also evaluated.

  17. Diagnostic Accuracy of Digital and Conventional Radiography in the Detection of Non-Cavitated Approximal Dental Caries

    Directory of Open Access Journals (Sweden)

    Farida Abesi

    2012-03-01

    Full Text Available Background: Radiography plays an important role in the detection of interproximal caries.Objectives: The aim of the present study was to determine diagnostic accuracy of chargecoupled devices (CCD, Photo Stimulable Phosphor (PSP and film radiography in detecting non-cavitated caries.Patients and Methods: Seventy-two non-cavitated approximal surfaces of extracted human posterior teeth were radiographed under standardized conditions using three intraoral modalities: CCD Dixi3 (Planmeca, Finland, PSP Digora PCT (Soredex, Finland, and E-speed film (Kodak, USA. Radiographs were interpreted by four observers and caries lesions were classified as sound (R0, restricted to enamel (R1, reaching the dentinoenamel junction (DEJ and the outer half of the dentin (R2 and the inner half of the dentin (R3. The teeth were subsequently sectioned for histological analysis which served as the gold standard for radiographic examination.Results: Microscopic examinations showed that the distribution of caries were 63.9% sound, 18.1% enamel, 9.7% DEJ and outer half of the dentin and 8.3% into the inner half of the dentin.The sensitivity and specificity of film, CCD and PSP for the detection of enamel caries were 38% and 98%; 15% and 96 %; and 23% and 98%, respectively. The sensitivity and specificity of film, CCD and PSP for the detection of both dentin and enamel caries were 55% and 100%; 45% and 100% ; and 55% and 100%, respectively.Conclusions: The results demonstrated that the diagnostic accuracy of digital images is similar to that of conventional film radiography in the detection of non-cavitated approximal caries.

  18. Dental caries among children visiting a mobile dental clinic in South Central Kentucky: a pooled cross-sectional study

    Science.gov (United States)

    2013-01-01

    Background Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Methods Study subjects were children aged 6 to 15 years who participated in the school-based dental sealant program through the mobile dental clinic operated by the Institute for Rural Health at Western Kentucky University between September 2006 and May 2011 (n = 2,453). Descriptive statistics were calculated for sociodemographic factors (age, gender, race/ethnicity, insurance status, and urban versus rural residential location) and caries status. We used chi-square tests to compare sociodemographic differences of children stratified by caries and no caries status as well as three levels of caries severity. We developed a logistic regression model to investigate factors associated with untreated dental caries while controlling for sociodemographic characteristics. Results The proportion of children having untreated dental caries was 49.7% and the mean number of untreated dental caries was 2.0. The proportion of untreated dental caries was higher in older children, children with no insurance and living in rural residential locations, and caries severity was also higher in these groups. Odds ratio indicated that older ages, not having private insurance (having only public, government-sponsored insurance or no insurance at all) and rural residential location were associated with having untreated dental caries after controlling for sociodemographic characteristics of children. Conclusions Untreated dental caries was more likely to be present in older children living in rural areas without

  19. Dental caries among children visiting a mobile dental clinic in South Central Kentucky: a pooled cross-sectional study.

    Science.gov (United States)

    Dawkins, Erika; Michimi, Akihiko; Ellis-Griffith, Gregory; Peterson, Tina; Carter, Daniel; English, Gary

    2013-05-02

    Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Study subjects were children aged 6 to 15 years who participated in the school-based dental sealant program through the mobile dental clinic operated by the Institute for Rural Health at Western Kentucky University between September 2006 and May 2011 (n = 2,453). Descriptive statistics were calculated for sociodemographic factors (age, gender, race/ethnicity, insurance status, and urban versus rural residential location) and caries status. We used chi-square tests to compare sociodemographic differences of children stratified by caries and no caries status as well as three levels of caries severity. We developed a logistic regression model to investigate factors associated with untreated dental caries while controlling for sociodemographic characteristics. The proportion of children having untreated dental caries was 49.7% and the mean number of untreated dental caries was 2.0. The proportion of untreated dental caries was higher in older children, children with no insurance and living in rural residential locations, and caries severity was also higher in these groups. Odds ratio indicated that older ages, not having private insurance (having only public, government-sponsored insurance or no insurance at all) and rural residential location were associated with having untreated dental caries after controlling for sociodemographic characteristics of children. Untreated dental caries was more likely to be present in older children living in rural areas without insurance. Health interventionists may use

  20. Evaluating the impact of caries prevention and management by caries risk assessment guidelines on clinical practice in a dental teaching hospital

    OpenAIRE

    Lee, HMG; McGrath, CPJ; Yiu, CKY

    2016-01-01

    Background Clinical practice guidelines on ‘Dental caries prevention and management by caries risk assessment for pre-school children in Hong Kong’ were developed using ADAPTE process and Delphi consensus technique. This study aimed to evaluate the feasibility of disseminating and implementing the guidelines, and to evaluate their effectiveness in changing clinical practice. Methods The study was conducted in two phases, examining clinical records of pre-school aged patients being treate...

  1. Comparison of the efficacy of chemicomechanical caries removal with conventional methods - a clinical study.

    Science.gov (United States)

    Goomer, Pallvi; Jain, R L; Kaur, Harsimrat; Sood, Rahul

    2013-06-01

    There has been considerable interest in developing alternative methods of cavity preparation and caries removal due to disadvantages of using traditional rotating instruments which can result in heat, pressure ,dentin dessication, vibration and pain. Hence, the aim of this study was to compare different methods of caries removal in terms of efficacy, time taken and pain during caries removal. A total of 150 carious teeth were selected among 80 children of 6-10 years of age, following Radiovisiography (RVG) according to specific inclusion criteria and caries removal was done by hand instruments ,air rotor and carisolv respectively. The efficacy, time taken and pain threshold were evaluated during caries removal by Ericson D et al scale, Time scale (Raber H et al), visual analogue scale (Nayak R et al) and verbal pain scale (Cinzia Brunelli et al) respectively. Data was collected and statistically analysed. Mean value of time taken for removal of caries by carisolv group (580.26 sec) was found to be significantly higher as compared to conventional hand excavation and air rotor. Air rotor was found to be the most efficient method (mean value 1.20). Mean value of pain perception was significantly less with carisolv (0.82) as compared to air rotor and hand instrument. It was concluded that chemicomechanical removal of caries with Carisolv was found to be effective measure of caries removal and could be considered as viable alternatives to painful procedures like airotor in management of dental caries especially in children. How to cite this article: Goomer P, Jain R L, Kaur H, Sood R. Comparison of the Efficacy of Chemicomechanical Caries Removal with Conventional Methods - A Clinical Study. J Int Oral Health 2013; 5(3):42-47.

  2. Salivary pH and Buffering Capacity as Risk Markers for Early Childhood Caries: A Clinical Study

    OpenAIRE

    D. Jayaraj; Ganesan, S.

    2015-01-01

    ABSTRACT Background: The diagnostic utility of saliva is currently being explored in various branches of dentistry, remarkably in the field of caries research. This study was aimed to determine if assessment of salivary pH and buffering capacity would serve as reliable tools in risk prediction of early childhood caries (ECC). Materials and methods: Paraffin-stimulated salivary samples were collected from 50 children with ECC (group I) and 50 caries free children (group II). Salivary pH and bu...

  3. Sex differences in dental caries experience: clinical evidence, complex etiology.

    Science.gov (United States)

    Lukacs, John R

    2011-10-01

    A sex difference in oral health has been widely documented through time and across cultures. Women's oral health declines more rapidly than men's with the onset of agriculture and the associated rise in fertility. The magnitude of this disparity in oral health by sex increases during ontogeny: from childhood, to adolescence, and through the reproductive years. Representative studies of sex differences in caries, tooth loss, and periodontal disease are critically reviewed. Surveys conducted in Hungary, India, and in an isolated traditional Brazilian sample provide additional support for a significant sex bias in dental caries, especially in mature adults. Compounding hormonal and reproductive factors, the sex difference in oral health in India appears to involve social and religious causes such as son preference, ritual fasting, and dietary restrictions during pregnancy. Like the sex difference in caries, tooth loss in women is greater than in men and has been linked to caries and parity. Results of genome wide association studies have found caries susceptible and caries protective loci that influence variation in taste, saliva, and enamel proteins, affecting the oral environment and the micro-structure of enamel. Genetic variation, some of which is X-linked, may partly explain how sex differences in oral health originate. A primary, but neglected, factor in explaining the sex differential in oral health is the complex and synergistic changes associated with female sex hormones, pregnancy, and women's reproductive life history. Caries etiology is complex and impacts understanding of the sex difference in oral health. Both biological (genetics, hormones, and reproductive history) and anthropological (behavioral) factors such culture-based division of labor and gender-based dietary preferences play a role.

  4. Clinical evaluation of near-infrared light transillumination in approximal dentin caries detection.

    Science.gov (United States)

    Ozkan, Gokhan; Guzel, Kadriye Gorkem Ulu

    2017-08-01

    The objective of this clinical study was to compare conventional caries detection techniques, pen-type laser fluorescence device, and near-infrared light transillumination method in approximal dentin caries lesions. The study included 157 patients, aged 12-18, without any cavity in the posterior teeth. Two calibrated examiners carried out the assessments of selected approximal caries sites independently. After the assessments, the unopened sites were excluded and a total of 161 approximal sites were included in the study. When both the examiners arrived at a consensus regarding the presence of dentin caries, the detected lesions were opened with a conical diamond burr, the cavity extent was examined and validated (gold standard). Sensitivity, specificity, negative predictive value, positive predictive value, accuracy, and area under the ROC curve (Az) values among the caries detection methods were calculated. Bitewing radiography and near-infrared (NIR) light transillumination methods showed the highest sensitivity (0.83-0.82) and accuracy (0.82-0.80) among the methods. Visual inspection showed the lowest sensitivity (0.54). Laser fluorescence device and visual inspection showed nearly equal performance. Near-infrared light transillumination can be used as an alternative method to approximal dentin caries detection. Visual inspection and laser fluorescence device alone should not be used for approximal dentin caries.

  5. Comparison of the clinical examination with the panoramic radiography in the diagnosis of dental caries

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hang Moon [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1999-02-15

    The objective of this study was to compare clinical examination of of dental caries and secondary caries with panoramic examination, and to examine bone lesions and dental anomaly of unerupted state. In this study, clinical records and panoramic radiographs were available for 89 first grade students in elementary school. Dental caries of occlusal surfaces, proximal surfaces, and buccolingual surfaces were examined. Secondary caries was examined too. In addition, the central lesion and dental anomaly of unerupted state were examined in panoramic radiographs. The obtained results were as followed :1. Carious detectability of clinical examination in occlusal and buccolingual surface was higher than that of panoramic examination, but it is statistically insignificant (p>0.05). In proximal surface, carious detectability of panoramic examination was higher than that of clinical examination, and it is statistically significant (p<0.01). 2. In contrast to clinical examination only, when the two examination methods were combined, there was additional detection of dental caries (26.7% in occlusal surface, 48.2% in proximal surface, 33.3% in buccolingual surface, and 38.3% totally). 3. In detection of secondary caries, panoramic examination had lower ability than clinical examination in all three surfaces, but in case that both methods were combined, totally 36.0% extra carious lesions were detected. 4. In panoramic examination, detectability of secondary caries in upper teeth is lower than lower teeth. 5. In panoramic examination, it was possible to detect the central lesions and dental anomalies of unerupted state which cannot be detected in clinical examination. It is useful to combine the panoramic examination with clinical examination in order to increase carious detectability and to evaluate the central lesions and dental anomalies of unerupted state.

  6. Diagnostic discrepancies in clinical practice

    Science.gov (United States)

    Issa, Victor Sarli; Dinardi, Layara Fernanda Lipari; Pereira, Thiago Vicente; de Almeida, Lyna Kyria Rodrigues; Barbosa, Thaisa Silveira; Benvenutti, Luiz Alberto; Ayub-Ferreira, Silvia Moreira; Bocchi, Edimar Alcides

    2017-01-01

    Abstract Autopsies are the gold standard for diagnostic accuracy; however, no recent study has analyzed autopsies in heart failure (HF). We reviewed 1241 autopsies (January 2000–May 2005) and selected 232 patients with HF. Clinical and autopsy diagnoses were analyzed and discrepancies categorized according to their importance regarding therapy and prognosis. Mean age was 63.3 ± 15.9 years; 154 (66.4%) patients were male. The causes of death at autopsy were end-stage HF (40.9%), acute myocardial infarction (17.2%), infection (15.9), and pulmonary embolism 36 (15.5). Diagnostic discrepancies occurred in 191 (82.3%) cases; in 56 (24.1%), discrepancies were related to major diagnoses with potential influence on survival or treatment; pulmonary embolism was the cause of death for 24 (42.9%) of these patients. In 35 (15.1%), discrepancies were related to a major diagnosis with equivocal influence on survival or treatment; in 100 (43.1%), discrepancies did not influence survival or treatment. In multivariate analysis, age (OR: 1.03, 95% CI: 1.008–1.052, P = 0.007) and presence of diabetes mellitus (OR: 0.359, 95% CI: 0.168–0.767, P = 0.008) influenced the occurrence discrepancies. Diagnostic discrepancies with a potential impact on prognosis are frequent in HF. These findings warrant reconsideration in diagnostic and therapeutic practices with HF patients. PMID:28121951

  7. Prevalence and clinical consequences of untreated dental caries using PUFA index in suburban Nigerian school children.

    Science.gov (United States)

    Oziegbe, E O; Esan, T A

    2013-08-01

    Dental caries is the most common childhood disease and the most frequent non-communicable disease worldwide. In developing countries, a vast majority of the caries remains unrestored. However, the severity and consequences of untreated dental caries among Nigerian children is unknown. To determine the prevalence using the DMFT/dmft index and severity of oral conditions related to dental caries using the PUFA/pufa index in suburban Nigerian children. The study population consisted of 1,266 randomly selected school children in Ile-Ife, Nigeria. Dental caries status was assessed using the DMFT/dmft index, described by WHO for epidemiological studies. The PUFA/pufa index was used to assess the clinical consequences of untreated dental caries. The mean dmft was 0.58 for the 4-6 years age group while the mean pufa score was 0.16 for the same age group. The mean DMFT score (0.16) was highest for the 13-16 years age group, while the mean PUFA score was 0.05 for the same age group. The prevalence of dmft > 0 was highest in the 4-6 years age group (16.9 %) while the prevalence of DMFT > 0 was highest in the 13-16 years age group (7.2 %). The mean pufa > 0 was highest in the 4-6 years age group (9.2 %). The overall caries prevalence was highest in the 4-6 years age group (17.4 %). Thirty-three percent of decayed teeth in the permanent dentition and 28.2 % of the primary dentition had signs of odontogenic infections. Despite the increase in the consumption of westernised diets by Nigerian children coupled with limited access to dental care, the prevalence was low but the clinical consequences of untreated dental caries was still high.

  8. Computer-aided proximal caries diagnosis: correlation with clinical examination and histology

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Cheol [Chonnam University, School of Dentistry, Gwangju (Korea, Republic of); Scheetz, James P.; Aarman, Allan G. [University of Louisville, School of Dentistry, Louisville (United States)

    2002-09-15

    To evaluate the performance of the LOGICON Caries Detector using RVG-4 and RVG-ui sensors, by comparing results of each detector to the results of clinical and histological examinations. Pairs of extracted teeth were radiographed, and a total of 57 proximal surfaces, which included both carious and non-carious situations, were analyzed. The RVG-4 produced 8-bit images, while the RVG-ui unit produced 12-bit images, which were taken in the high sensitivity mode. The images produced by the LOGICON were evaluated by a trained observer using both automated and manual caries detection software modes. Ground sections of the teeth established the actual absence or existence of caries. LOGICON-aided caries detection and depth discrimination of the RVG-4 and RVG-ui sensors were equally inconsistent irrespective of whether the LOGICON software was set to the automated or manual mode. Sensitivity ranged from 50% to 57% for caries penetration of the enamel-dentin junction. Care needs to be taken when using LOGICON in conjunction with RVG images as an adjunct for treatment planning dental caries. Even when applied by a trained observer, substantial discrepancies exist between the results of the LOGICON software-guided evalutation using RVG images and histologic examination.

  9. Diagnostic value of DIAGNOdent in detecting caries under composite restorations of primary molars

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    Ava Vali Sichani

    2016-01-01

    Conclusion: DIAGNOdent showed a greater accuracy in detecting secondary caries under primary molar restorations, compared to radiographs. Although DIAGNOdent is an effective method for detecting caries under composite restorations, it is better to be used as an adjunctive method alongside other detecting procedures.

  10. Clinical evaluation of diagnodent in detection of occlusal caries in children.

    Science.gov (United States)

    Olmez, Aysegül; Tuna, Dilek; Oznurhan, Fatih

    2006-01-01

    The aim of this in vivo study was to evaluate the effectiveness of DIAGNOdent, visual and radiographic examination in detecting non-invasive diagnosis of occlusal caries in children. In this study, 92 untreated molars with sound occlusal surface or enamel and/or dentin caries were selected from 28 healthy patients, aged 7-17 years. All teeth were examined by two researchers using each of three diagnostic system (DIAGNOdent, visual, radiographic). Interpretation of the DIAGNOdent value and the radiolucency on the bitewing film were combined with the visual examination to decide where the teeth had to be opened. Depth of caries was recorded. Sensitivities and specificities were calculated for each diagnostic method using the biopsy scores as gold standard. Intra- and inter-examiner reproducibility for each method was assessed by calculating Cohen's kappa. The kappa value of inter-examiner reproducibilty was highest for visual examination (0.935), and lowest for DIAGNOdent measurements (0.698). Intra-examiner reproducibilty of DIAGNOdent mesurements was also good (0.745 and 0.665). Sensitivity and specificity for DIAGNOdent, visual examination and bitewing radiography were 0.86/0.80, 0.69/1.00 and 0.36/1.00, respectively. It was concluded that Diagnodent with a high sensitivity may be useful adjunct to visual examination with a high specificity in detecting occlusal caries.

  11. Caries risk and prevention: Evaluation of a preventive program in a clinic for children

    Directory of Open Access Journals (Sweden)

    Fábio Correia Sampaio

    2008-01-01

    Full Text Available Objective: The aim of this study was to verify the use of the Nexø caries risk assessment system together with the Cariogram® (School of Dentistry, Malmö, Sweden, in a preventive program for children at the cariology clinic at Federal University of Paraíba. Methods: A sample of 107 children (2- to 14-year-old was attended on two occasions. The patients’ clinical data (DMF-T, dmf-t, Bleeding index, OHI-S and those from the preventive procedures performed (professional cleaning, fluoride application, Cariogram® (School of Dentistry, Malmö, Sweden, Nexø caries risk were collected twice: first from the clinical record cards and on the second occasion by exams. Parents and guardians evaluated the clinical attendance in an interview and the children, by means of a VAS scale. According to the Nexø caries risk assessment system, 53 children (49.5% were classified at low risk (6. Data analysis was carried out using SPSS (11.0. Results: A positive correlation was observed between the two risk systems: Nexø and Cariogram® (School of Dentistry, Malmö, Sweden of chances of avoiding new caries lesions. The possibility of avoiding new caries lesions increased 5% in both groups and a discrete increase was observed in the other parameters. Conclusion: It can be concluded that the Nexø system associated with the Cariogram® (School of Dentistry, Malmö, Sweden, contributed to the assessment of the patients’ caries risk profile and to the success of the preventive program for children at the cariology clinic at Universidade Federal da Paraíba.

  12. [Serial clinical examinations as the main approach to dental caries prevention in children].

    Science.gov (United States)

    Skripkina, G I; Garifullina, A Zh

    2015-01-01

    Leading scientific and organizational prerequisites for the feasibility of clinical examination of the entire child population of the Russian Federation to the dentist is, above all, the high prevalence and intensity of dental diseases in children of all ages. As a result of many years of research and follow-up of children of preschool and school age we have proved the need to distinguish a group of children with zero activity of dental caries. The referring criteria are determined according to the results of comprehensive clinical and laboratory examination in order to determine the degree of risk of dental caries and individual caries resistance. The age-specific risk group is settled by "Stop caries" software. In order to optimize the preventive activities children are divided in 5 groups for routine preventive dental care. Unfortunately the efforts of modern dental services aimed at eliminating the consequences of caries process by filling cavities. Individualized preventive approach will increase the effectiveness of preventive measures and save public funds allocated in the amount of compulsory health insurance for pediatric dentistry.

  13. Diagnostic performance of cone-beam computed tomography on detection of mechanically-created artificial secondary caries

    Energy Technology Data Exchange (ETDEWEB)

    Charuakkra, Arnon; Prapayasatok, Sangsom; Janhom, Apirum; Pongsirwet, Surawut; Verochana, Karune; Mahasantipiya, Phattaranant [Faculty of Dentistry, Chiang Mai University, Chiang Mai (Thailand)

    2011-12-15

    The aim of this study was to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) images and bitewing images in detection of secondary caries. One hundred and twenty proximal slots of Class II cavities were randomly prepared on human premolar and molar teeth, and restored with amalgam (n=60) and composite resin (n=60). Then, artificial secondary caries lesions were randomly created using round steel No. 4 bur. The teeth were radiographed with a conventional bitewing technique and two CBCT systems; Pax-500ECT and Promax 3D. All images were evaluated by five observers. The area under the receiver operating characteristic (ROC) curve (Az) was used to evaluate the diagnostic accuracy. Significant difference was tested using the Friedman test (p value<0.05). The mean Az values for bitewing, Pax-500ECT, and Promax 3D imaging systems were 0.882, 0.995, and 0.978, respectively. Significant differences were found between the two CBCT systems and film (p=0.007). For CBCT systems, the axial plane showed the greatest Az value. Based on the design of this study, CBCT images were better than bitewing radiographs in detection of secondary caries.

  14. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF THREE METHODS FOR PROXIMAL CARIES DIAGNOSIS – A CLINICAL STUDY.

    OpenAIRE

    Mirela Marinova-Takorova; Radostina Anastasova; Vladimir E. Panov; Spartak Yanakiev

    2014-01-01

    Aim: The aim of the presented study is to compare the effectiveness of the diagnosis with a dental microscope, laser fluorescence (DIAGNOcam) and X-ray examination in proximal caries diagnosis. Material and methods: Thirty-eight adult patients were examined. They were first examined with a dental mirror and a probe, under magnification 6.4 times. After that a diagnosis with DIAGNOcam was performed. Bitewing X-ray images were administered. The data from the three diagnostic methods was comp...

  15. Efficacy of chemomechanical caries removal in reducing cariogenic microbiota: a randomized clinical trial.

    Science.gov (United States)

    Ammari, Michelle Mikhael; Moliterno, Luiz Flávio Martins; Hirata Júnior, Raphael; Séllos, Mariana Canano; Soviero, Vera Mendes; Coutinho Filho, Wagner Pereira

    2014-01-01

    The aim of this study was to compare the efficacy of chemochemical methods (Carisolv™ and Papacárie®) versus the manual method (excavators) in reducing the cariogenic microbiota in dentine caries of primary teeth. Forty-six healthy children (5 to 9 years old) having at least one primary tooth with a cavitated dentine carious lesion were included in the study. The teeth presented no clinical or radiographic signs of pulpal involvement. The sample of 74 teeth was randomly divided into three different groups: Papacárie® (n = 25), Carisolv™ (n = 27) and Manual (n = 22). Samples of carious and sound dentine were collected with sterile excavators before and after caries removal in the three groups. The dentine samples were transferred to glass tubes containing a 1mL thioglycollate medium used as a carrier and enriched for microbiological detection of mutans streptococci and Lactobacillus spp, after incubation for 6h at room temperature. The minimum detection value for colony forming units (CFU) was 3.3 x 102 CFU/ml, and the results were converted into scores from 0 to 4. A significant difference was observed in relation to the microbiological scores before and after caries removal for all methods (Wilcoxon test; p chemomechanical methods for caries removal did not improve the reduction of cariogenic microorganisms in dentine caries lesions, in comparison with manual excavation.

  16. Efficacy of chemomechanical caries removal in reducing cariogenic microbiota: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Michelle Mikhael AMMARI

    2014-08-01

    Full Text Available The aim of this study was to compare the efficacy of chemochemical methods (Carisolv™ and Papacárie® versus the manual method (excavators in reducing the cariogenic microbiota in dentine caries of primary teeth. Forty-six healthy children (5 to 9 years old having at least one primary tooth with a cavitated dentine carious lesion were included in the study. The teeth presented no clinical or radiographic signs of pulpal involvement. The sample of 74 teeth was randomly divided into three different groups: Papacárie® (n = 25, Carisolv™ (n = 27 and Manual (n = 22. Samples of carious and sound dentine were collected with sterile excavators before and after caries removal in the three groups. The dentine samples were transferred to glass tubes containing a 1mL thioglycollate medium used as a carrier and enriched for microbiological detection of mutans streptococci and Lactobacillus spp, after incubation for 6h at room temperature. The minimum detection value for colony forming units (CFU was 3.3 x 102 CFU/ml, and the results were converted into scores from 0 to 4. A significant difference was observed in relation to the microbiological scores before and after caries removal for all methods (Wilcoxon test; p < 0.001. The use of chemomechanical methods for caries removal did not improve the reduction of cariogenic microorganisms in dentine caries lesions, in comparison with manual excavation.

  17. NEW DATA ON THE CLINICAL AND THERAPEUTIC MANAGEMENT OF OCCLUSAL CARIES (III

    Directory of Open Access Journals (Sweden)

    Sorin ANDRIAN

    2017-06-01

    Full Text Available In the control of occlusal caries, the major challenges are related not only to the detection of non-cavitary lesions, but also to the establishment of the treatment strategies to be subsequently applied. Considering the objective of each treatment, that of helping the patient, it is essential to control the progression of carious lesions by means of nonsurgical, preventive/therapeutical methods, whenever necessary. The new strategies applied in caries management are based on the evaluation and predictibility of possible risks, a major aspect in the daily taking of therapeutical decisions. The management plan should include: (I patient’s level of risk, (II patient’s activity level and (III severity of the lesion. Various strategies for a most efficient management of patient’s problems, as well as of the carious lesions, have been elaborated by specialized medical organisms, such as: strategies established within ICDAS, CAMBRA, strategies of the caries management system (SMC and protocols indicated by the system of caries classification according to ADA (American Dental Association. The mission of any new model of caries management is first of all to preserve the dental tissues, and to restore them when only recommended – an idea to guide the decisions of practitioners, starting with the moment of anamnesis, clinical examination and estabishment of diagnosis, until the end of the treatment

  18. Progress in Early Childhood Caries and Opportunities in Research, Policy, and Clinical Management

    DEFF Research Database (Denmark)

    Garcia, Raul; Borrelli, Belinda; Dhar, Vineet;

    2015-01-01

    The 2014 Early Childhood Caries Conference encompassed evidence-based reviews on the state of the science regarding early childhood carries (ECC) epidemiology, etiology, prevention, and disease management. The purpose of this paper was to discuss the work presented at the conference and identify...... opportunities in research, policy, and clinical management that may improve early childhood caries outcomes and lower costs of care. While great progress has been made since the 1997 ECC Conference, there remains a paucity of high-quality evidence from randomized controlled trials on what are the most effective...... to identify preschool children at risk for caries. Fluoridated toothpaste and fluoride varnish currently are the most effective chemotherapeutic strategies to prevent ECC. Motivational interviewing, a form of patient-centered counseling, is effective for motivating oral health behaviors and shows promise...

  19. Clinical relevance of studies on the accuracy of visual inspection for detecting caries lesions

    DEFF Research Database (Denmark)

    Gimenez, Thais; Piovesan, Chaiana; Braga, Mariana M

    2015-01-01

    the clinical relevance and methodological quality of studies on the accuracy of visual inspection for assessing caries lesions. Two independent reviewers searched several databases through July 2013 to identify papers/articles published in English. Other sources were checked to identify unpublished literature...

  20. Caries Risk Assessment for Determination of Focus and Intensity of Prevention in a Dental School Clinic.

    Science.gov (United States)

    Dodds, Michael W. J.; Suddick, Richard P.

    1995-01-01

    A study at the University of Texas, San Antonio's dental school resulted in development of a system of caries risk assessment, applied to all undergraduate clinic patients. The rationale, structure, elements, and application of the system are outlined, and course content supporting the system is noted. Need for validation and other improvements is…

  1. Clinical performance of two visual scoring systems in detecting and assessing activity status of occlusal caries in primary teeth

    DEFF Research Database (Denmark)

    Braga, M M; Ekstrand, K R; Martignon, S

    2010-01-01

    This study aimed to compare the clinical performance of two sets of visual scoring criteria for detecting caries severity and assessing caries activity status in occlusal surfaces. Two visual scoring systems--the Nyvad criteria (NY) and the ICDAS-II including an adjunct system for lesion activity...

  2. Primary teeth caries removal using the Carisolv chemomechanical method: a clinical trial.

    Science.gov (United States)

    Kavvadia, Katerina; Karagianni, Vassiliki; Polychronopoulou, Argy; Papagiannouli, Lisa

    2004-01-01

    The purpose of this controlled clinical trial was to compare the working time for caries removal in primary teeth, the need for local anesthesia and patient cooperation, when the chemomechanical Carisolv or the conventional mechanical method were used. The sample consisted of primary teeth of children who had occlusal or buccal carious lesions into dentin. High speed and/or low speed were used as the conventional mechanical method of caries removal. The efficiency in caries removal was judged on the basis of clinical criteria. Length of working time, need of local anesthesia, and level of patient cooperation were recorded for both methods. Statistical analysis was performed using the student's t test and chi-square test. Working time with the chemomechanical method was much more prolonged than with the mechanical method (P chemomechanical method reduced the need for administration of local anesthesia for Class V cavity preparations. The chemomechanical method, although more prolonged, is effective in caries removal in primary teeth, does not influence children's cooperation and may reduce the need of local anesthesia in Class V restorations.

  3. Comparison of Streptococcus mutans strains from children with caries-active, caries-free and gingivitis clinical diagnosis by pulsed-field gel electrophoresis.

    Science.gov (United States)

    Herczegh, Anna; Ghidán, A; Deseo, Kinga; Kamotsay, Katalin; Tarján, Ildikó

    2008-12-01

    A study was conducted to compare the DNA structure of Streptococcus mutans strains in children with caries-active, caries-free, and gingivitis clinical diagnosis. Twenty-eight Streptococcus mutans strains from 100 children's plaques were examined by pulsed-field gel electrophoresis (PFGE) method. The classified strains were closely related to one another, though the strains originated from different disease groups. Three identical pairs were found, but the pairs in two cases belonged to different disease groups. The results of the PFGE experiments suggest that there is no correlation between the different DNA patterns ofS. mutans strains and their cariogenecity. So the different DNA strains ofS. mutans are not the only determining factor in the development of dental caries.

  4. MDS clinical diagnostic criteria for Parkinson's disease

    NARCIS (Netherlands)

    Postuma, R.B.; Berg, D; Stern, M.; Poewe, W.; Olanow, C.W.; Oertel, W.; Obeso, J.; Marek, K.; Litvan, I.; Lang, A.E.; Halliday, G.; Goetz, C.G.; Gasser, T.; Dubois, B.; Chan, P.; Bloem, B.R.; Adler, C.H.; Deuschl, G.

    2015-01-01

    This document presents the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (PD). The Movement Disorder Society PD Criteria are intended for use in clinical research but also may be used to guide clinical diagnosis. The benchmark for these criteria is expert clinical di

  5. Diagnostic Accuracy of Image Enhancement in Intra-Oral Direct Digital Radiography in the Assessment of Interproximal Caries

    Directory of Open Access Journals (Sweden)

    Farzad Esmaeili

    2016-07-01

    Full Text Available Background The first commercial system for digital radiography was introduced in 1987, and it has evolved a great deal since then. Currently, it is possible to enhance images in digital radiography. Objectives The aim of this study is to evaluate the diagnostic accuracy of image enhancement in direct digital radiography as it relates to interproximal carries assessment. Materials and Methods Following extraction, 50 human teeth were kept in acidic gel (methyl cellulose + acetate buffer PH = 4.8 for 42 days at 37°C to cause caries before mounting. Direct digital radiography was then taken. Two filters were used: sharpen and emboss. Three radiologists evaluated the images with two weeks interval. The histologic assessments were gold standard. Additionally, SPSS 20 was used to draw an ROC curve and calculate AUC. Cohen’s kappa and interclass correlation coefficient (ICC were used to measure intra- and inter-observer reliability. Results For the emboss filter, sensitivity was 95%, specificity was 100%, and accuracy was 96%. For the sharpen filter, sensitivity was 88%, specificity was 100%, and accuracy was 90%. Also, the AUC for the emboss filter was 0.97, and it was 0.94 for the sharpen filter. Cohen’s simple kappa was in the range of excellent. Conclusions Using these filters in intra-oral direct digital radiography (especially the emboss filter can help some clinicians to increase diagnostic accuracy in the assessment of inter proximal caries of posterior teeth.

  6. Dental diagnostic clinical instrument ('Canary') development using photothermal radiometry and modulated luminescence

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, R J; Sivagurunathan, K; Garcia, J; Matvienko, A; Mandelis, A [Center for Advanced Diffusion Wave Technologies (CADIFT), Department of Mechanical and Industrial Engineering, University of Toronto, 5 King' s College Road, Toronto, Ontario, M5S 3G8 (Canada); Abrams, S, E-mail: mandelis@mie.utoronto.c [Quantum Dental Technologies, 748 Briar Hill Avenue, Toronto, Ontario, M6B 1L3 (Canada)

    2010-03-01

    Since 1999, our group at the CADIFT, University of Toronto, has developed the application of Frequency Domain Photothermal Radiometry (PTR) and Luminescence (LUM) to dental caries detection. Various cases including artificial caries detection have been studied and some of the inherent advantages of the adaptation of this technique to dental diagnostics in conjunction with modulated luminescence as a dual-probe technique have been reported. Based on these studies, a portable, compact diagnostic instrument for dental clinic use has been designed, assembled and tested. A semiconductor laser, optical fibers, a thermoelectric cooled mid-IR detector, and a USB connected data acquisition card were used. Software lock-in amplifier techniques were developed to compute amplitude and phase of PTR and LUM signals. In order to achieve fast measurement and acceptable signal-to-noise ratio (SNR) for clinical application, swept sine waveforms were used. As a result sampling and stabilization time for each measurement point was reduced to a few seconds. A sophisticated software interface was designed to simultaneously record intra-oral camera images with PTR and LUM responses. Preliminary results using this instrument during clinical trials in a dental clinic showed this instrument could detect early caries both from PTR and LUM signals.

  7. Genetic sensitivity to bitter taste of 6-n Propylthiouracil: A useful diagnostic aid to detect early childhood caries in pre-school children

    Directory of Open Access Journals (Sweden)

    Raghavendra Pidamale

    2012-01-01

    Full Text Available Purpose: Genetic factor to bitter taste perception appears to be largely mediated by the TAS2R38 gene. The insensitivity to bitter compounds like 6-n-propylthiouracil (PROP is mediated by this gene. PROP, a pharmacological drug used in treatment of Graves′ disease, proved to be useful tool in determining the genetic sensitivity levels to bitter and sweet taste. The purpose of this study is to show much simpler PROP sensitivity technique for the clinical examiner and its application as a diagnostic aid in Early Childhood Caries (ECC detection among preschool children. Materials and Methods: A total of 119 children belonging to the age group of 36 to 71 months of both sexes, were recruited from A. J. Institute of Dental Sciences, Mangalore (Karnataka. PROP sensitivity test was carried out to determine the inherent genetic ability to taste a bitter or sweet substance. This study used simpler scaling method to find out genetic sensitivity to bitter taste; one who tasted bitter as taster and one who was not able to differentiate/tasted like paper as non-taster. A questionnaire was provided to evaluate their dietary habits and caries experience was recorded. Collected data were tabulated and subjected to statistical analysis. Results: In the total of 119 children the mean dmfs was definitely higher in non-taster children compared to tasters. The tasters had a mean dmfs value of 9.5120 (S.D. 7.0543 and non-tasters had a value of 7.7250 (S.D. 8.33147, which was statistically significant. The results suggested that there was increase in caries experience among the group of non-tasters as compared to tasters. Tasters tended to be sweet dislikers and non-tasters tended to be sweet likers. On the whole, tasters had a bad dentition as compared to non tasters. Conclusion: The PROP sensitivity test (filter paper test proved to be a useful diagnostic tool in determining the genetic sensitivity levels of bitter taste. The knowledge of a child′s taste

  8. EVALUATION OF DIAGNODENT FOR THE DIAGNOSIS OF FISSURAL CARIES. A CLINICAL STUDY

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    Luiza Ungureanu

    2011-12-01

    Full Text Available Diagnosis of fissural caries, especially in young permanent teeth, is quite difficult to establish, its sometimes aleatory character possibly leading to incorrect therapeutical decisions. The aim of the study is to evaluate laser fluorescence (LF represented by Diagnodent as a diagnosis means, comparatively with the exams involving inspection and probing (VI, the validation test of which is the exploratory drilling. Method: 72 occlusal surfaces of the permanent molars of 10-15 year-old children have been examined, the diagnosis being established by two methods; after validation of the diagnosis through exploratory drilling, specific treatments were performed, exemplified by self-evident clinical cases. Results: The obtained values are: VI sensitivity 68.1%, LF 83.3%, specificity VI 77.7%, LF 50%, comparable with the results of other studies. Conclusions: Due to its increased sensitivity, Diagnodent completes the examination through inspection and probing, for the establishment of a correct diagnosis and treatment of fissural caries.

  9. Diagnostic accuracy of direct digital radiography and conventional radiography for proximal caries detection in primary teeth: A systematic review

    Directory of Open Access Journals (Sweden)

    Sivakumar Nuvvula

    2016-01-01

    Full Text Available Objective: The present study was conducted to uncover the diagnostic accuracy of digital versus conventional radiographic methods for the detection of proximal caries in primary teeth. Methods: Two researchers independently involved in the search process to explore Medical Subject Heading terms "dental digital radiography," "dental radiography," "bitewing," "dental caries," and "primary teeth" using PubMed, Cochrane Library, Ovid SP, and SIGLE databases. Search was confined to the articles published in English language only, with time period limit January 1996 to April 2014 and a hand search was performed to retrieve additional citations. Explicit inclusion and exclusion criteria were applied to eliminate undesired studies. Critical appraisal of the retrieved articles was done using the quality rating based on Bader and co-workers criteria. Results: A total of 129 articles were retrieved, among which 4 articles were included. All the four studies included were in vitro, of which two studies attained a high-quality score, whereas the other two attained average, and low scores based on Bader et al.′s criteria. Conclusions: A big lacuna exists in the literature, regarding the evaluation of radiographic systems in primary teeth, suggesting an immediate need for well conducted in vivo studies. The quality of available evidence can be regarded as fair but cannot be suggested to set a baseline, indicating a need to perform high-quality studies in a randomized sample to find out the accuracy of digital and conventional radiographs.

  10. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF THREE METHODS FOR PROXIMAL CARIES DIAGNOSIS – A CLINICAL STUDY.

    Directory of Open Access Journals (Sweden)

    Mirela Marinova-Takorova

    2014-06-01

    Full Text Available Aim: The aim of the presented study is to compare the effectiveness of the diagnosis with a dental microscope, laser fluorescence (DIAGNOcam and X-ray examination in proximal caries diagnosis. Material and methods: Thirty-eight adult patients were examined. They were first examined with a dental mirror and a probe, under magnification 6.4 times. After that a diagnosis with DIAGNOcam was performed. Bitewing X-ray images were administered. The data from the three diagnostic methods was compared using SPSS 16 package of Windows. The lesions that were diagnosed as involving dentin were then excavated which served as a confirmation of the diagnosis. Results: The results of the study showed that dentinal lesions were detected with a high degree of correlation with all three diagnostic methods. The visual examination seriously underestimated lesions involving only enamel. In these cases there was a good correlation between laser fluorescence and X-ray data. Conclusions: Based on the conducted study we could conclude that the diagnosis of proximal caries with DIAGNOcam is equivalent to X-ray, both being more accurate in cases with early lesions, compared to visual diagnosis.

  11. Inferences of clinical diagnostic reasoning and diagnostic error.

    Science.gov (United States)

    Lawson, Anton E; Daniel, Erno S

    2011-06-01

    This paper discusses clinical diagnostic reasoning in terms of a pattern of If/then/Therefore reasoning driven by data gathering and the inference of abduction, as defined in the present paper, and the inferences of retroduction, deduction, and induction as defined by philosopher Charles Sanders Peirce. The complex inferential reasoning driving clinical diagnosis often takes place subconsciously and so rapidly that its nature remains largely hidden from the diagnostician. Nevertheless, we propose that raising such reasoning to the conscious level reveals not its basic pattern and basic inferences, it also reveals where errors can and do occur and how such errors might be reduced or even eliminated.

  12. [Clinical aspects of use of preparations from seaweeds for caries and gingivitis prevention].

    Science.gov (United States)

    Vilova, T V; Zenovskiĭ, V P; Deviatkova, M A

    2005-01-01

    Clinical application of seaweed's preparations has shown the appreciable preventive effect, which is connected, first of all, with structure of a water solution of a laminaria's mineral concentrate. This perspective direction contains the following ways of perfection of primary prevention of dental caries: improvement of salivary glands function, optimization of saturation of oral liquid by mineral components, amplification of autopurification of oral cavity, increase of dental tissue's resistance. Application of a fususe's water solution extract improves clinical condition of paradontium, reduces quantity of pathogenic microorganisms that testifies to high anti-inflammatory efficiency of an extract.

  13. [Spigelian hernia: clinical, diagnostic and therapeutical aspects].

    Science.gov (United States)

    Versaci, A; Rossitto, M; Centorrino, T; Barbera, A; Fonti, M T; Broccio, M; Ciccolo, A

    1998-01-01

    The Authors describing a case of Spigelian hernia observed point out clinical, diagnostic and therapeutic considerations about this rare pathology of abdominal wall. They specify the anatomic characteristics of the region and underline as any diagnostic difficulties are by passed by use of USG and TC imaging for formulation of correct preoperative diagnosis. They confirm as surgical treatment by a correct access isn't different by a normal hernioplasty and guarantee the long term surgical outcome.

  14. Effectiveness of sealing active proximal caries lesions with an adhesive system: 1-year clinical evaluation

    Directory of Open Access Journals (Sweden)

    Clarisse Abuchaim

    2010-09-01

    Full Text Available The objective of this study was to evaluate the effectiveness of a therapeutic sealant to arrest non-cavitated proximal carious lesion progression. The study population comprised 44 adolescents who had bitewing radiographs taken for caries diagnosis. Non-cavitated lesions extending up to half of dentin thickness were included in the sample. In the experimental group (n = 33, the proximal caries-lesion surfaces were sealed with an adhesive (OptiBond Solo, Kerr after tooth separation. The control group (n = 11 received no treatment, except for oral hygiene instructions including use of dental floss. Follow-up radiographs were taken after one year and were analyzed in comparison with baseline radiographs. In a blind study setting, visual readings were performed by two examiners, blinded to whether the examined radiograph was baseline or follow-up, and whether it concerned a test or control lesion. The efficacy of sealing treatment was evaluated by the McNemar test (0.05. About 22% of the sealed lesions showed reduction, 61% showed no change and 16% showed progression. For the control lesions, the corresponding values were 27%, 36% and 36% respectively. The number of lesions that showed reduction and no changes were merged and therefore 83.3% of the sealed lesions and 63.6% of the control lesions were considered clinically successful. No statistical significance was detected (p > 0.05. In the course of 1 year, sealing proximal caries lesions was not shown to be superior to lesion monitoring.

  15. A comparative study of the clinical efficiency of chemomechanical caries removal using Carisolv and Papacarie - a papain gel.

    Science.gov (United States)

    Kumar, J; Nayak, M; Prasad, K L; Gupta, N

    2012-01-01

    The purpose of this study was to compare the clinical efficiency of chemomechanical caries removal using Carisolv and Papacarie - a papain gel. The Carisolv system for caries removal, consisting of a solvent gel and a specially designed hand instrument, was compared to Papacarie - a papain gel. The outcome variables were: time taken for complete caries removal and volume of carious tissue excavated. Forty patients in the age-group of 20-40 years, having Black's class I dentinal caries with cavity entrance size of ≥3 mm in the molars, were enrolled for the study. The time taken for the complete removal of caries was measured using a stopwatch. Pre- and post-excavation single-step putty/wash elastomeric impression was recorded using addition silicone impression material. Subsequently, casts were poured and measured under a traveling microscope. The total volume of caries excavated was computed using the formula π (d/2)² h. The difference between the two groups in clinical efficiency and volume excavated was statistically analyzed using the Student's unpaired 't' test. The time for caries removal with Carisolv and Papacarie were, respectively, 11.67 ± 3.25 minutes and 10.48 ± 2.96 minutes (P>.05). The mean volume of carious tissue removed with Papacarie (135.99 ± 66.43 mm ³ ) was higher than that with Carisolv (126.33 ± 53.56 mm ³ ); however, the difference was not significant. Carisolv and Papacarie have similar clinically efficiency as chemomechanical agents for dentinal caries removal.

  16. Diagnostic agreement between radiologists, dentists and dental students for radiographic detection of approximal caries.

    Directory of Open Access Journals (Sweden)

    Sergio E Uribe

    2015-06-01

    Full Text Available Aim: To assess intraobserver and interobserver agreement for radiographic detection of approximal caries among radiologists, dentists and senior dental students. Materials and methods: 75 standardized bitewing radiographs were examined by four maxillofacial radiologists, four dentists and four senior dental students. Iinterobserver agreement was calculated using a weighted Kappa Cohen test. Two weeks later, the examiners re-evaluated 10% of the sample under the same conditions and intraobserver agreement weighted Kappa Cohen test was calculated. Results: The interobserver Kappa value was 0.68 (good for the dentist-student pair, 0.51 (moderate for the student-radiologist and 0.62 (good for the dentist-radiologist pair. All these differences were significant. The intraobserver agreement Kappa values obtained were 0.56 (moderate for students (p=0.46, 0.46 (moderate for dentists (p<0.05 and 0.68 (good for radiologists. Conclusion: The agreement for proximal caries detection by dental students, dentists and radiologists was moderate to good.

  17. Evaluating the impact of caries prevention and management by caries risk assessment guidelines on clinical practice in a dental teaching hospital.

    Science.gov (United States)

    Lee, Gillian H M; McGrath, Colman; Yiu, Cynthia K Y

    2016-05-26

    Clinical practice guidelines on 'Dental caries prevention and management by caries risk assessment for pre-school children in Hong Kong' were developed using ADAPTE process and Delphi consensus technique. This study aimed to evaluate the feasibility of disseminating and implementing the guidelines, and to evaluate their effectiveness in changing clinical practice. The study was conducted in two phases, examining clinical records of pre-school aged patients being treated by non-academic clinical staff in the Paediatric Dentistry Clinic of a dental teaching hospital in Hong Kong. The clinical guidelines were introduced to the staff in a departmental seminar at the end of pre-intervention phase. Post-intervention phase began one month after the introduction of guidelines. Clinical records for three consecutive months were reviewed against standards and recommendations derived from the newly developed clinical guidelines in both phases. The results were assessed by Chi-square test, ANOVA and regression analyses. A total of 237 and 147 clinical records were reviewed in pre-intervention and post-intervention phases, respectively. Guideline adherence percentage increased significantly on almost all aspects of the guidelines in the post-intervention phase (P practice (P best practice. The findings have implication for widespread implementation.

  18. Clinics in diagnostic imaging (171)

    Science.gov (United States)

    Ooi, Su Kai Gideon; Tan, Tien Jin; Ngu, James Chi Yong

    2016-01-01

    A 46-year-old Chinese woman with a history of cholecystectomy and appendicectomy presented to the emergency department with symptoms of intestinal obstruction. Physical examination revealed central abdominal tenderness but no clinical features of peritonism. Plain radiography of the abdomen revealed a grossly distended large bowel loop with the long axis extending from the right lower abdomen toward the epigastrium, and an intraluminal air-fluid level. These findings were suspicious for an acute caecal volvulus, which was confirmed on subsequent contrast-enhanced computed tomography (CT) of the abdomen and pelvis. CT demonstrated an abnormal positional relationship between the superior mesenteric vein and artery, indicative of an underlying intestinal malrotation. This case highlights the utility of preoperative imaging in establishing the diagnosis of an uncommon cause of bowel obstruction. It also shows the importance of recognising the characteristic imaging features early, so as to ensure appropriate and expedient management, thus reducing patient morbidity arising from complications. PMID:27872936

  19. Serumferritin - diagnostic relevance and clinical usefulness

    Energy Technology Data Exchange (ETDEWEB)

    Linkesch, W. (Vienna Univ. (Austria). 2. Medizinische Klinik)

    1984-01-01

    The introduction of a WHO Standard for serumferritin effected a standardisation of different methods, improving quality and security for clinical routine diagnostic purposes. Therefore the clinical evaluation of serumferritin gained even more importance. For evaluation of iron stores of children, pregnant women, population studies, patients on hemodialysis or patients with rheumatoid arthritis low serumferritin values give safe results. In addition serumferritin is of clinical usefulness in monitoring therapy of both iron deficiency and iron overload. Evaluating a single serumferritin value one should consider the total clinical situation of the patient. As some tumors can produce and secrete serumferritin, e.g. acute myeloblastic leukemia, germ cell tumors, malignant melanoma, serumferritin might be helpful in monitoring the malignant disease. The ongoing characterization of tissue isoferritin, especially acidic isoferritin, may eventually lead to a clinically significant diagnostic marker of neoplasia.

  20. Diagnostic agreement between radiologist, dentist and dental students for radiographic detection of approximal caries.

    Directory of Open Access Journals (Sweden)

    Sergio E Uribe

    2015-06-01

    Full Text Available ABSTRACT Aim: To assess intraobserver and interobserver agreement for radiographic detection of approximal caries among dentists, senior’s dental students and radiologists. Materials and methods: 75 standardized bitewing radiographs were examined by four maxillofacial radiologist, four dentist and four senior dental students. Interobserver agreement was calculated using a weighted Kappa Cohen test. Two weeks later, the examiners re-evaluated 10% of the sample under the same conditions and intraobserver agreement weighted Kappa Cohen test were calculated.Results: The interobserver Kappa value was 0.68 (good for the dentist-student pair, 0.51 (moderate for the student-radiologist and 0.62 (good for the dentist-radiologist pair. All these differences were significant. The intraobserver agreement Kappa values obtained were 0.56 (moderate for students (p=0.46, 0.46 (moderate for dentist (p

  1. Dental management of early childhood caries in spastic quadriparesis: a case report and clinical guidelines.

    Science.gov (United States)

    Hotwani, Kavita; Sharma, Krishna

    2013-01-01

    Cerebral palsy (CP) describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of CP are often accompanied by epilepsy, secondary musculoskeletal problems, and disturbances of sensation, perception, cognition, communication, and behavior. Spastic quadriparesis is the most severe form of spastic cerebral palsy. The present report describes the management of a 5-year-old patient with early childhood caries and spastic quadriparesis. The oral manifestations and clinical guidelines are discussed considering the special health care needs in these patients so as to provide comprehensive dental care.

  2. Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: A clinical variant.

    Science.gov (United States)

    Prajapati, V K; Mitra, Ruchi; Vinayak, K M

    2017-01-01

    Caries in second molar is common and prophylactic removal of the impacted teeth may be considered appropriate. Caries detection and restoration can be difficult and a restored second molar can undergo recurrent caries if the third molar is not removed prophylactically. In this study, the clinical findings related to impaction and its association with angular position and depth of impacted third molar were evaluated. A retrospective descriptive study was carried out among the patients visiting the outpatient, department of Dentistry, RIMS, Ranchi. The clinical examination, periapical radiographs and Pre-op OPG were taken. Teeth positions were analyzed by Pell and Gregory and Winter classification. The angulation and depth of mandibular third molar impaction and caries in the second molar with the eruption status of the mandibular third molar was determined. A total of 200 patients were included in the study between age group 17-45 years. Majority of the Patients reported to the hospital with complaints of decayed tooth (66%) and pain (59%). The most common third molar impaction was mesioangular followed by distoangular. A statistically highly significant difference (P = 0.001) was obtained with the presence of caries in second molar adjacent to mesioangular third molar in class I and level B. According to this study, pattern of mandibular third molar impaction is in association to caries in mandibular second molar. More future studies are needed. In addition, the results of the present study can be used to screen and inform the patients about the possibility of caries in relation to third molar mandibular impaction.

  3. Clinical relevance of studies on the accuracy of visual inspection for detecting caries lesions: a systematic review.

    Science.gov (United States)

    Gimenez, Thais; Piovesan, Chaiana; Braga, Mariana M; Raggio, Daniela P; Deery, Chris; Ricketts, David N; Ekstrand, Kim R; Mendes, Fausto Medeiros

    2015-01-01

    Although visual inspection is the most commonly used method for caries detection, and consequently the most investigated, studies have not been concerned about the clinical relevance of this procedure. Therefore, we conducted a systematic review in order to perform a critical evaluation considering the clinical relevance and methodological quality of studies on the accuracy of visual inspection for assessing caries lesions. Two independent reviewers searched several databases through July 2013 to identify papers/articles published in English. Other sources were checked to identify unpublished literature. The eligible studies were those which (1) assessed the accuracy of the visual method for detecting caries lesions on occlusal, approximal or smooth surfaces, in primary or permanent teeth, (2) used a reference standard, and (3) reported data about sample size and accuracy of the methods. Aspects related to clinical relevance and the methodological quality of the studies were evaluated. 96 of the 5,578 articles initially identified met the inclusion criteria. In general, most studies failed in considering some clinically relevant aspects: only 1 included study validated activity status of lesions, no study considered its prognosis, 79 studies did not consider a clinically relevant outcome, and only 1 evaluated a patient-centred outcome. Concerning methodological quality, the majority of the studies presented a high risk of bias in sample selection. In conclusion, studies on the accuracy of the visual method for caries detection should consider clinically relevant outcomes besides accuracy; moreover, they should be conducted with higher methodological quality, mainly regarding sample selection.

  4. Clinical outcome of root caries restorations using ART and rotary techniques in institutionalized elders

    Directory of Open Access Journals (Sweden)

    Alberto Carlos CRUZ GONZALEZ

    2016-01-01

    Full Text Available Abstract The aim of this study was to compare the clinical performance of root caries restorations after a six-month period using two methods, a conventional technique with rotary instruments and an atraumatic restorative technique (ART, in an institutionalized elderly population in the city of Bogotá, Colombia. Root caries represents a multifactorial, progressive, chronic lesion with softened, irregular and darkened tissue involving the radicular surface; it is highly prevalent in the elderly, especially in those who are physically or cognitively impaired. A quasi-experimental, double-blind, longitudinal study was carried out after cluster randomization of the sample. Two different experienced dentists, previously trained, performed the restorations using each technique. After six months, two new investigators performed a blind evaluation of the condition of the restorations. The results showed a significantly higher rate of success (92.9% using the conventional technique (p < 0.03. However, we concluded that ART may have been the preferred technique in the study population because 81% of those restorations survived or were successful during the observation period.

  5. Assembling Amperometric Biosensors for Clinical Diagnostics

    Directory of Open Access Journals (Sweden)

    Claudia Marina Lagier

    2007-02-01

    Full Text Available Clinical diagnosis and disease prevention routinely require the assessment ofspecies determined by chemical analysis. Biosensor technology offers several benefits overconventional diagnostic analysis. They include simplicity of use, specificity for the targetanalyte, speed to arise to a result, capability for continuous monitoring and multiplexing,together with the potentiality of coupling to low-cost, portable instrumentation. This workfocuses on the basic lines of decisions when designing electron-transfer-based biosensorsfor clinical analysis, with emphasis on the strategies currently used to improve the deviceperformance, the present status of amperometric electrodes for biomedicine, and the trendsand challenges envisaged for the near future.

  6. Comparison of three diagnostic techniques for detecting occlusal dental caries in primary molars: An in vivo study

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    Farhin Katge

    2016-01-01

    Conclusion: This study showed low sensitivity but substantial specificity with visual inspection. Bitewing radiography performed poorly overall when compared with the other two systems. The CarieScan PRO technique gave the highest overall combination of sensitivity and specificity for detection of occlusal caries.

  7. MDS clinical diagnostic criteria for Parkinson's disease.

    Science.gov (United States)

    Postuma, Ronald B; Berg, Daniela; Stern, Matthew; Poewe, Werner; Olanow, C Warren; Oertel, Wolfgang; Obeso, José; Marek, Kenneth; Litvan, Irene; Lang, Anthony E; Halliday, Glenda; Goetz, Christopher G; Gasser, Thomas; Dubois, Bruno; Chan, Piu; Bloem, Bastiaan R; Adler, Charles H; Deuschl, Günther

    2015-10-01

    This document presents the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (PD). The Movement Disorder Society PD Criteria are intended for use in clinical research but also may be used to guide clinical diagnosis. The benchmark for these criteria is expert clinical diagnosis; the criteria aim to systematize the diagnostic process, to make it reproducible across centers and applicable by clinicians with less expertise in PD diagnosis. Although motor abnormalities remain central, increasing recognition has been given to nonmotor manifestations; these are incorporated into both the current criteria and particularly into separate criteria for prodromal PD. Similar to previous criteria, the Movement Disorder Society PD Criteria retain motor parkinsonism as the core feature of the disease, defined as bradykinesia plus rest tremor or rigidity. Explicit instructions for defining these cardinal features are included. After documentation of parkinsonism, determination of PD as the cause of parkinsonism relies on three categories of diagnostic features: absolute exclusion criteria (which rule out PD), red flags (which must be counterbalanced by additional supportive criteria to allow diagnosis of PD), and supportive criteria (positive features that increase confidence of the PD diagnosis). Two levels of certainty are delineated: clinically established PD (maximizing specificity at the expense of reduced sensitivity) and probable PD (which balances sensitivity and specificity). The Movement Disorder Society criteria retain elements proven valuable in previous criteria and omit aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. As understanding of PD expands, the Movement Disorder Society criteria will need continuous revision to accommodate these advances. © 2015 International Parkinson and Movement Disorder Society.

  8. The American Dental Association Caries Classification System for clinical practice: a report of the American Dental Association Council on Scientific Affairs.

    Science.gov (United States)

    Young, Douglas A; Nový, Brian B; Zeller, Gregory G; Hale, Robert; Hart, Thomas C; Truelove, Edmond L

    2015-02-01

    The caries lesion, the most commonly observed sign of dental caries disease, is the cumulative result of an imbalance in the dynamic demineralization and remineralization process that causes a net mineral loss over time. A classification system to categorize the location, site of origin, extent, and when possible, activity level of caries lesions consistently over time is necessary to determine which clinical treatments and therapeutic interventions are appropriate to control and treat these lesions. In 2008, the American Dental Association (ADA) convened a group of experts to develop an easy-to-implement caries classification system. The ADA Council on Scientific Affairs subsequently compiled information from these discussions to create the ADA Caries Classification System (CCS) presented in this article. The ADA CCS offers clinicians the capability to capture the spectrum of caries disease presentations ranging from clinically unaffected (sound) tooth structure to noncavitated initial lesions to extensively cavitated advanced lesions. The ADA CCS supports a broad range of clinical management options necessary to treat both noncavitated and cavitated caries lesions. The ADA CCS is available for implementation in clinical practice to evaluate its usability, reliability, and validity. Feedback from clinical practitioners and researchers will allow system improvement. Use of the ADA CCS will offer standardized data that can be used to improve the scientific rationale for the treatment of all stages of caries disease. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  9. The Value of Periapical Radiograph in the Diagnosis of Interproximal Caries

    Energy Technology Data Exchange (ETDEWEB)

    KIm, Young Hee; Kang, Byung Chul [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chonnam National University, Kwangju (Korea, Republic of)

    2000-03-15

    To compare the diagnostic performance of clinical and radiologic examination for the interproximal caries on intraoral periapical radiographs and to evaluate the value of periapical radiographs. One hundred seven dental patients were examined clinically, with a mouth mirror and an explorer, by a dentist at the department of oral medicine, and the presence or absence of interproximal caries lesion was recorded. The patients were prescribed one or more dental periapical radiographs. Radiographs were assessed for the presence of interproximal caries by three radiologists independently. Two thousand sixty interproximal surfaces were included in this study. The diagnostic accuracies of clinical and radiologic examinations for interproximal caries were calculated. To assess the degree of agreement between clinical and radiologic examinations, Cohen's coefficient of agreement was computed. The specificity of clinical and radiologic examination was 0.991, 0.997 and the sensitivity was 0.279, 0.985 respectively. The diagnostic accuracy of radiologic examination was statistically significantly higher than that of clinical examination (P<0.05). Cohen's kappa value of clinical and radiologic examination was 0.335, 0.942 respectively. These results suggested that clinical examination show only fair agreement, whereas radiologic examination show perfect agreement. The diagnostic performance of the dental periapical radiographs on interproximal caries were higher than that of clinical examination, thus this study showed the validity of periapical radiographs for detecting interproximal caries lesion without bitewing radiograph.

  10. THE PROBLEMS OF EARLY CLINICAL DEFECTOLOGICAL DIAGNOSTICS

    Directory of Open Access Journals (Sweden)

    Aleksandar CORDIC

    1997-06-01

    Full Text Available Clinical defectological diagnostics, related to diagnostics of each individual's impairment of his cognitive and socializing abilities, has been applied in our country for a long time. Since it is a new area in the clinical defectological work and a new form of research in defectology, it poses a series of problems which have not been met so far. We shall to recognize some of them in this paper and to aim at their solution.This time we shall consider only the most prominent problems towards which we direct our interventions:· When does defectological diagnostics take part in diagnosis as treatment of impairments of the handicapped person? When does it function in the process of rehabilitation? For example, is working with a dyslexic child treatment or rehabilitation?· When does the early diagnostics reveal a problem arising from inappropriate intersection of different development courses, which can sometimes be solved without any particular treatment (early stuttering, various convulsions, and when does it reveal actual condition, such as oligophrenia or autism. Thereby we ask ourselves if early stimulative treatment of oligophrenic children or children with early childhood psychosis is treatment or rehabilitation.We tried to classify end explain the problems of diagnostics in the context of treatment and rehabilitation and to define the theoretical grounds for our standpoints.We wanted to point out the unity of the process of any impairment of the handicapped person from early childhood to the end of his life. Treatment and rehabilitation should be a united process and follow the course of development of early disorders which sometimes end up as handicaps, and sometimes, thanks to the treatment, may end up in successful socialization, for example, persons with impaired hearing or sight.We establish defectology as a complete theoretical standpoint and expert procedure which is parallel to and complementary with medicine. The only difference we

  11. Research on optical properties of dental enamel for early caries diagnostics using a He-Ne laser

    Science.gov (United States)

    Tang, Jing; Liu, Li; Li, Song-zhan

    2008-12-01

    A new and non-invasive method adapted for optical diagnosis of early caries is proposed by researching on the interaction mechanism of laser with dental tissue and relations of remitted light with optical properties of the tissue. This method is based on simultaneous analyses of the following parameters: probing radiation, backscattering and auto-fluorescence. Investigation was performed on 104 dental samples in vitro by using He-Ne laser (λ=632.8nm, 2.0+/-0.1mW) as the probing. Spectrums of all samples were obtained. Characteristic spectrums of dental caries in various stages (intact, initial, moderate and deep) were given. Using the back-reflected light to normalize the intensity of back-scattering and fluorescence, a quantitative diagnosis standard for different stages of caries is proposed. In order to verify the test, comparison research was conducted among artificial caries, morphological damaged enamel, dental calculus and intact tooth. Results show that variations in backscattering characteristic changes in bio-tissue morphological and the quantity of auto-fluorescence is correlated with concentration of anaerobic microflora in hearth of caries lesion. This method poses a high potential of diagnosing various stages of dental caries, and is more reliability to detect early caries, surface damage of health enamel and dental calculus.

  12. A randomized clinical trial on arresting dentin caries in preschool children by topical fluorides

    OpenAIRE

    Duangthip, Duangporn

    2015-01-01

    Introduction: Silver diammine fluoride (SDF) has been found to be effective in preventing and arresting dental caries in children. The annual or semi-annual application of SDF may not be practical in migratory populations or effective high caries risk patients. So far, no data are available about the effectiveness of intensive fluoride treatment in arresting dental caries in primary teeth. Objectives: This study aimed to compare the effectiveness of three topical fluoride application prot...

  13. Comparison between Clinical Aspects and Salivary Microbial Profile of Children with and without Early Childhood Caries: A Preliminary Study.

    Science.gov (United States)

    Neves, A B; Lobo, L A; Pinto, K C; Pires, E S; Requejo, Mep; Maia, L C; Antonio, A G

    2015-01-01

    To compare the clinical aspects and microbial profile of children with and without early childhood caries (ECC). 14 patients (7 without caries and 7 with ECC) were submitted to anamnesis, clinical exam and saliva collection for microbiological analyses. Counts of Streptococcus mutans, Lactobacillus spp. Candida spp., and total microorganisms were performed by culture methods. Microbial diversity was characterized by PCR-DGGE. Demographic/clinical data and salivary microbial counts were compared between groups. Habits of hygiene and breastfeeding presented no association with ECC. Use of pacifiers was associated with absence of caries (p=0.035). Counts of total microorganisms and Candida spp. did not differ between the groups. The ECC group presented larger quantity of S. mutans (p=0.026) and Lactobacillus spp. (p=0.002). There was no correlation between microorganisms and breastfeeding and pacifier use. The dmf-t of ECC Group was 10.5 ± 1.9 and the modified dmf-t was 11.3 ± 3.6. The DGGE demonstrated difference in the pattern of bands between the groups. Pacifiers usage was associated with the absence of ECC and microorganism number was higher in the caries group. The PCR-DGGE revealed a characteristic microbial diversity in the ECC Group, being an excellent tool for observing the dynamics of the salivary microbial community in these patients.

  14. Depth profilometric case studies in caries diagnostics of human teeth using modulated laser radiometry and luminescence

    Science.gov (United States)

    Jeon, Raymond J.; Mandelis, Andreas; Abrams, Stephen H.

    2003-01-01

    Simultaneous measurements from human teeth of photothermal radiometric (PTR) and luminescence (LM) signals induced by an intensity modulated laser have been performed to assess the feasibility of detecting deep lesions and near-surface cracks, to examine the effects of varying enamel thicknesses, the presence of fillings, and stains on the surface of teeth. A commercial dc luminescence monitoring instrument (DIAGNOdent by KaVo) was also used to examine a set of teeth for comparison purposes with PTR and LM. PTR amplitude signals from carious regions and from thin enamel were higher than those from healthy regions and thicker enamel. A crack produces a peak in the PTR amplitude scan, as well as a sudden change in the luminescence amplitude at the corresponding point. At low frequencies (5 Hz), the PTR amplitude showed high sensitivity to a deep (about 2 mm) lesion, while at high frequencies (700 Hz) it was more sensitive to surface cracks. It was concluded that by selecting proper modulation frequencies of the laser, measurements of PTR and LM signals could be used as a dental diagnostic technique with a small, inexpensive, low-power (<30 mW) semiconductor laser as a light source emitting in the optical window range of hard tissue (650-1000 nm).

  15. Clinical decision-making for coronal caries management in the permanent dentition.

    Science.gov (United States)

    Anusavice, K

    2001-10-01

    Optimal conservative treatment decisions to prevent, arrest, and reverse tooth demineralization caused by caries require probability estimates on caries risk and treatment outcomes. This review is focused on the use of the best scientific evidence to recommend treatment strategies for management of coronal caries in permanent teeth as a function of caries risk. Evidence suggests that assigning therapeutic regimens to individuals according to their risk levels should yield a significantly greater probability of success and better cost effectiveness than applying identical treatments to all patients independent of risk. Depending on caries risk levels, treatment decisions based on risk can minimize unnecessary surgical intervention by incorporating the best evidence to prescribe treatment regimens for the use of fluoride-releasing agents, sealants, chlorhexidine, or combinations of these products.

  16. Dental caries, restorations and extractions by dental caries in first permanent molars. Clinical and radiographic study; Lesoes cariosas, restauracoes e extracoes por processo carioso de primeiros molares permanentes. Estudo clinico e radiografico

    Energy Technology Data Exchange (ETDEWEB)

    Aguiar, Sandra Maria H.C. Avila de; Santos Pinto, Ruy dos [UNESP, Aracatuba, SP (Brazil). Faculdade de Odontologia

    1996-07-01

    This research analyse by clinical and radiographic study, dental caries, restorations and extractions in 1.600 first permanent molars, from 400 children, both sexes, aged 5 to 13 years old, assisted in the Children`s Clinic, Faculdade de Odontologia de Aracatuba, UNESP, in 1994. (author). 3 refs., 4 figs.

  17. Stereomicroscopic study of the human tooth caries: clinical and morphological correlations

    Science.gov (United States)

    Oancea, Roxana; Vasile, Liliana; Marchese, Cristian; Sava-Rosianu, Ruxandra

    2012-06-01

    Objectives: Stereomicroscopy allows a three-dimensional study of the images and of laterality at superior quality in comparison with other methods. Those advantages are given by the large examination fields and the wide work distances. The adding of the clinical and morphological data at the results gathered with stereomicroscopy and the stereo micrometry is useful in order to appreciate the deepness and the widening of the carious process, and the necessity to reconsider the therapeutically strategy. Materials and methods: During 2009-2011 the study material was represented by 10 surgically removed impacted third molars, and by 20 premolars extracted for orthodontic purposes, with closed and macroscopically apparently integer surfaces. 13 premolars with different degrees of carious affectation and periodontal lesions, which were surgically extracted without trauma, were also selected. The in situ measurements at the occlusal site were realized through the utilization of a fluorescent laser device - DIAGNOdent. The basic principles in stereomicroscopy stood at the base of the obliquely and circularly coaxial illumination techniques, one with optical alignment adjustment of the optical microscope and mechanical adjustment for the optimal illumination and micrometry. The Olympus Microscope SZ ×7 and an Olympus camera with 2,5 × digital zoom and a 3× optical zoom has been used to study the samples in stereomicroscopy and through polarized light it. Results: The DiagnoDent measured the following data: out of 43 apparently healthy teeth, 18 presented values between 2 and 13 (D1), 13 showed values between 14 and 24 (D2), 12 measured values over 24 (D3). After the histological examination in stereomicroscopy and in the polarized light: 25 teeth were healthy, 10 presented caries extended in dental enamel and 8 presented dentinal caries. Stereomicroscopy has allowed the morphological study, the color absorption, the appreciation of the lesions' deepness and substance

  18. Osteoporosis and osteomalacia - clinical and diagnostic problems

    Directory of Open Access Journals (Sweden)

    A. S. Avrunin

    2014-01-01

    Full Text Available Aim: to define main clinical and diagnostical problems related to osteoporosis and osteomalacia. Literature data showed that not only osteoporosis but osteomalacia may be the reason for decreasing of mechanical properties of skeleton with risk of low-energy fractures. The solution of associated medical and social problems is difficult because DEXA does not allow to differentiate between osteoporosis and osteomalacia that leads to misdiagnosis and unnecessary prescription of antiosteoporotic drugs. This approach is pathogenetically unproved and even may be harmful for the patient. Osteoporosis and osteomalacia does not exclude each other so bone mass reducing in one cohort of patient may be due to osteoporosis, other - osteomalacia and some of them - combinations of both. Another point is that results of controlled clinical trials that evaluated efficacy of antiosteoporotic drugs without differentiative histology tests for osteoporosis and osteomalacia are of doubtful value. As the bone biopsy that is necessary for osteomalacia diagnosis is invasive procedure there is need in definition of clear criteria when it has to be done in patient with reduced bone mass.

  19. Impact of untreated dental caries and its clinical consequences on the oral health-related quality of life of schoolchildren aged 8-10 years.

    Science.gov (United States)

    Mota-Veloso, Isabella; Soares, Maria Eliza C; Alencar, Bruna Mota; Marques, Leandro Silva; Ramos-Jorge, Maria Letícia; Ramos-Jorge, Joana

    2016-01-01

    This study aims to evaluate the impact of untreated dental caries and its clinical consequences on the quality of life of Brazilian schoolchildren aged 8-10 years. A randomly selected sample of 587 children underwent a clinical oral examination for the assessment of untreated dental caries and clinical consequences. The WHO criteria (decayed component of the decayed, missing, and filled teeth--D-DMFT in permanent teeth or d-dfmt in primary teeth) and the PUFA index, which records the presence of severely decayed permanent (upper case) and primary (lower case) teeth with visible pulpal involvement (P/p), as well as ulceration caused by dislocated tooth fragments (U/u), fistula (F/f), and abscesses (A/a), were used for the oral examination. Oral health-related quality of life (OHRQoL) was evaluated using the Child's Perception Questionnaire (CPQ8-10). Poisson regression was employed to test unadjusted and adjusted associations between untreated dental caries/clinical consequences and OHRQoL. The prevalence of untreated dental caries was 64.6% (D/d component of DMFT/dmft > 0) and 17.9% of children exhibited clinical consequences of caries (PUFA/pufa index >0). In the adjusted models, untreated caries was significantly associated with the total CPQ8-10 score and all subscale scores. The clinical consequences of dental caries (PUFA/pufa index >0) were significantly associated with the total CPQ8-10 as well as the oral symptoms and functional limitations' subscales. Untreated dental caries and its clinical consequences exerted a negative impact on the OHRQoL of the schoolchildren analyzed.

  20. Diagnostic accuracy of consensus diagnostic criteria for frontotemporal dementia in a memory clinic population

    NARCIS (Netherlands)

    Y. Pijnenburg (Yolande); J.L. Mulder (Jacqueline); J.C. van Swieten (John); B.M. Uitdehaag (Bernard); M. Stevens (Martijn); P. Scheltens (Philip); C. Jonker (Cees)

    2008-01-01

    textabstractBackground/Aims: The goal of the present study was to evaluate the diagnostic accuracy of the core diagnostic criteria for frontotemporal dementia (FTD) [Neary D, et al: Neurology 1998;51:1546-1554] within a memory clinic population. Methods: The 5 core diagnostic criteria for FTD were o

  1. Clinical diagnosis of fissure caries with conventional and laser-induced fluorescence techniques

    OpenAIRE

    Chu, C. H.; Lo, E. C. M.; You, D. S. H.

    2010-01-01

    We studied the in vivo validity of dentinal fissure caries diagnosis by visual examination, bitewing radiography, and use of a laser-induced fluorescence device (DIAGNOdent). A total of 144 and second molars with macroscopically intact occlusal surfaces in 41 Chinese young adults were examined visually, by bitewing radiography, and by DIAGNOdent. Visual examination after pit and fissure opening was used as the reference standard. The sensitivity and specificity of detecting caries that had ex...

  2. Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from The National Dental PBRN

    Science.gov (United States)

    Fellows, Jeffrey L; Gordan, Valeria V.; Gilbert, Gregg H.; Rindal, D. Brad; Qvist, Vibeke; Litaker, Mark S.; Benjamin, Paul; Flink, Håkan; Pihlstrom, Daniel J.; Johnson, Neil

    2014-01-01

    Purpose Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. We used actual clinical data to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Methods We combined data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists. Analysis of variance and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Results Network dentists from 5 regions placed 6,891 restorations involving occlusal and/or proximal caries lesions. Enamel restorations accounted for 16% of enrolled occlusal caries lesions and 6% of enrolled proximal caries lesions. Enamel occlusal restorations varied significantly (pEnamel proximal restorations varied significantly (penamel caries restorations can guide strategies to improve provider adherence to evidence-based clinical recommendations. PMID:25000667

  3. Caries detection in primary teeth is less challenging than in permanent teeth

    Directory of Open Access Journals (Sweden)

    Fausto M Mendes

    2013-01-01

    Full Text Available Introduction: Most studies about caries detection methods have been performed using permanent teeth. Primary teeth, however, present significant differences from permanent teeth; hence findings of these studies with permanent teeth cannot be extrapolated. The Hypothesis: Our hypothesis is that the caries diagnosis process in primary teeth is less challenging than in permanent teeth. This assertion is based on the fact that primary enamel is thinner and the caries process progresses faster in this type of teeth when compared to permanent teeth. For these reasons, the majority of caries lesions in primary teeth would be more evident and therefore, easily detected through visual inspection. Only a few number of caries lesions would be missed by visual inspection. Thus, adjunct diagnostic methods, such as radiographs, would be unnecessary for primary teeth. Evaluation of the Hypothesis: To evaluate this hypothesis, researchers should conduct studies about the performance of the caries detection methods avoiding selection bias and defining appropriate settings. Clinical trials randomizing the diagnostic strategies would be worthwhile. The evidence supporting the benefits of adjunct methods in detecting caries lesions in primary lesions is limited. However, clinical guidelines have recommended the use of the radiographic method to detect caries in primary teeth in all symptomless children. The confirmation of our hypothesis would lead to the need to re-evaluate such guidelines.

  4. RECENT ADVANCES IN DETECTION AND DIAGNOSIS OF DENTAL CARIES

    Directory of Open Access Journals (Sweden)

    Prachi

    2014-01-01

    Full Text Available Dental caries , a progressive bacterial damage to teeth , is one of the most commondiseases that affects 95% of the population and is still a major cause of tooth loss.Recent years have seen an increase in research activity surrounding diagnostic methods , particularly in the assessment of early caries lesions. The use of technologi es as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technolog ies available to aid the dental practitioners in detecting and diagnosis ofdental caries at the earliest stage of its formation , assessing the activities of the detected carious lesion , and quantitatively or qualitatively monitoring of the lesion over time .

  5. Nd:YAG laser in caries prevention: a clinical study; Avaliacao clinica da eficiencia do laser de Nd:YAG associado ao fluor fosfato acidulado na prevencao de caries de sulcos e fissuras de criancas e adolescentes

    Energy Technology Data Exchange (ETDEWEB)

    Boari, Heloisa Gomes Dimiranda

    2000-07-01

    The caries prevention by using laser irradiation has been investigated during the last 30 years. The Nd: YAG laser associated with acidulated phosphate fluoride has been shown as a very promising technique for enamel caries prevention. The aim of this work was to clinically evaluate the efficiency of Nd: YAG laser associated with acidulated phosphate fluoride in pit and fissure caries prevention of children and adolescents. In this work it was determined the dye that enhance the effect of Nd: YAG laser in enamel. It was selected 242 pre-molar and molar teeth from 33 children and adolescents, aged from 7 to 15 years old. The selected teeth were free from caries or decalcification marks (active white marks) to the clinical and radiographic exams. The teeth were divided into two groups: the first group was laser irradiated and their homologous remained as a control. The right side teeth were dye-assisted Nd:YAG laser irradiated. The dye solution was a moisture of dust coal and equal parts of water and alcohol. The irradiation conditions were 60 mJ/10 Hz, optical fiber in contact mode, with diameter of 300 {mu}m, resulting in an energy density of 84,9 J/cm{sup 2}. The oclusal surface of the teeth was completely irradiated, specially on the slopes and in the deepest part of the pits and fissures. This procedure was repeated three times. In the sequence it was applied the acidulated phosphate fluoride for 4 minutes. On the left side teeth - control group- only acidulated phosphate fluoride was applied for the same time. The final examination considered the presence of caries and active white marks after a period of one year. There were statistical significant differences (p < 0.01) between the lased + fluoride group and the non irradiated group. The present study concluded that the technique used in this work can be an alternative clinical method for caries prevention. (author)

  6. Infectious myocarditis (Clinic, diagnostics, principles of treatment

    Directory of Open Access Journals (Sweden)

    Yu. P. Finogeev

    2016-01-01

    Full Text Available Infective myocarditis can be considered as a case of myocardial damage caused by different infectious agents. Traditionally discusses the questions of diagnostics and treatment infectious myocarditis. The paper has repeatedly stressed the difficulty of clinical diagnosis, and the laboriousness and economic costs of laboratory tests and additional researches. Endomyocardial biopsy findings remain the gold standard for unequivocally establishing the diagnosis. However, it is technically extremely invasive test and can be performed only in specialized cardiology centers. The paper analyzes in detail not only own materials, but also results of researches published in numerous domestic and foreign sources of literature. Publication of «Infectious myocarditis» is necessary due to the fact that patients with a diagnosis of «Myocarditis » account for 11% of all cardiovascular disease in the world. Article is timely and necessary for many professionals, senior students of medical universities.

  7. Orthogonal NGS for High Throughput Clinical Diagnostics.

    Science.gov (United States)

    Chennagiri, Niru; White, Eric J; Frieden, Alexander; Lopez, Edgardo; Lieber, Daniel S; Nikiforov, Anastasia; Ross, Tristen; Batorsky, Rebecca; Hansen, Sherry; Lip, Va; Luquette, Lovelace J; Mauceli, Evan; Margulies, David; Milos, Patrice M; Napolitano, Nichole; Nizzari, Marcia M; Yu, Timothy; Thompson, John F

    2016-04-19

    Next generation sequencing is a transformative technology for discovering and diagnosing genetic disorders. However, high-throughput sequencing remains error-prone, necessitating variant confirmation in order to meet the exacting demands of clinical diagnostic sequencing. To address this, we devised an orthogonal, dual platform approach employing complementary target capture and sequencing chemistries to improve speed and accuracy of variant calls at a genomic scale. We combined DNA selection by bait-based hybridization followed by Illumina NextSeq reversible terminator sequencing with DNA selection by amplification followed by Ion Proton semiconductor sequencing. This approach yields genomic scale orthogonal confirmation of ~95% of exome variants. Overall variant sensitivity improves as each method covers thousands of coding exons missed by the other. We conclude that orthogonal NGS offers improvements in variant calling sensitivity when two platforms are used, better specificity for variants identified on both platforms, and greatly reduces the time and expense of Sanger follow-up, thus enabling physicians to act on genomic results more quickly.

  8. [Clinical evaluation of fluor protector and glass-ionomer cement used as pit and fissure sealant for preventing pit and fissure caries in children].

    Science.gov (United States)

    Ji, Pei-hong; Xu, Quan-lin; Ba, Yong

    2007-08-01

    To study the clinical effect of the fluor protector and glass-ionomer cement used as pit and fissure sealant for preventing pit and fissure caries in children. 622 health permanent teeth in 6-8 years old children were divided into three groups. Children in the experimental group A (n=207,335 teeth) underwent fluor protector every six months, experimental group B(n=205, 327 teeth) with glass-ionomer cement used as pit and fissure sealant and children in the control group(n=210, 354 teeth) underwent no treatment. The incidence of caries were compared among the three groups using SPSS10.0 software package after 3 years. After 3 years, the incidence of caries in A and B experimental groups were lower than in the control group, the difference was significant (P0.05). Fluor protector and glass-ionomer cement used as pit and fissure sealant also have good clinical effect in preventing caries.

  9. A randomized, double-blind, placebo-controlled clinical trial of fluoride varnish in preventing dental caries of Sjögren's syndrome patients.

    Science.gov (United States)

    Xin, Weini; Leung, Katherine Chiu Man; Lo, Edward Chin Man; Mok, Mo Yin; Leung, Moon Ho

    2016-09-23

    Sjögren's syndrome (SS) patients are prone to caries development due to reduction of salivary flow. Topical fluoride is commonly prescribed for caries prevention. In this 24-month randomized, double-blind, placebo-controlled clinical trial, SS patients were randomly assigned to receive either fluoride varnish or placebo gel quarterly. Development and arrest of caries at the coronal and root surfaces were recorded at 12-month and 24-month and compared to that of the baseline. Effect of fluoride varnish on oral Candida and lactobacilli colonization was explored by comparing baseline oral microbiological assessments to data obtained at 12-month and 24-month. Seventy-eight SS patients (mean age = 50 years, 2 men) completed this trial. At 24-month, the mean new coronal enamel caries were 1.6 surfaces in both groups, and new dentin caries were 1.4 and 2.7 surfaces in the fluoride and placebo group respectively (p > 0.05). Mean arrested caries were 0.6 and 0.7 surfaces for fluoride and placebo groups respectively and that of root caries were 0.3 and 0.1 surfaces (p > 0.05). The mean oral Candida count was reduced by 30 % in the fluoride group but increased 61 % in the placebo group while no change in oral lactobacilli counts in both groups at 24 months (p > 0.05). SS patients receiving fluoride varnish were significantly less likely to develop dentin caries (p fluoride varnish can prevent development of dental caries in people with Sjögren's syndrome. This study was retrospectively registered at the ISRCTN registry ( ISRCTN85164658 ) on 9 Sept 2016 and was funded by the Research Grant Council of Hong Kong.

  10. The effects of noise reduction, sharpening, enhancement, and image magnification on diagnostic accuracy of a photostimulable phosphor system in the detection of non-cavitated approximal dental caries

    Energy Technology Data Exchange (ETDEWEB)

    Kajan, Zahra Dalili; Davalloo, Reza Tayefeh; Tavangar, Mayam; Valizade, Fatemeh [Faculty of Dentistry, Guilan University of Medical Sciences, Rasht (Iran, Islamic Republic of)

    2015-06-15

    Contrast, sharpness, enhancement, and density can be changed in digital systems. The important question is to what extent the changes in these variables affect the accuracy of caries detection. Forty eight extracted human posterior teeth with healthy or proximal caries surfaces were imaged using a photostimulable phosphor (PSP) sensor. All original images were processed using a six-step method: (1) applying 'Sharpening 2' and 'Noise Reduction' processing options to the original images; (2) applying the 'Magnification 1:3' option to the image obtained in the first step; (3) enhancing the original images by using the 'Diagonal/' option; (4) reviewing the changes brought about by the third step of image processing and then, applying 'Magnification 1:3'; (5) applying 'Sharpening UM' to the original images; and (6) analyzing the changes brought about by the fifth step of image processing, and finally, applying 'Magnification 1:3.' Three observers evaluated the images. The tooth sections were evaluated histologically as the gold standard. The diagnostic accuracy of the observers was compared using a chi-squared test. The accuracy levels irrespective of the image processing method ranged from weak (18.8%) to intermediate (54.2%), but the highest accuracy was achieved at the sixth image processing step. The overall diagnostic accuracy level showed a statistically significant difference (p=0.0001). This study shows that the application of 'Sharpening UM' along with the 'Magnification 1:3' processing option improved the diagnostic accuracy and the observer agreement more effectively than the other processing procedures.

  11. Progress in Early Childhood Caries and Opportunities in Research, Policy, and Clinical Management

    DEFF Research Database (Denmark)

    Garcia, Raul; Borrelli, Belinda; Dhar, Vineet

    2015-01-01

    to identify preschool children at risk for caries. Fluoridated toothpaste and fluoride varnish currently are the most effective chemotherapeutic strategies to prevent ECC. Motivational interviewing, a form of patient-centered counseling, is effective for motivating oral health behaviors and shows promise...... for reducing caries. Additionally, evidence is emerging that shows the value of chronic disease management approaches and integrating ECC oral health care within medical care settings. Recommendations for future directions in ECC research and policy were also key outcomes of the conference....

  12. Clinical evaluation of the Carisolv chemomechanical caries removal technique according to the site/stage concept, a revised caries classification system.

    Science.gov (United States)

    Chaussain-Miller, C; Decup, F; Domejean-Orliaguet, S; Gillet, D; Guigand, M; Kaleka, R; Laboux, O; Lafont, J; Medioni, E; Serfaty, R; Toumelin-Chemla, F; Tubiana, J; Lasfargues, J J

    2003-03-01

    The objective of the present study was to assess the efficiency and benefit of a chemomechanical system for carious dentin removal, Carisolv, in general practice. A revised caries classification, the site/stage concept, was used to describe the clinical situations of all carious lesions treated. The study was performed by 12 investigators, and 120 carious lesions were treated with Carisolv. Sixty percent of the cases were treated without anaesthesia, and we found a significant correlation between chemomechanical treatment without anaesthesia and absence of pain ( P=0.01). In 78.3% of the cases, carious dentin was totally removed with Carisolv, and in 21.7%, the dentin treatment was completed by drilling. In cases performed with Carisolv alone, the time required to remove carious dentin was 11.1+/-9.51 min (mean+/-SD). Treatment time was equivalent for all sites and increased significantly with each successive stage of lesion progression ( Premove carious dentin at all sites and stages of carious lesions but must be made more efficient for use in general practice.

  13. Dental caries

    DEFF Research Database (Denmark)

    Pitts, Nigel B; Zero, Domenick T; Marsh, Phil D

    2017-01-01

    , exposed root surfaces. The balance between pathological and protective factors influences the initiation and progression of caries. This interplay between factors underpins the classification of individuals and groups into caries risk categories, allowing an increasingly tailored approach to care. Dental......Dental caries is a biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues. Caries can occur throughout life, both in primary and permanent dentitions, and can damage the tooth crown and, in later life...... caries is an unevenly distributed, preventable disease with considerable economic and quality-of-life burdens. The daily use of fluoride toothpaste is seen as the main reason for the overall decline of caries worldwide over recent decades. This Primer aims to provide a global overview of caries...

  14. Clinically based diagnostic wax-up for optimal esthetics: the diagnostic mock-up.

    Science.gov (United States)

    Simon, Harel; Magne, Pascal

    2008-05-01

    A diagnostic wax-up can enhance the predictability of treatment by modeling the desired result in wax prior to treatment. It is critical to correlate the wax-up to the patient to avoid a result that appears optimal on the casts but does not correspond to the patient's smile. This article reviews the applications and techniques for clinically based diagnostic wax-up, and focuses on the diagnostic mock-up philosophy as a means to obtain predictable esthetics and function.

  15. Dermatoglyphic patterns and salivary pH in subjects with and without dental caries: A cross-sectional study

    Science.gov (United States)

    Yamunadevi, Andamuthu; Dineshshankar, Janardhanam; Banu, Safeena; Fathima, Nilofar; Ganapathy; Yoithapprabhunath, Thukanayakanpalayam Ragunathan; Maheswaran, Thangadurai; Ilayaraja, Vadivel

    2015-01-01

    Background: Dermatoglyphic patterns, which are regularly used in judicial and legal investigations, can be valuable in the diagnosis of many diseases associated with genetic disorders. Dental caries although of infectious origin, may have a genetic predisposition. Hence, we evaluated the correlation between dental caries and dermatoglyphic patterns among subjects with and without dental caries and evaluated its association with environmental factors such as salivary pH. Materials and Methods: Totally, 76 female students within the age group of 18-23 years were clinically examined, and their decayed, missing, filled teeth (DMFT) score and oral hygiene index-simplified were recorded. Based on their DMFT score, they were divided into following three groups; group I (n = 16, DMFT score = 0), group II (n = 30, DMFT score Dermatoglyphic pattern distribution in caries-free group showed more ulnar loops than high caries group (group III) while high caries group showed more whorl patterns. Presence of whorl with double loop, whorl within a loop was associated with high DMFT score. The total finger ridge count was lower in caries group. The mean salivary pH was higher in caries-free group than high caries group. Thus, we conclude that dermatoglyphic patterns may be potential diagnostic tool for detecting patients prone to develop dental caries. PMID:26283816

  16. Randomized controlled clinical trial of long-term chemo-mechanical caries removal using PapacarieTM gel

    Directory of Open Access Journals (Sweden)

    Lara Jansiski MOTTA

    2014-07-01

    Full Text Available Objectives: Compare the effectiveness of PapacarieTM gel for the chemo-mechanical removal of carious lesions on primary teeth to conventional caries removal with a low-speed bur with regard to execution time, clinical aspects and radiographic findings. Material and Methods: A randomized controlled clinical trial with a split-mouth design was carried out. The sample was composed of 20 children aged four to seven years, in whom 40 deciduous teeth were randomly divided into two groups: chemo-mechanical caries removal with PapacarieTM and removal of carious dentin with a low-speed bur. Each child underwent both procedures and served as his/her own control. Restorations were performed with glass ionomer cement. The time required to perform the procedure was also analyzed. The patients underwent longitudinal clinical and radiographic follow-up of the restorations. Results: No statistically significant difference between groups was found regarding the time required to perform the procedures and the radiographic follow up. Statistically significant differences between groups were found in the clinical evaluation at 6 and 18 months after treatment. Conclusion: PapacarieTM is as effective as the traditional method for the removal of carious dentin on deciduous teeth, but offers the advantages of the preservation of sound dental tissue as well as the avoidance of sharp rotary instruments and local anesthesia.

  17. An in vitro comparison of diagnostic accuracy of cone beam computed tomography and phosphor storage plate to detect simulated occlusal secondary caries under amalgam restoration

    Science.gov (United States)

    Shahidi, Shoaleh; Zadeh, Nahal Kazerooni; Sharafeddin, Farahnaz; Shahab, Shahriar; Bahrampour, Ehsan; Hamedani, Shahram

    2015-01-01

    Background: This study was aimed to compare the diagnostic accuracy and feasibility of cone beam computed tomography (CBCT) with phosphor storage plate (PSP) in detection of simulated occlusal secondary caries. Materials and Methods: In this in vitro descriptive-comparative study, a total of 80 slots of class I cavities were prepared on 80 extracted human premolars. Then, 40 teeth were randomly selected out of this sample and artificial carious lesions were created on these teeth by a round diamond bur no. 1/2. All 80 teeth were restored with amalgam fillings and radiographs were taken, both with PSP system and CBCT. All images were evaluated by three calibrated observers. The area under the receiver operating characteristic curve was used to compare the diagnostic accuracy of two systems. SPSS (SPSS Inc., Chicago, IL, USA) was adopted for statistical analysis. The difference between Az value of bitewing and CBCT methods were compared by pairwise comparison method. The inter- and intra-operator agreement was assessed by kappa analysis (P < 0.05). Results: The mean Az value for bitewings and CBCT was 0.903 and 0.994, respectively. Significant differences were found between PSP and CBCT (P = 0.010). The kappa value for inter-observer agreement was 0.68 and 0.76 for PSP and CBCT, respectively. The kappa value for intra-observer agreement was 0.698 (observer 1, P = 0.000), 0.766 (observer 2, P = 0.000) and 0.716 (observer 3, P = 0.000) in PSP method, and 0.816 (observer 1, P = 0.000), 0.653 (observer 2, P = 0.000) and 0.744 (observer 3, P = 0.000) in CBCT method. Conclusion: This in vitro study, with a limited number of samples, showed that the New Tom VGI Flex CBCT system was more accurate than the PSP in detecting the simulated small secondary occlusal caries under amalgam restoration. PMID:25878682

  18. Autoimmune Hepatitis: Clinical Manifestations and Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Ian G Mcfarlane

    2001-01-01

    Full Text Available In 1998, the International Autoimmune Hepatitis Group - a panel of 40 hepatologists and hepatopathologists from 17 countries who have a particular interest in autoimmune hepatitis (AIH - undertook a review, in light of subsequent experience, of the descriptive criteria and diagnostic scoring system that it had proposed in 1993 for the diagnosis of AIH. This review (published in 1999 noted that the original descriptive criteria appeared to be quite robust and required only relatively minor modifications to bring them up to date with developments and experience in diagnostic modalities for liver disease in general. Analysis of published data on the application of the original criteria in nearly 1000 patients revealed that the diagnostic scoring system had an overall diagnostic accuracy of 89.8%, with a sensitivity of 98.0%. Specificity for excluding definite AIH in patients with chronic viral hepatitis and circulating autoantibodies or patients with overlapping cholestatic syndromes was 98% to 100%, but specificity for excluding probable AIH in these disorders ranged from only 60% to 80%. Modifications, including adjustments to the weightings against biochemical and histological cholestatic features, have been made to the scoring system to improve its specificity.

  19. Genetics and caries: prospects

    Directory of Open Access Journals (Sweden)

    Alexandre Rezende Vieira

    2012-01-01

    Full Text Available Caries remains the most prevalent non-contagious infectious disease in humans. It is clear that the current approaches to decrease the prevalence of caries in human populations, including water fluoridation and school-based programs, are not enough to protect everyone. The scientific community has suggested the need for innovative work in a number of areas in cariology, encompassing disease etiology, epidemiology, definition, prevention, and treatment. We have pioneered the work on genetic studies to identify genes and genetic markers of diagnostic, prognostic, and therapeutic value. This paper summarizes a presentation that elaborated on these initial findings.

  20. Quantification and Management of Manifest Occlusal Caries Lesions in Adults: A Methodological and a Clinical Study

    DEFF Research Database (Denmark)

    Bakhshandeh, Azam

    2010-01-01

    resin sealants on medium deep or deep dentinal lesions; and only few studies examine the effect of resin sealants of lesions in adult patients. The progression of dentinal caries lesions are evaluated radiographically based on scores of lesion depth by paired comparison of X-rays, or by subtractions...... teeth with primary occlusal lesions. Randomization was performed in cases of more than one lesion in the same patient, so that the final material consisted of 60 resin sealed and 12 restored lesions. After 2-3 years, there was a drop-out of 15%; 2 patients did not show up for the control and 9...... tooth was color-dyed with Caries Detector®, and digitally photographed. The maximum width and the deepest extent of the lesions, enamel-dentin-junction and enamel-cement-junction were marked, and their relative dentinal depth and width were measured in the 2 histological images before and after dying...

  1. The potential advantages of digital PCR for clinical virology diagnostics.

    Science.gov (United States)

    Hall Sedlak, Ruth; Jerome, Keith R

    2014-05-01

    Digital PCR (dPCR), a new nucleic acid amplification technology, offers several potential advantages over real-time or quantitative PCR (qPCR), the current workhorse of clinical molecular virology diagnostics. Several studies have demonstrated dPCR assays for human cytomegalovirus or HIV, which give more precise and reproducible results than qPCR assays without sacrificing sensitivity. Here we review the literature comparing dPCR and qPCR performance in viral molecular diagnostic assays and offer perspective on the future of dPCR in clinical virology diagnostics.

  2. First step toward translation of thermophotonic lock-in imaging to dentistry as an early caries detection technology

    Science.gov (United States)

    Ojaghi, Ashkan; Parkhimchyk, Artur; Tabatabaei, Nima

    2016-09-01

    Early detection of the most prevalent oral disease worldwide, i.e., dental caries, still remains as one of the major challenges in dentistry. The current dental standard of care relies on caries detection methods, such as visual inspection and x-ray radiography, which lack the sufficient specificity and sensitivity to detect caries at early stages of formation when they can be healed. We report on the feasibility of early caries detection in a clinically and commercially viable thermophotonic imaging system. The system incorporates intensity-modulated laser light along with a low-cost long-wavelength infrared (LWIR; 8 to 14 μm) camera, providing diagnostic contrast based on the enhanced light absorption of early caries. The LWIR camera is highly suitable for integration into clinical platforms because of its low weight and cost. In addition, through theoretical modeling, we show that LWIR detection enhances the diagnostic contrast due to the minimal LWIR transmittance of enamel and suppression of the masking effect of the direct thermal Planck emission. Diagnostic performance of the system and its detection threshold are experimentally evaluated by monitoring the inception and progression of artificially induced occlusal and smooth surface caries. The results are suggestive of the suitability of the developed LWIR system for detecting early dental caries.

  3. Rampant Caries

    Science.gov (United States)

    Guzman-Armstrong, Sandra

    2005-01-01

    Although dental caries in the pediatric and adolescent population has consistently declined in the United States, it is still the most common childhood disease. Dental problems are the number one reason for missing school next to the common cold. Dental caries are an infectious, communicable disease resulting in destruction of tooth structure by…

  4. Dental caries: Therapeutic possibilities

    Directory of Open Access Journals (Sweden)

    Perić Tamara

    2008-01-01

    Full Text Available Contemporary tendencies in dentistry are based on the concept of maximal protection of healthy tooth tissues. Caries removal has been done traditionally with mechanical rotary instruments that are fast and precise. However, conventional cavity preparation has potential adverse effects to the pulp due to heat, pressure and vibrations. Moreover, drilling often causes pain and requires local anaesthesia, and these procedures are frequently perceived as unpleasant. Etiology, development and prevention of dental caries are better understood today and new restorative materials that bond micromechanically and/or chemically to dental tissues have been introduced. Thus, development of a new, less destructive caries removal technique is allowed. In the last decades, many alternative methods have been introduced in an attempt to replace rotary instruments. These are claimed to be efficient and selective for diseased tissues and to offer comfortable treatment to the patients. New methods include air abrasion, air polishing, ultrasonic, polymer burs, enzymes, systems for chemo-mechanical caries removal, and lasers. The aim of this paper was to discuss various caries removal techniques and possibilities of their use in clinical practice. Based on the literature review it can be concluded that none of the new caries removal methods can completely replace conventional rotary instruments.

  5. The prevalence of questionable occlusal caries

    DEFF Research Database (Denmark)

    Makhija, Sonia K; Gilbert, Gregg H; Funkhouser, Ellen;

    2012-01-01

    Questionable occlusal caries (QOC) can be defined as clinically suspected caries with no cavitation or radiographic evidence of occlusal caries. To the authors' knowledge, no one has quantified the prevalence of QOC, so this quantification was the authors' objective in conducting this study...

  6. Clinical consequences of untreated dental caries assessed using PUFA index and its covariates in children residing in orphanages of Pakistan.

    Science.gov (United States)

    Kamran, Ramsha; Farooq, Warda; Faisal, Mehreen Riaz; Jahangir, Faisal

    2017-07-11

    The purpose of this study was to determine the prevalence and clinical effects of untreated dental caries in Pakistani children residing in orphanages using the DMFT and PUFA index; association of decay and untreated dental caries with demographics including type of orphanage; behavioural and dental visiting pattern; and association of dental pain experience and type of orphanage with dental visiting. A cross-sectional survey was conducted on a total of 753 orphan children belonging to 4-17 years of age group residing in twin cities of Rawalpindi and Islamabad, Pakistan. Clinical examination of children was performed using the DMFT and PUFA index for the assessment of dental caries and untreated decay, followed by questionnaire enquiring about eating and oral hygiene habits, dental visiting pattern and dental pain and swelling experience. Association between dental decay, child's dental visiting and pain as a consequence of untreated decay was carried out using chi square test and logistic regression analysis. The overall caries prevalence was 34.8% and overall prevalence of PUFA/pufa was 15.9%. The mean score of DMFT and dmft was 1.18 (SD 0.39) and 1.04 (SD 0.23), and mean PUFA was 1.18 (SD 0.57) and mean pufa score 1.14 (SD 0.35). Untreated caries ratio was found to be 49.1% indicating half the decay had progressed to involve the pulp. No significant association of gender was found with DMFT, dmft, PUFA and pufa (p > 0.05), however, when analysed individually, the 'D' component of DMFT was significantly associated with male gender (p = 0.05). Furthermore, no significant association of DMFT/dmft or PUFA/pufa in either dentition was found with behavioural characteristics such as dietary and oral hygiene habits. Also, 66.2% children who experienced pain had not been to the dentist in the past year (p = 0.013) and 52.6% children who mentioned experiencing pain at night had not been to the dentist in the past year (p = 0.009). Children with decay were more

  7. Developing clinical practice guidelines for caries prevention and management for pre-school children through the ADAPTE process and Delphi consensus.

    Science.gov (United States)

    Lee, Gillian H M; McGrath, Colman; Yiu, Cynthia K Y

    2016-06-14

    This study aims to develop consensus evidence-based clinical guidelines for caries prevention and management by caries risk assessment for pre-school children in Hong Kong. Employing the ADAPTE process, guidelines for caries prevention and management by caries risk assessment for pre-school children with a preliminary list of 91 recommendations was complied. External review of the guidelines was conducted by a panel of 41 reviewers from the Hong Kong Society of Paediatric Dentistry using a two-round web-based Delphi process. The reviewers were invited to contribute any comments on the draft-adapted guidelines and rated their agreement with each recommendation using a 9-point Likert scale. During the second round, 36 participants received anonymous feedback from the first round and assessed a narrowed list of 28 recommendations. Recommendations were retained and classified according to the median score and rating percentages by the reviewers. A total of 70 out of 91 recommendations were retained (five reached high consensus, 65 reached consensus), and 21 recommendations were discarded. Recommendations and guidelines were outlined. Caries prevention and management guidelines for pre-school children were developed for use in Hong Kong using the ADAPTE process and Delphi consensus to develop evidence-based recommendations. This can facilitate the translation of guidelines into dental practice.

  8. Dental caries.

    Science.gov (United States)

    Pitts, Nigel B; Zero, Domenick T; Marsh, Phil D; Ekstrand, Kim; Weintraub, Jane A; Ramos-Gomez, Francisco; Tagami, Junji; Twetman, Svante; Tsakos, Georgios; Ismail, Amid

    2017-05-25

    Dental caries is a biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues. Caries can occur throughout life, both in primary and permanent dentitions, and can damage the tooth crown and, in later life, exposed root surfaces. The balance between pathological and protective factors influences the initiation and progression of caries. This interplay between factors underpins the classification of individuals and groups into caries risk categories, allowing an increasingly tailored approach to care. Dental caries is an unevenly distributed, preventable disease with considerable economic and quality-of-life burdens. The daily use of fluoride toothpaste is seen as the main reason for the overall decline of caries worldwide over recent decades. This Primer aims to provide a global overview of caries, acknowledging the historical era dominated by restoration of tooth decay by surgical means, but focuses on current, progressive and more holistic long-term, patient-centred, tooth-preserving preventive care.

  9. Screening of a Pediatric and Adult Clinic Population for Caries Pathogen Scardovia Wiggsiae.

    Science.gov (United States)

    Row, Lindsay; Repp, Matthew R; Kingsley, Karl

    Dental caries remains one of the most common morbidities worldwide, with research focusing on the most prevalent cariogenic bacteria including Streptococcus, Actionmyces and Lactobacillus species. However, recent evidence has begun to reveal novel pathogens that may alter current understanding of caries risk, including the recently discovered Gram-positive bacillus Scardovia wiggsiae. This prospective, cross-sectional study collected saliva from healthy adults and children for DNA isolation and PCR screening (n=149) in order to evaluate the prevalence of this potential oral pathogen. This analysis revealed that although half of these samples harbored traditional pathogens (S. mutans), approximately one quarter also harbored detectable levels of Scardovia. Further analysis using semi-quantitative methods, however, suggested only a small percentage had elevated (high) microbial burden (5.4%). These data suggest that cariogenic microbial composition among some patients may differ significantly, with some patients harboring comparatively larger percentages of Scardovia within their oral microbial flora. A complete understanding of the microbial interactions that facilitate or hinder the growth of Scardovia within the oral cavity remains largely unknown, suggesting the need for long-term studies to more fully elucidate demographic or health parameters, as well as the potential disease risk, associated with this organism.

  10. PERCEPTION OF Er-YAG LASER DENTAL CARIES TREATMENT IN ADOLESCENTS - A CLINICAL EVALUATION.

    Directory of Open Access Journals (Sweden)

    Galia G. Zhegova

    2014-06-01

    Full Text Available The aim of this study was to evaluate adolescents’ acceptance and pain perception of Er-YAG laser preparation in comparison to conventional mechanical preparation. Material and methods: Forty four adolescents between the age of 16 and 18 years with bilateral matched pairs of carious permanent molars participated in this study. In each patient one of the 2 cavities was prepared conventionally, the other with the Er-YAG laser. All cavities were restored with light-cured composite resin following the application of acid etch and a bonding agent. The patients were instructed to rate pain (sensitivity during treatment according to visual analogue scale and to decide which method they would prefer for their future caries treatment. Results: The patients rated lower pain perception during laser treatment. It was found that 86.36 % of the adolescents indicated that they would prefer the Er:YAG laser preparation for further caries treatment. Conclusion: The application of the Er-YAG laser for carious tissue removal, compared to conventional mechanical preparation, is perceived as more comfortable and the adolescents prefer it for a future treatment.

  11. Prosthetic crowns and other clinical risk indicators of caries among old-old Swedish adults: findings from the KEOHS Project. Kungsholmen Elders Oral Health Study

    DEFF Research Database (Denmark)

    Morse, Douglas E; Holm-Pedersen, Poul; Holm-Pedersen, Jytte;

    2002-01-01

    The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, community-dwelling persons over the age of 80 living in Kungsholmen, Sweden. This paper explored possible clinical risk indicators of coronal and root caries among the KEOHS subjects....

  12. [Celiac disease : Pathogenesis, clinics, epidemiology, diagnostics, therapy].

    Science.gov (United States)

    Schuppan, Detlef

    2016-07-01

    Celiac disease is induced by the consumption of gluten containing cereals (wheat, spelt, barley, rye). With a prevalence of ~ 1 %, it is the most common non-infectious chronic inflammatory intestinal disease worldwide. It manifests in all age groups, either classically with abdominal pain, diarrhoea and growth failure or weight loss, more commonly with indirect consequences of malabsorption, such as anaemia and osteoporosis, or with associated autoimmune diseases like type 1 diabetes, autoimmune thyroiditis or dermatitis herpetiformis. The pathogenesis of celiac disease is well explored. Gluten, the cereal storage protein, is not completely digested and reaches the intestinal mucosa where it activates inflammatory T cells, which cause atrophy of the resorptive villi. This T‑cell activation requires a genetic predisposition (the molecules HLA-DQ2 or -DQ8 on antigen-presenting immune cells). Moreover, the enzyme tissue transglutaminase (TG2) which is released in the mucosa increases the immunogenicity of the gluten peptides by a deamidation reaction. The test for serum antibodies to the autoantigen TG2 is one of the best diagnostic markers in medicine, which in combination with endoscopically obtained biopsies, secures the diagnosis of celiac disease. Despite these tools celiac disease is severely underdiagnosed, with 80-90 % of those affected being undetected. The untreated condition can lead to grave complications. These include the consequences of malabsorption, cancers (especially intestinal T‑cell lymphoma), and likely also the promotion of autoimmune diseases. The therapy of celiac disease, a strict gluten-free diet, is difficult to maintain and not always effective. Alternative, supporting pharmacological therapies are urgently needed and are currently in development.

  13. PERICARDITIS: ETIOLOGY, CLASSIFICATION, CLINIC, DIAGNOSTICS, TREATMENT. PART I

    Directory of Open Access Journals (Sweden)

    A.B. Sugak

    2009-01-01

    Full Text Available Pericarditis is relatively widespread inflammatory disease of pericardium. Symptoms of this disease was described already in the beginning of XIXth century, but it's clinical diagnostics in patient's lifetime is difficult up to now. Majority of acute pericardites have favorable clinical course, but some of them have complications (cardiac tamponade and constrictive pericarditis, which are potentially lethal. Development of non-invasive radiation methods of heart visualization technologies improved diagnostics of pericarditis in last years. Besides, achievements of immunology, virology and microbiology allowed widening of data of etiology and pathogenesis of pericardial diseases. Present lecture gives modern data of etiology, classification, clinical signs, diagnostics and treatment of pericarditis. The description of separate specific types of pericardites is given.Key words: children, pericarditis.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:77-84

  14. Peripheral cementifying fibroma: a clinical diagnostic dilemma.

    Science.gov (United States)

    Choubey, Shikha; Banda, Naveen Reddy; Banda, Vanaja Reddy; Vyawahare, Saket

    2013-05-13

    The peripheral ossifying fibroma (POF) is a reactive gingival overgrowth occurring frequently in the anterior maxilla. It originates in the cells of the periodontal ligament and is more common in children and young adults. In the current article a case of gingival over growth, which was thought to be puberty-induced gingivitis was seen in the lower anterior maxillary gingiva. Histology of the excised tissue showed cellular, fibrous connective tissue stroma with calcified osseous calcifications indicative of POF. The definitive diagnosis is established only by histological examination, which revealed the presence of highly cellular connective tissue with focal calcifications. Surgery is the treatment of choice, though the recurrence rate can reach 20% in case of POF. After histological confirmation the recall and clinical evaluation protocol of POF varies due to its increased recurrence rate, which the general dentist should be aware of.

  15. Confetti-like Sparing: A Diagnostic Clinical Feature of Melasma.

    Science.gov (United States)

    Wu, Douglas C; Fitzpatrick, Richard E; Goldman, Mitchel P

    2016-02-01

    Diagnostic uncertainty when a patient presents with melasma-like Undings can lead to suboptimal treatment and inaccurate prognostic expectations. In this study, the authors present a unique clinical feature of melasma that they term the "Fitzpatrick macule" and test its Utility in establishing diagnostic certainty. The "Fitzpatrick macule" is a confetti-like macule of regularly pigmented skin located within a larger patch of melasma hyperpigmentation. To test its diagnostic Utility, the authors compared clinical photography of known cases of melasma with common mimickers, such as poikiloderma of Civatte and solar lentiginosis, and determined the positivity rate of the Fitzpatrick macule in each scenario. Their results show that 89.1 percent of clinical photographs of melasma were positive for the presence of Fitzpatrick macules compared to 1.1 percent that were negative. In contrast, 37.5 and 56.3 percent of clinical photographs of poikiloderma of Civatte were positive and negative for Fitzpatrick macules, respectively. Solar lentiginosis showed a 5.6 percent positivity and a 77.8 percent negativity for Fitzpatrick macules. The sensitivity and specificity of Fitzpatrick macules for melasma was 99 and 83 percent, respectively. In summary, the authors report a highly sensitive and specific clinical feature of melasma. In cases of diagnostic uncertainty, the presence of Fitzpatrick macules may aid in establishing a diagnosis of melasma.

  16. Hashimoto thyroiditis: clinical and diagnostic criteria.

    Science.gov (United States)

    Caturegli, P; De Remigis, A; Rose, N R

    2014-01-01

    Hashimoto thyroiditis (HT), now considered the most common autoimmune disease, was described over a century ago as a pronounced lymphoid goiter affecting predominantly women. In addition to this classic form, several other clinico-pathologic entities are now included under the term HT: fibrous variant, IgG4-related variant, juvenile form, Hashitoxicosis, and painless thyroiditis (sporadic or post-partum). All forms are characterized pathologically by the infiltration of hematopoietic mononuclear cells, mainly lymphocytes, in the interstitium among the thyroid follicles, although specific features can be recognized in each variant. Thyroid cells undergo atrophy or transform into a bolder type of follicular cell rich in mitochondria called Hürthle cell. Most HT forms ultimately evolve into hypothyroidism, although at presentation patients can be euthyroid or even hyperthyroid. The diagnosis of HT relies on the demonstration of circulating antibodies to thyroid antigens (mainly thyroperoxidase and thyroglobulin) and reduced echogenicity on thyroid sonogram in a patient with proper clinical features. The treatment remains symptomatic and based on the administration of synthetic thyroid hormones to correct the hypothyroidism as needed. Surgery is performed when the goiter is large enough to cause significant compression of the surrounding cervical structures, or when some areas of the thyroid gland mimic the features of a nodule whose cytology cannot be ascertained as benign. HT remains a complex and ever expanding disease of unknown pathogenesis that awaits prevention or novel forms of treatment.

  17. Clinical evaluation of the laser fluorescence device for detection of approximal caries in primary molars%激光龋蚀检测仪在乳磨牙邻面龋早期诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    马文利; 杨彩红; 秦满

    2009-01-01

    significant (P<0.01). The correlation with DIAGNOdent and clinical final diagnose was high. But the correlation with clinical classification of caries vs DIAGNOdent (γ=0.304) was lower than the correlation with clinical classification vs the caries classification in bitewing radiography (γ=0.688).Conclusion DIAGNOdent had very high reliabilities. The indirect method of laser fluorescence showed a good performance to detect approximal caries early. It could be used as an adjunct to other conventional caries diagnostic methods.

  18. Implementation of Targeted Next Generation Sequencing in Clinical Diagnostics

    DEFF Research Database (Denmark)

    Larsen, Martin Jakob; Burton, Mark; Thomassen, Mads;

    Accurate mutation detection is essential in clinical genetic diagnostics of monogenic hereditary diseases. Targeted next generation sequencing (NGS) provides a promising and cost-effective alternative to Sanger sequencing and MLPA analysis currently used in most diagnostic laboratories. One...... advantage of targeted NGS is that multiple disease-specific genes can easily be sequenced simultaneously, which is favorable in genetic heterogeneous diseases. Prior to implementation in our diagnostic setting, we aimed to assess the sensitivity and specificity of targeted NGS by sequencing a collection......, respectively. For diagnostics, the sequencing coverage is essential, wherefore a minimum coverage of 30x per nucleotide in the coding regions was used as our primary quality criterion. For the majority of the included genes, we obtained adequate gene coverage, in which we were able to detect 100% of the known...

  19. Caries preventive efficiency of therapeutic complex accomponying orthodontic treatment of children with initial dental caries

    Directory of Open Access Journals (Sweden)

    Denga A.E.

    2013-12-01

    Full Text Available The use of orthodontic non-removable appliance in orthodontic treatment inter¬feres with the process of teeth mineralization, worsens level of oral cavity hygiene, stimulates development of caries process. The situation is complicated when a patient has an initial tooth decay. The aim of this study was to determine genetic characteristics of children with initial caries and clinical evaluation of effectiveness of the developed caries preventive therapeutic complex accompanying treatment of jaw facial anomalies (JFA. 47 children aged 12-14 with initial tooth decay participated in the examination. Complex diagnostics, including molecular genetic studies was carried out. Therapeutic complex for children, of the main group included remineralizing, adaptogenic, biogenic agents, which increase non-specific resistance, as well as infiltration ICON therapy before fixing braces. Caries preventive complex accompanying JFA treatment in children with primary tooth decay developed with regard to revealed genetic disorders of amelogenesis, 2-nd of phase detoxification, collagen formation, functional responses in the oral cavity, state of hard tissues of teeth and periodontal tissues enabled to preserve existing carious process, normalize periodontal and hygienic indices at all stages of treatment.

  20. Social Class and Diagnostic Suggestion as Variables in Clinical Judgment

    Science.gov (United States)

    Di Nardo, Peter A.

    1975-01-01

    Sixty graduate students in clinical psychology made diagnostic assessments of one of two staged interviews identical in content but enacted to convey either a middle- or lower-class impression. The results indicate the existence of a class bias and suggest a status differential between psychologists and psychiatrists. (Author)

  1. Teaching perceptual skills in clinical diagnostics using digital media

    NARCIS (Netherlands)

    Scheiter, Katharina; Jarodzka, Halszka

    2011-01-01

    Scheiter, K., & Jarodzka, H. (2011, May). Teaching perceptual skills in clinical diagnostics using digital media. Presentation at the 2nd International Conference “Research in Medical Education”: Shaping diamonds from bench to bedside, Universität Tübingen.

  2. Developments and Clinical Applications in Diagnostic Molecular Microbiology

    NARCIS (Netherlands)

    T. Schuurman (Timothy)

    2008-01-01

    textabstractDiagnostic Microbiology probably started in the late 17th century when the Dutch scientist Antoni van Leeuwenhoek made microorganisms visible for the first time. Since then, 3 major revolutions have taken place, all of which had a major impact on the field of clinical microbiology.

  3. Developments and Clinical Applications in Diagnostic Molecular Microbiology

    NARCIS (Netherlands)

    T. Schuurman (Timothy)

    2008-01-01

    textabstractDiagnostic Microbiology probably started in the late 17th century when the Dutch scientist Antoni van Leeuwenhoek made microorganisms visible for the first time. Since then, 3 major revolutions have taken place, all of which had a major impact on the field of clinical microbiology.

  4. Teaching perceptual skills in clinical diagnostics using digital media

    NARCIS (Netherlands)

    Scheiter, Katharina; Jarodzka, Halszka

    2011-01-01

    Scheiter, K., & Jarodzka, H. (2011, May). Teaching perceptual skills in clinical diagnostics using digital media. Presentation at the 2nd International Conference “Research in Medical Education”: Shaping diamonds from bench to bedside, Universität Tübingen.

  5. PERICARDITIS: ETIOLOGY, CLASSIFICATION, CLINIC, DIAGNOSTICS, TREATMENT. PART I

    OpenAIRE

    A.B. Sugak

    2009-01-01

    Pericarditis is relatively widespread inflammatory disease of pericardium. Symptoms of this disease was described already in the beginning of XIXth century, but it's clinical diagnostics in patient's lifetime is difficult up to now. Majority of acute pericardites have favorable clinical course, but some of them have complications (cardiac tamponade and constrictive pericarditis), which are potentially lethal. Development of non-invasive radiation methods of heart visualization technologies im...

  6. Palmar hyperhidrosis: clinical, pathophysiological, diagnostic and therapeutic aspects*

    Science.gov (United States)

    Romero, Flávio Ramalho; Haddad, Gabriela Roncada; Miot, Hélio Amante; Cataneo, Daniele Cristina

    2016-01-01

    Abstract Palmar hyperhidrosis affects up to 3% of the population and inflict significant impact on quality of life. It is characterized by chronic excessive sweating, not related to the necessity of heat loss. It evolves from a localized hyperactivity of the sympathetic autonomic system and can be triggered by stressful events. In this study, the authors discuss clinical findings, pathophysiological, diagnostic and therapeutic issues (clinical and surgical) related to palmar hyperhidrosis. PMID:28099590

  7. 21 CFR 872.1740 - Caries detection device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Caries detection device. 872.1740 Section 872.1740...) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1740 Caries detection device. (a) Identification. The caries detection device is a device intended to show the existence of decay in a patient's...

  8. 21 CFR 872.1745 - Laser fluorescence caries detection device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Laser fluorescence caries detection device. 872... SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1745 Laser fluorescence caries detection device. (a) Identification. A laser fluorescence caries detection device is a laser,...

  9. Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: A clinical variant

    Directory of Open Access Journals (Sweden)

    V K Prajapati

    2017-01-01

    Conclusion: According to this study, pattern of mandibular third molar impaction is in association to caries in mandibular second molar. More future studies are needed. In addition, the results of the present study can be used to screen and inform the patients about the possibility of caries in relation to third molar mandibular impaction.

  10. Diagnosis of Dentin Caries – Ultraviolet Fluorescence

    Directory of Open Access Journals (Sweden)

    Uzunov Ts.

    2014-12-01

    Full Text Available The technology advance in recent years determines the need of construction of modern appliances for early diagnosis of dental caries, which are categorized by great precision, non-invasiveness, easy usage and wide availability. Such non-invasive and accurate tool for diagnostics of caries is Caries Detector (LED, Bulgarian product by “Optica Laser”. The detector emits a specific wavelength of near ultraviolet light, which causes fluorescence to porphyrins - metabolic products of the life cycle of caries-inducing bacteria. The purpose of the study is piloting a new diagnostic tool for detection and monitoring of caries excavation based on fluorescence - LED UV caries detector of company “Optica laser”. Subjected to examination by caries indicator dye and UV caries detector were sixty permanent teeth with deep dentine caries. Two methods were used to assess the dentin caries - UV fluorescence detector of “Optica Laser” and staining with caries indicator - dye (Sable ™ Seek®. It was found that among all sixty teeth, the fields, closed by margins of carious process overlap. Fifty-four of tested teeth has shown bigger field of images with staining method and six - smaller in comparison to the fluorescent method. Ultraviolet fLuorescence caries detector of “Optica Laser” company is affordable and easy applicable method for controlled excavation of dentine caries. The detector can be used in daily dental practice equally with other methods. The unit has a number of advantages - non-invasiveness, lack of interaction with tooth structures, speed, reliability, efficiency, predictability and repeatability of results.

  11. Translating RNA sequencing into clinical diagnostics: opportunities and challenges.

    Science.gov (United States)

    Byron, Sara A; Van Keuren-Jensen, Kendall R; Engelthaler, David M; Carpten, John D; Craig, David W

    2016-05-01

    With the emergence of RNA sequencing (RNA-seq) technologies, RNA-based biomolecules hold expanded promise for their diagnostic, prognostic and therapeutic applicability in various diseases, including cancers and infectious diseases. Detection of gene fusions and differential expression of known disease-causing transcripts by RNA-seq represent some of the most immediate opportunities. However, it is the diversity of RNA species detected through RNA-seq that holds new promise for the multi-faceted clinical applicability of RNA-based measures, including the potential of extracellular RNAs as non-invasive diagnostic indicators of disease. Ongoing efforts towards the establishment of benchmark standards, assay optimization for clinical conditions and demonstration of assay reproducibility are required to expand the clinical utility of RNA-seq.

  12. Clinical utility of diagnostic guidelines and putative biomarkers in lymphangioleiomyomatosis

    Directory of Open Access Journals (Sweden)

    Chang William YC

    2012-04-01

    Full Text Available Abstract Background Lymphangioleiomyomatosis is a rare disease occurring almost exclusively in women. Diagnosis often requires surgical biopsy and the clinical course varies between patients with no predictors of progression. We evaluated recent diagnostic guidelines, clinical features and serum biomarkers as diagnostic and prognostic tools. Methods Serum vascular endothelial growth factor-D (VEGF-D, angiotensin converting enzyme (ACE, matrix metalloproteinases (MMP -2 and -9, clinical phenotype, thoracic and abdominal computerised tomography, lung function and quality of life were examined in a cohort of 58 patients. 32 healthy female controls had serum biomarkers measured. Results Serum VEGF-D, ACE and total MMP-2 levels were elevated in patients. VEGF-D was the strongest discriminator between patients and controls (median = 1174 vs. 332 pg/ml p  Conclusions Combining ERS criteria and serum VEGF-D reduces the need for lung biopsy in LAM. VEGF-D was associated with lymphatic disease but not lung function.

  13. Probiotics for future caries control: A short-term clinical study

    Directory of Open Access Journals (Sweden)

    Anitha Chinnappa

    2013-01-01

    Full Text Available Objectives: To compare mutans streptococci levels in saliva, before and after consumption of probiotic ice-cream and curds. Materials and Methods: Forty caries free children in the age group of 12-14 years were selected and equally divided into four groups I, II, III, IV. Children in group I and II were given 100 ml probiotic ice-cream and plain ice cream respectively and group III and IV were given 100 ml probiotic curd and plain curd respectively for a period of 7 days. Saliva samples were assessed at baseline, 1 hour after consumption and after 7 days intervention period using Mitis salivarius Bacitracin agar. The number of colonies was counted and subjected to statistical analysis. Results: The study revealed a reduction in salivary mutans streptococci (MS counts after 1 hour in all the groups. However after 7 days, probiotic ice-cream and curd showed a statistically significant (P < 0.001 reduction in MS counts as compared to the control ice cream and curd. The difference in the reduction of MS counts with probiotic ice-cream and probiotic curd at 1 hour and 7 days was not statistically significant. Conclusion: The use of probiotic products could be an alternative strategy of displacing pathogenic microorganisms by probiotic bacteria and can thus be exploited for the prevention of enamel demineralization.

  14. Translating biological parameters into clinically useful diagnostic tests.

    Science.gov (United States)

    Arfken, Cynthia L; Carney, Stuart; Boutros, Nash N

    2009-08-01

    Psychiatry has lagged behind other specialties in developing diagnostic laboratory tests for the purpose of confirming or ruling out a diagnosis. Biological research into the pathophysiology of psychiatric disorders has, however, yielded some highly replicable abnormalities that have the potential for development into clinically useful diagnostic tests. To achieve this goal, a process for systematic translation must be developed and implemented. Building on our previous work, we review a proposed process using four clearly defined steps. We conclude that biological parameters currently face challenges in their pathways to becoming diagnostic tests because of both the premature release and premature abandonment of tests. Attention to a systematic translation process aided by these principles may help to avoid these problems.

  15. Marginal ditching and staining as a predictor of secondary caries around amalgam restorations: a clinical and microbiological study.

    Science.gov (United States)

    Kidd, E A; Joyston-Bechal, S; Beighton, D

    1995-05-01

    Caries at the margins of restorations is difficult to diagnose. In particular, the relevance of both marginal ditching and staining around amalgam restorations is unclear. This clinical study questions the relevance of marginal ditching and color change to the level of infection of the dentin beneath the margins of amalgam restorations. Clinically visible sites (330) on the tooth/restoration margin were selected on 175 teeth. The enamel adjacent to each site was noted as stained (a grey discoloration) or stain-free. One hundred and seventy-eight sites were clinically intact, 83 sites had narrow ditches (ditches were present (> 0.4 mm). Twenty sites with frankly carious lesions were also included. Plaque was sampled at the tooth-restoration margin, and the dentin was sampled at the enamel-dentin junction below each site. Samples were vortexed, diluted, and cultured for total anaerobic counts, mutans streptococci, lactobacilli, and yeasts. Plaque samples showed that margins with wide ditches (> 0.4 mm) harbored significantly more bacteria, mutans streptococci, and lactobacilli than did clinically intact margins and margins with narrow ditches. There were no significant differences in the degree of infection of the dentin beneath clinically intact restorations and those with narrow ditches, but samples associated with wide ditches and carious lesions yielded significantly more bacteria, mutans streptococci, and lactobacilli. The color of the enamel adjacent to the sample site was irrelevant to the level of infection of the dentin beneath the filling margin, provided a frankly carious lesion was not present.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Clinical use of dental radiography in the diagnosis of interproximal caries and periodontal disease

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1987-11-15

    The purpose of the present study was to investigate associations between periapical and bitewing techniques by assessing the crestal alveolar bone. This article also reports the ability of these two techniques to correctly detect evidence of interproximal dental caries, and comparison between the interproximal overlapping of teeth. Bitewing and periapical radiographs were used from posterior quadrants of 243 dental students in Seoul National University. The distance from cemento-enamel junction to the alveolar crest (CEJ-AC) was measured for each proximal surface from the distal of cuspid to the distal of second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows: 1. In maxilla, a significant ratio with a P value of 0.05 or les reached for 100% and in mandible, reached for 94%. 2. The anatomic limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 3. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is importance to define which technique is used. 4. The number of the interproximal overlapping was the largest media side of the maxillary second molar, while the smallest at the distal side of the mandibular second premolar. And the overall number of the interproximal overlapping was more (538) in the periapical technique than in the bitewing technique (372). 5. The interproximal dental carious lesions were detected more (74) on the bitewing films than on the periapical ones (23). The fact was resulted from the small number of interproximal overlapping and relative easiness of obtaining horizontal angulation in taking the bitewing radiographs.

  17. An in vitro comparison of diagnostic abilities of conventional radiography, storage phosphor, and cone beam computed tomography to determine occlusal and approximal caries

    Energy Technology Data Exchange (ETDEWEB)

    Kayipmaz, Saadettin, E-mail: kayipmaz@ktu.edu.tr [Karadeniz Technical University, Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Farabi, 61080 Trabzon (Turkey); Sezgin, Omer Said, E-mail: omersaidsezgin@gmail.com [Karadeniz Technical University, Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Farabi, 61080 Trabzon (Turkey); Saricaoglu, Senem Tugra, E-mail: senem_tugra@hotmail.com [Karadeniz Technical University, Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Farabi, 61080 Trabzon (Turkey); Can, Gamze, E-mail: gcanktu@yahoo.com [Karadeniz Technical University Faculty of Medicine Department of Public Health (Turkey)

    2011-11-15

    Aim: The aim of this study was to compare conventional radiography, storage phosphor plate, and cone beam computed tomography for in vitro determination of occlusal and approximal caries. Methods: A total of 72 extracted human premolar and molar teeth were selected. Teeth were radiographed with conventional intraoral radiography, a storage phosphor plate system, and cone beam computed tomography and evaluated by two observers. The teeth were then separated and examined with a stereomicroscope and a scanner at approximately 8x magnification. Results: CBCT was statistically superior to conventional radiography and phosphor plate for determining occlusal caries. No significant difference from CBCT, conventional radiography and the phosphor plate system for determining approximal caries was found. Conclusion: The CBCT system may be used as an auxiliary method for the detection of caries.

  18. Prediction of dental caries activity

    OpenAIRE

    Crossner, Claes-Göran

    1980-01-01

    The aim of the present thesis was to find a test for prediction of caries activity which would be useful in routine clinical work.Correlations between oral health, general health, food habits and socioeconomic conditions were investigated in 4- and 8-year-old children. It was found that the salivary secretion rate and the prevalence of oral lactobacilli were factors which might be useful in caries prediction.In 5- and 8-year-old children negative correlations between caries frequency and secr...

  19. Clinical observation of two ways to repair caries%两种方式修复乳牙龋齿的临床观察

    Institute of Scientific and Technical Information of China (English)

    王燕

    2015-01-01

    Objective To discuss long-term clinical results of noninvasive repair surgery combined with Chenfil glass ionomer treatment and noninvasive repair surgery combined with reinforced glass ionomer treatment to repair caries.Methods 68 patients (200 caries) undergoing dental caries restoration in department of stomatology of our hospital from May 2011 to February 2013 were randomly divided into two groups.Group A received noninvasive repair surgery combined with Chenfil glass ionomer treatment,while group B received noninvasive repair surgery combined with reinforced glass ionomer treatment.Compared clinical results after caries restoration and in review.Results There were no statistically significant differences in the obvious efficiency,efficiency and total efficiency between two groups (P>0.05).2 years after caries restoration,the ratios of high caries marginal adaptation and less caries restoration surface wear in group A were significantly higher than those in group B,the ratio of secondary caries was lower than that in group B,with statistically significant differences (P<0.05).Conclusion There was no statistically significant difference in clinical effect after caries restoration between two groups.Long-term clinical effect of noninvasive repair surgery combined with Chenfil glass ionomer treatment was significantly better than noninvasive repair surgery combined with reinforced glass ionomer treatment with reference.%目的 探讨无创修复术联合Chenfil玻璃离子处理与无创修复术联合增强型玻璃离子处理修复乳牙龋齿的效果与远期效果.方法 将我院口腔科2011年5月至2013年2月收治的龋齿修复患者68例(共200颗龋齿)随机分为两组,A组患龋给予无创修复术联合Chenfil玻璃离子处理,B组患者给予无创修复术联合增强型玻璃离子处理,比较两组患龋的修复后、复查临床效果.结果 两组患龋修复后显效率、有效率、总有效率不存在统计学差异(P>0

  20. CLINICAL OBSERVING AND ANALYSES OF ROOT-CARIES(197 CASES)%根面龋临床观察与分析(附197例)

    Institute of Scientific and Technical Information of China (English)

    刘虹; 谢晓莉; 米大丽

    2001-01-01

    Root-caries is the disease which is often occured in old people.We investigated 197 patients(40~85 years old) in stomatological clinic,and found that there were 114 patients who had root-caries,an the incidence of root-caries is 57.87 percent.There was a significantly different in incidence between middle-aged people and old ones(P<0.01),and no significantly diferent in incidence between men and women(P>0.05).This conclusion is different from some domestic reports.Root-Caries Index (RCI) is 0.26.The incidecnce of root-caries and value of RCI are directly proportionate with age,but value of RCI in group of 40~49 years old is higher than it in the group of 50~59 years old.Gingival atrophy is relate to root-caries closely.Root-caries is mostly occurred in mandibular molar teeth,and is seldom seen in mandibular front teeth.%根面龋是老年人常见的口腔疾病,我们对口腔门诊40~85岁197例患者进行调查,发现患根面龋人数114例,根龋发病率57.87%,中、老年人发病率有高度显著性差异(P<0.01),男女发病率差异无显著性(P>0.05),与国内有些报道相异。根龋指数RCI为0.26。受检患者根龋发病率、RCI值与年龄呈正相关,但40~49岁年龄组RCI数据高于50~59岁组。调查发现,牙龈退缩与根面龋密切相关。根龋发生最多的牙位是下磨牙,最少的是下前牙。

  1. Verification and validation of diagnostic laboratory tests in clinical virology.

    Science.gov (United States)

    Rabenau, Holger F; Kessler, Harald H; Kortenbusch, Marhild; Steinhorst, Andreas; Raggam, Reinhard B; Berger, Annemarie

    2007-10-01

    This review summarizes major issues of verification and validation procedures and describes minimum requirements for verification and validation of diagnostic assays in clinical virology including instructions for CE/IVD-labeled as well as for self-developed ("home-brewed") tests or test systems. It covers techniques useful for detection of virus specific antibodies, for detection of viral antigens, for detection of viral nucleic acids, and for isolation of viruses on cell cultures in the routine virology laboratory.

  2. Saliva-based biosensors: noninvasive monitoring tool for clinical diagnostics.

    Science.gov (United States)

    Malon, Radha S P; Sadir, Sahba; Balakrishnan, Malarvili; Córcoles, Emma P

    2014-01-01

    Saliva is increasingly recognised as an attractive diagnostic fluid. The presence of various disease signalling salivary biomarkers that accurately reflect normal and disease states in humans and the sampling benefits compared to blood sampling are some of the reasons for this recognition. This explains the burgeoning research field in assay developments and technological advancements for the detection of various salivary biomarkers to improve clinical diagnosis, management, and treatment. This paper reviews the significance of salivary biomarkers for clinical diagnosis and therapeutic applications, with focus on the technologies and biosensing platforms that have been reported for screening these biomarkers.

  3. Saliva-Based Biosensors: Noninvasive Monitoring Tool for Clinical Diagnostics

    Directory of Open Access Journals (Sweden)

    Radha S. P. Malon

    2014-01-01

    Full Text Available Saliva is increasingly recognised as an attractive diagnostic fluid. The presence of various disease signalling salivary biomarkers that accurately reflect normal and disease states in humans and the sampling benefits compared to blood sampling are some of the reasons for this recognition. This explains the burgeoning research field in assay developments and technological advancements for the detection of various salivary biomarkers to improve clinical diagnosis, management, and treatment. This paper reviews the significance of salivary biomarkers for clinical diagnosis and therapeutic applications, with focus on the technologies and biosensing platforms that have been reported for screening these biomarkers.

  4. Clinical study of the caries-preventive effect of resin-modified glass ionomer restorations: aging versus the influence of fluoride dentifrice.

    Science.gov (United States)

    de Moraes, Maria Denise Rodrigues; de Melo, Mary Anne Sampaio; Bezerra, Daniela da Silva; Costa, Luciana Scarlazzari; Saboía, Vicente de Paula Aragão; Rodrigues, Lidiany Karla Azevedo

    2016-05-01

    The use of fluoride-releasing materials could be compromised due to aging and might also be influenced by other ordinary sources of fluoride. The aim of the present study was to investigate the aging effect on caries development around resin-modified glass ionomer cement (RMGIC) restorations and the influence of fluoride dentifrice use in this process under the oral environment. A clinical study was performed in two phases of 14 days each. A total of 16 volunteers wore palatal devices containing dental slabs restored with either a composite resin or RMGIC, either aged or unaged by thermocycling. To simulate a clinical situation of high caries risk, the slabs were exposed to a 20% sucrose solution 10 times per day via the in situ model, where non-fluoride or a fluoride dentifrice was used. Integrated demineralization was determined by cross-sectional microhardness at both margins of the restoration: enamel and dentin. For enamel, higher demineralization around the composite restorations was observed, regardless of dentifrice or aging. For dentin, higher demineralization was observed around the aged composite restorations regardless of the dentifrice type used. The RMGIC restorations provided more enhanced protection against secondary caries for dentin under aging, and the fluoride dentifrice used in this condition had either no clinically relevance or only a minimal effect. © 2015 Wiley Publishing Asia Pty Ltd.

  5. Gold Nanoparticles and Nanocomposites in Clinical Diagnostics Using Electrochemical Methods

    Directory of Open Access Journals (Sweden)

    Pranjal Chandra

    2013-01-01

    Full Text Available Progress and development in clinical diagnostics certainly focus upon the advances in the nanomaterials, particularly gold nanoparticles (AuNPs that offer promise to solve the biocompatible and sensitive detection systems. This paper focuses on the recent application of AuNPs in clinical diagnosis. Various important methods of AuNPs synthesis and their application in clinical detection of various biomolecules using electrochemical detection methods have been described. AuNPs alone and in various composites are also described based on the various biosensors design recently published for the detection of cancer biomarkers, proteins, bacteria, and cancer cells. The effect of AuNPs type and size in clinical detection has also been briefly illustrated.

  6. Caries detection and quantification with DIAGNOdent: prospects for occlusal and root caries?

    Science.gov (United States)

    Haak, R; Wicht, M J

    2004-10-01

    A possible consequence of light absorption as the interaction of electromagnetic radiation with molecules of the tooth's hard substances is, apart from the emission of heat, fluorescence. It was demonstrated that the emission spectra of enamel, dentin, and caries look alike upon excitation with red light; however, fluorescence increases with the process of carious destruction. Based on that, the DIAGNOdent System was developed, which simultaneously injects red light into the tooth surface and detects the resulting fluorescence. Due to this design, clinical application is currently limited to accessible occlusal and smooth surfaces. For occlusal caries detection, it was shown that validity and reproducibility could be optimized over classical diagnostic tests for deep dentin lesions with seemingly intact surfaces. The detection of root caries does not play a relevant role in the directly accessible areas, but estimation of the lesion's activity and progression rate is a prerequisite for differentiated lesion management Excellent reproducibility of the laser fluorescence measurements was confirmed for this scenario. Lesions with a soft surface texture show significantly higher fluorescence values than leathery or hard lesions, and values also increase with increasing cavity depth. DIAGNOdent offers the potential to improve follow-ups and estimation of the prognosis and to support clinical management of primary carious lesions.

  7. Preventing caries in preschoolers: successful initiation of an innovative community-based clinical trial in Navajo Nation Head Start.

    Science.gov (United States)

    Quissell, David O; Bryant, Lucinda L; Braun, Patricia A; Cudeii, Diana; Johs, Nikolas; Smith, Vongphone L; George, Carmen; Henderson, William G; Albino, Judith

    2014-03-01

    Navajo Nation children have the greatest prevalence of early childhood caries in the United States. This protocol describes an innovative combination of community-based participatory research and clinical trial methods to rigorously test a lay native Community Oral Health Specialists-delivered oral health intervention, with the goal of reducing the progression of disease and improving family knowledge and behaviors. This cluster-randomized trial designed by researchers at the Center for Native Oral Health Research at the University of Colorado in conjunction with members of the Navajo Nation community compares outcomes between the manualized 2-year oral health fluoride varnish-oral health promotion intervention and usual care in the community (child-caregiver dyads from 26 Head Start classrooms in each study arm; total of 1016 dyads). Outcome assessment includes annual dental screening and an annual caregiver survey of knowledge, attitudes and behaviors; collection of cost data will support cost-benefit analyses. The study protocol meets all standards required of randomized clinical trials. Aligned with principles of community-based participatory research, extended interaction between members of the Navajo community and researchers preceded study initiation, and collaboration between project staff and a wide variety of community members informed the study design and implementation. We believe that the benefits of adding CBPR methods to those of randomized clinical studies outweigh the barriers and constraints, especially in studies of health disparities and in challenging settings. When done well, this innovative mix of methods will increase the likelihood of valid results that communities can use. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Pyrosequencing for EGFR mutation detection: diagnostic accuracy and clinical implications.

    Science.gov (United States)

    Sahnane, Nora; Gueli, Rossana; Tibiletti, Maria G; Bernasconi, Barbara; Stefanoli, Michele; Franzi, Francesca; Pinotti, Graziella; Capella, Carlo; Furlan, Daniela

    2013-12-01

    EGFR-activating mutations predict responsiveness to EGFR tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC) patients. Mutation screening is crucial to support therapeutic decisions and is commonly conducted using dideoxy sequencing, although its sensitivity is suboptimal in clinical settings. To evaluate the diagnostic performance of pyrosequencing and dideoxy sequencing, we examined EGFR mutation status in a retrospective cohort of 53 patients with NSCLCs clinically selected for TKI therapy and whose clinical outcome was available. Moreover, pyrosequencing quantitative results were compared with EGFR amplification data. EGFR mutations were investigated by pyrosequencing and by dideoxy sequencing. Detection rates of both methods were determined by titration assays using NCI-H1975 and HCC-827 cell lines. Increased EGFR copy number was assessed by fluorescence in situ hybridization (FISH). Pyrosequencing showed a higher detection rate than dideoxy sequencing. Tumor control rate of cases with mutant and wild-type EGFR was 86% and 29%, respectively. EGFR amplification was significantly associated with EGFR mutation and a positive correlation between high percentages of mutant alleles and clinical response to TKI was observed. We concluded that pyrosequencing is more sensitive than dideoxy sequencing in mutation screening for EGFR mutations. Detection rate of dideoxy sequencing was suboptimal when low frequencies of mutant alleles or low tumor cell contents were observed. Pyrosequencing enables quantification of mutant alleles that correlates well with increased EGFR copy number assessed by FISH. Pyrosequencing should be used in molecular diagnostic of NSCLC to appropriately select patients who are likely to benefit from TKI therapy.

  9. Changes in the prevalence of dental caries in primary school ...

    African Journals Online (AJOL)

    2013-03-06

    Mar 6, 2013 ... Nigerian Journal of Clinical Practice • Mar-Apr 2014 • Vol 17 • Issue 2 ... Conclusion: The study showed no overall changes in caries severity ...... Surveillance for dental caries, dental sealants, tooth retention, edentulism, and.

  10. Randomised Clinical Trial on Resin Infiltration and Fluoride Varnish vs Fluoride Varnish Treatment Only of Smooth-surface Early Caries Lesions in Deciduous Teeth.

    Science.gov (United States)

    Turska-Szybka, Anna; Gozdowski, Dariusz; Mierzwińska-Nastalska, Elżbieta; Olczak-Kowalczyk, Dorota

    2016-01-01

    To clinically evaluate the effectiveness of resin infiltration in conjunction with fluoride varnish treatment vs fluoride varnish treatment alone on facial smooth-surface caries lesions in deciduous teeth. This randomised clinical trial was conducted in 419 children aged 18-71 months with at least two active smooth-surface caries lesions in deciduous teeth (ICDAS II score 2). Eighty-one participants met the inclusion criteria and were allocated to one of the two treatment groups: resin infiltration and fluoride varnish (RI+FV) (n = 41) and fluoride varnish only (FV) (n = 40). The prevalence of treated white spot lesions (WSL) was scored. Fluoride varnish was applied in both groups every 3 months for a year. The mean baseline age of children was 3.8 ± 1.3 years. The effectiveness of resin infiltration measured as the percentage of children who did not present any progression of the treated lesions amounted to 43.1%. After one year, 92.1% of the infiltrated lesions (RI+FV) and 70.6% of the FV lesions had not progressed (p fluoride varnish treatment of early facial smooth-surface caries lesions in deciduous teeth is superior to fluoride varnish treatment alone for reducing lesion progression.

  11. Clinical approach to obscure GI bleeding - Diagnostic testing and management

    Directory of Open Access Journals (Sweden)

    Prashanth Prabakaran

    2013-01-01

    Full Text Available Obscure gastrointestinal bleeding (OGIB can present as a diagnostic dilemma and management can be challenging. The search for causes of OGIB is usually centered on visualizing the small bowel, and in the past decade, the technology to visualize the entire small bowel has significantly advanced. Moreover, small bowel endoscopic imaging has replaced, in many instances, prior radiographic evaluation for obscure GI bleeding. These new modalities, such as small bowel capsule endoscopy (CE, balloon-assisted deep enteroscopy [double balloon enteroscopy (DBE and single balloon enteroscopy (SBE], and overtube-assisted deep enteroscopy (spiral enteroscopy, are paving the way toward more accurately identifying and treating patients with OGIB. We will review the diagnostic modalities available in evaluating a patient with OGIB and also propose the management based on clinical and endoscopic findings.

  12. Clinical Evaluation on Several anti- HIV Diagnostic Reagents

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective We Joined clinical evaluation on 6 anti - HIV diagnostic reagents which was organized by National Reference Laboratory of National Center for AIDS Prevention and Control. Method 100 sera of known result and 100 sera of unknown result were detected with 6 reagents according to test procedure of the reagents. Result The crude agreement (99.5 % ) of Organon Teknika and Determine reagents were higher than that of the other reagents. No anti - HIV positive serum was detected negative with Organon Teknika and Determine reagents. The sensitivity and specificity of Organon Teknika and Determine reagents were higher than those of the other reagents. The capacity of Organon Teknika reagent to detect the mild positive serum was greater than that of the other reagent. Conclusion Organon Teknika and Determine antiHIV diagnostic reagents were qualified for anti - HIV screening test while the other 4 reagents should be improved on sensitivity and specificity.

  13. Dental Caries (Tooth Decay)

    Science.gov (United States)

    ... Find Data by Topic > Dental Caries (Tooth Decay) Dental Caries (Tooth Decay) Main Content Dental caries (tooth decay) remains the most prevalent chronic ... important source of information on oral health and dental care in the United States since the early ...

  14. Cost-effectiveness of caries-preventive fluoride varnish applications in clinic settings among patients of low, moderate and high risk.

    Science.gov (United States)

    Schwendicke, Falk; Splieth, Christian H; Thomson, William Murray; Reda, Seif; Stolpe, Michael; Foster Page, Lyndie

    2017-07-06

    The total body of evidence finds fluoride varnish effective to prevent caries. However, most trials were conducted in high-risk populations, with more recent trials on low-risk groups finding a lower efficacy. We aimed to assess the cost-effectiveness of fluoride varnish application in clinic setting in populations with different caries risk. A mixed public-private-payer perspective in the context of German health care was performed using a lifetime Markov model. Effectiveness data were derived from an update of the most recent systematic Cochrane review and synthesized in three different risk groups according to control group caries increment via random-effects meta-analysis. Varnish was assumed to be applied twice yearly between age 6 and 18 years. Teeth with carious defects would be treated restoratively and could experience further follow-up treatments. Costs were deduced from German fee item catalogues. Monte Carlo microsimulations were used for to analyse lifetime treatment costs and caries increment (Euro/Decayed, Missing, Filled Teeth (DMFT)). In low-risk groups, fluoride varnish was nearly twice as costly and minimally more effective (293 Euro, 8.1 DMFT) than no varnish (163 Euro, 8.5 DMFT). The incremental cost-effectiveness ratio (ICER) was 343 Euro spent per avoided DMFT. The ICER was lower in medium-risk (ICER 93 Euro/DMFT) and high-risk groups (8 Euro/DMFT). Application of fluoride varnish in the clinic setting is unlikely to be cost-effective in low-risk populations. There is the need to either target high-risk groups or to provide fluoride varnish at lower costs, possibly in nonclinic settings. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Understanding Caries From the Oral Microbiome Perspective.

    Science.gov (United States)

    Tanner, Anne C R; Kressirer, Christine A; Faller, Lina L

    2016-07-01

    Dental caries is a major disease of the oral cavity with profound clinical significance. Caries results from a transition of a healthy oral microbiome into an acidogenic community of decreased microbial diversity in response to excessive dietary sugar intake. Microbiological cultivation, molecular identification, gene expression and metabolomic analyses show the importance of the entire microbial community in understanding the role of the microbiome in the pathology of caries.

  16. Risk, diagnostic error, and the clinical science of consciousness

    Directory of Open Access Journals (Sweden)

    Andrew Peterson

    2015-01-01

    Full Text Available In recent years, a number of new neuroimaging techniques have detected covert awareness in some patients previously thought to be in a vegetative state/unresponsive wakefulness syndrome. This raises worries for patients, families, and physicians, as it indicates that the existing diagnostic error rate in this patient group is higher than assumed. Recent research on a subset of these techniques, called active paradigms, suggests that false positive and false negative findings may result from applying different statistical methods to patient data. Due to the nature of this research, these errors may be unavoidable, and may draw into question the use of active paradigms in the clinical setting. We argue that false positive and false negative findings carry particular moral risks, which may bear on investigators' decisions to use certain methods when independent means for estimating their clinical utility are absent. We review and critically analyze this methodological problem as it relates to both fMRI and EEG active paradigms. We conclude by drawing attention to three common clinical scenarios where the risk of diagnostic error may be most pronounced in this patient group.

  17. Hemicrania Continua: Functional Imaging and Clinical Features With Diagnostic Implications.

    Science.gov (United States)

    Sahler, Kristen

    2013-04-10

    This review focuses on summarizing 2 pivotal articles in the clinical and pathophysiologic understanding of hemicrania continua (HC). The first article, a functional imaging project, identifies both the dorsal rostral pons (a region associated with the generation of migraines) and the posterior hypothalamus (a region associated with the generation of cluster and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing [SUNCT]) as active during HC. The second article is a summary of the clinical features seen in a prospective cohort of HC patients that carry significant diagnostic implications. In particular, they identify a wider range of autonomic signs than what is currently included in the International Headache Society criteria (including an absence of autonomic signs in a small percentage of patients), a high frequency of migrainous features, and the presence of aggravation and/or restlessness during attacks. Wide variations in exacerbation length, frequency, pain description, and pain location (including side-switching pain) are also noted. Thus, a case is made for widening and modifying the clinical diagnostic criteria used to identify patients with HC.

  18. Development, Methodology and Potential of the New Universal Visual Scoring System (UniViSS for Caries Detection and Diagnosis

    Directory of Open Access Journals (Sweden)

    Thomas Oehme

    2009-09-01

    Full Text Available Given the limitations of adjunct caries detection and diagnostic tools, e.g., imperfect validity and reproducibility, as well as the difficulties in controlling all possible confounding factors, the need for an objective visual caries detection and diagnosis system has become evident. Our work has therefore aimed at systematizing caries lesions with the Universal Visual Scoring System (UniViSS for occlusal and smooth surface lesions, which can be used for primary and permanent teeth, as well as under clinical, epidemiological, public health and laboratory conditions. Besides the description of the development and methodology of UniViSS, it is shown that UniViSS allows an accurate and reproducible classification of caries lesions on occlusal surfaces.

  19. Bilateral vestibular hypofunction: Insights in etiologies, clinical subtypes and diagnostics

    Directory of Open Access Journals (Sweden)

    F. eLucieer

    2016-03-01

    Full Text Available Objective:To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH and the value of diagnostic tools in the diagnostic process of BVH.Materials and methods: A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised 1 imbalance and/or oscillopsia during locomotion, and 2 summated slow phase velocity of nystagmus of less than 20 degrees per second during bithermal caloric tests.Results:The definite etiology of BVH was determined in 47% of the cases and the probable etiology in 22%. In 31%, the etiology of BVH remained idiopathic. BVH resulted from more than 20 different etiologies. In the idiopathic group, the percentage of migraine was significantly higher compared to the non-idiopathic group (50% versus 11%, p<0.001. Among all patients, 23.4% were known with autoimmune disorders in their medical history. All 4 clinical subtypes (recurrent vertigo with BVH, rapidly progressive BVH, slowly progressive BVH and slowly progressive BVH with ataxia were found in this population. Slowly progressive BVH with ataxia comprised only 4.5% of the cases. The head impulse test was abnormal in 94% of the cases. The torsion swing test was abnormal in 66%. Bilateral normal hearing to moderate hearing loss was found in 49%. Blood tests did not often contribute to the determination of the etiology of the disease. Abnormal cerebral imaging was found in 21 patients.Conclusion:BVH is a heterogeneous condition with various etiologies and clinical characteristics. Migraine seems to play a significant role in idiopathic BVH and auto-immunity could be a modulating factor in the development of BVH. The distribution of etiologies of BVH probably depends on the clinical setting. In the diagnostic process of BVH, the routine use of some blood tests can be reconsidered and a low-threshold use of audiometry and cerebral imaging is

  20. [Clinical importance and diagnostic methods of minimal hepatic encephalopathy].

    Science.gov (United States)

    Stawicka, Agnieszka; Zbrzeźniak, Justyna; Świderska, Aleksandra; Kilisińska, Natalia; Świderska, Magdalena; Jaroszewicz, Jerzy; Flisiak, Robert

    2016-02-01

    Minimal hepatic encephalopathy (MHE) encompasses a number of neuropsychological and neurophysiological disorders in patients suffering from liver cirrhosis, who do not display abnormalities during a medical interview or physical examination. A negative influence of MHE on the quality of life of patients suffering from liver cirrhosis was confirmed, which include retardation of ability of operating motor vehicles and disruption of multiple health-related areas, as well as functioning in the society. The data on frequency of traffic offences and accidents amongst patients diagnosed with MHE in comparison to patients diagnosed with liver cirrhosis without MHE, as well as healthy persons is alarming. Those patients are unaware of their disorder and retardation of their ability to operate vehicles, therefore it is of utmost importance to define this group. The term minimal hepatic encephalopathy (formerly "subclinical" encephalopathy) erroneously suggested the unnecessity of diagnostic and therapeutic procedures in patients with liver cirrhosis. Diagnosing MHE is an important predictive factor for occurrence of overt encephalopathy - more than 50% of patients with this diagnosis develop overt encephalopathy during a period of 30 months after. Early diagnosing MHE gives a chance to implement proper treatment which can be a prevention of overt encephalopathy. Due to continuing lack of clinical research there exist no commonly agreed-upon standards for definition, diagnostics, classification and treatment of hepatic encephalopathy. This article introduces the newest findings regarding the importance of MHE, scientific recommendations and provides detailed descriptions of the most valuable diagnostic methods.

  1. Proximal caries detection using digital subtraction radiography in the artificial caries activity model

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Hoon; Lee, Gi Ja; Choi, Sam Jin; Park, Young Ho; Kim, Kyung Soo; Jin, Hyun Seok; Hong, Kyung Won; Oh, Berm Seok; Park, Hun Kuk [Department of Biomedical Engineering, School of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Choi, Yong Suk; Hwang, Eui Hwan [Department of Oral and Maxillofacial Radiology, Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    2009-03-15

    The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. Digital radiographs of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size no.2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. In artificial caries activity model, the range of lesional depth was 572-1,374 {mu}m and the range of lesional area was 36.95-138.52 mm{sup 2}. The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.

  2. Diagnostic and clinical considerations in prolonged grief disorder.

    Science.gov (United States)

    Maercker, Andreas; Lalor, John

    2012-06-01

    This review focuses on the similarities and differences between prolonged grief disorder (PGD) and post-traumatic stress disorder (PTSD). It highlights how a PTSD-related understanding aids the investigation and clinical management of PGD. Grief has long been understood as a natural response to bereavement, as serious psychological and physiological stress has been regarded as a potential outcome of extreme or traumatic stress. PTSD was first included in DSM-III in 1980. In the mid-1980s, the first systematic investigation began into whether there is an extreme or pathological form of mourning. Meanwhile, there is much research literature on complicated, traumatic, or prolonged grief This literature is reviewed in this article, with the following questions: Is it possible to distinguish normal from non-normal grief? Which clinical presentation does PGD have-and how does this compare with PTSD? Finally, diagnostic, preventive, and therapeutic approaches and existing tools are presented.

  3. Uso de sellantes de fosas y fisuras para la prevención de caries en población infanto-juvenil: Methodological review of clinical trials Use of pit and fissure sealants for preventing caries in child population

    Directory of Open Access Journals (Sweden)

    S Faleiros Chioca

    2013-04-01

    using complementary methods for its control. Pit and fissures sealants represent one of the most effective preventive interventions in dentistry, being considered as a contribution to the public health interventions. Nevertheless, there are no consistent evidences about their true effectiveness and impact in the prevention of caries. These inconsistencies could be due to the presence of bias or the heterogeneity of the studies available in literature. Thus, we propose to make a review with the aim to evaluate the methodological quality of clinical trials using pit and fissure sealants. A search of studies between 1990 and 2012 was conducted and 18 clinical trials that fulfilled the inclusion and exclusion criteria were found. The studies included were obtained and evaluated by a single reviewer. This review concludes that the evidence that guarantees the use of this intervention is methodologically poor. These findings may stimulate the professionals to clarify the truth referring to the effectiveness of sealants, before applying it indiscriminately. The accomplishment of new clinical trials executed with an appropriate methodological design and statistical analysis is recommended, generating reliable results for the decision making that guides the Public Health Policies.

  4. Late-onset hypogonadism: etiology, clinical features, diagnostics, treatment

    Directory of Open Access Journals (Sweden)

    E. Yu. Pashkova

    2015-01-01

    Full Text Available In a critical review of the literature current data concerning etiology, clinical features, diagnostics, treatment of late-onset hypogonadism (LOH are given. LOH is a multidisciplinary problem, because a patient with LOH can have osteoporosis, anemia, depression, obesity, diabetes mellitus, erectile dysfunction. Sometimes it is hard to realize that all this complaints are symptoms of LOH. LOH has a negative impact on a patient,s quality of life and it,s impossible to help without androgen replacement therapy. Furthermore doctors often have doubts about testosterone replacement therapy safety because of lack of accurate information. In a convenient for medical practitioners form clinical and laboratory diagnostic criteria of LOH are presented together with formulas for conversion from one measurement unit of main sex hormones into another. Based on latest ISSAM guidelines (International Society for the Study of the Aging Male modern treatment options of LOH are summarized, full information about available testosterone preparations (oral, transdermal, injectable with comparative analysis of advantages and disadvantages of each is given. A full description of indications and contraindications for androgen replacement treatment is presented, also treatment regimen and medical supervision algorithm during treatment are described. 

  5. Late-onset hypogonadism: etiology, clinical features, diagnostics, treatment

    Directory of Open Access Journals (Sweden)

    E. Yu. Pashkova

    2015-04-01

    Full Text Available In a critical review of the literature current data concerning etiology, clinical features, diagnostics, treatment of late-onset hypogonadism (LOH are given. LOH is a multidisciplinary problem, because a patient with LOH can have osteoporosis, anemia, depression, obesity, diabetes mellitus, erectile dysfunction. Sometimes it is hard to realize that all this complaints are symptoms of LOH. LOH has a negative impact on a patient,s quality of life and it,s impossible to help without androgen replacement therapy. Furthermore doctors often have doubts about testosterone replacement therapy safety because of lack of accurate information. In a convenient for medical practitioners form clinical and laboratory diagnostic criteria of LOH are presented together with formulas for conversion from one measurement unit of main sex hormones into another. Based on latest ISSAM guidelines (International Society for the Study of the Aging Male modern treatment options of LOH are summarized, full information about available testosterone preparations (oral, transdermal, injectable with comparative analysis of advantages and disadvantages of each is given. A full description of indications and contraindications for androgen replacement treatment is presented, also treatment regimen and medical supervision algorithm during treatment are described. 

  6. [The sacroiliac joint dysfunction: clinical manifestations, diagnostics and manual therapy].

    Science.gov (United States)

    Grgić, Vjekoslav

    2005-01-01

    Sacroiliac joint dysfunction is one of the proved causes of sacroiliac joint syndrome. We are talking about the restricted mobility of sacrum opposite to ilium the type of "reversible blockage of movement". Main characteristics of dysfunction are as follows: restricted "joint play", referred pain, normal radiological finding, normal lab results and disappearance of clinical symptoms after deblocking of articular bodies. Pain from a blocked joint can be referred to lower back, buttocks, hip, groin, thigh, calf and lower part of abdomen. Dispersion of painful regions is a consequence of a complex and variable innervation of articular capsule. Blocked position of articular bodies and protracted tension of articular capsule causes a stimulus of nociceptors by which a capsule is protected. Nociceptive activity is manifested with referred pains in innervational region of stimulated sensitive nerves. In the article, besides the clinical manifestations, there is described a diagnostics and manual therapy of dysfunction. Springing tests by means of which a passive mobility ("joint play") is being tested, are most valuable in dysfunction diagnostics. Manual therapy (mobilization/manipulation) is indicated and efficacious with the patients suffering from dysfunction.

  7. Evaluation Clinical Effects of Anti-Septic Solution Based on Propolis in Caries-Active Children

    Directory of Open Access Journals (Sweden)

    Rossana Vanessa Dantas de ALMEIDA

    2006-04-01

    Full Text Available Objective: This study aimed validate the action of one anti-septic solution based on propolis against the clinical indexes and levels of S. mutans. Method: The antimicrobial activity of the extract was done on solid plates to determinate the Minimum Inhibitory Concentration (MIC using sorts of S. mutans. With the MIC of the extract, was made a mouthrinse solution of propolis (6.25%, which was used clinically as a test solution and compared with positive control solution, the chlorexidine (0.12%. Through the crossover design, fifteen children used the mouthrinse solution of propolis during 15 consecutive days and after a break of 21 days, they used daily mouthrinse with the chlorexidine. Were collected indexes for accumulation of oral biofilm (OHI-S and for gun disease (GBI before (T0 and 24 hours after (T1 the use of the solutions, besides of the couting of the S. mutans from saliva's samples before (T0 and 24 hours (T0, 7 days (T7, 15 days (T15 e 21 days (T21 after the end of both mouthrinses. Results: The results demonstrated significative reduction of the S. mutans levels 24 hours (p0.05. Conclusion: The propolis extract showed satisfactory antimicrobial activity and close to the chlorexidine's action, besides of act against clinical conditions of oral biofilm's presence and gun disease what becomes it useful as therapeutic agent.

  8. A novel caries risk test.

    Science.gov (United States)

    Denny, Paul C; Denny, Patricia A; Takashima, Jona; Galligan, Joyce; Navazesh, Mahvash

    2007-03-01

    A diagnostic test is particularly beneficial if it reveals the level of susceptibility prior to onset of a disease process. In the case of childhood caries, such a diagnostic test affords the opportunity for preventive measures to be implemented before caries begins. Salivary glycoproteins contain a wealth of individually specific oligosaccharide motifs. Depending on microbial compatibilities and individual genotypes, the glycoproteins that form the pellicle coating of teeth may provide attachment sites that foster colonization leading to cariogenesis. Alternatively, certain oligosaccharides, when present in nonpellicle glycoproteins, can interact with planktonic bacteria and lower their ability to interact with the tooth surface. We have found that in young adults the ratio of the two classes of oligosaccharides present in resting saliva exhibits a strong correlation with caries history (DFT: number of decayed and filled teeth). Oligosaccharide moieties associated with the test are quantitated in dried spots of whole saliva on nitrocellulose using commercially available biotinylated lectins with a variety of reporters. A combination of multiple linear regression and neural net analyses were used to develop the algorithms that describe the relationship between oligosaccharide patterns and DFT. During test development several different groups of adults and children have been studied. The correlation algorithms routinely exceed an R(2) (coefficient of determination) of 0.96. When the test is applied to the saliva of children, it yields a projection of their future caries history. Modifying the test result metric to reflect the groups of teeth with caries in young adults, the test identifies those teeth at risk for future caries in children. This test outcome can then be accompanied with suggested specific preventive measures for each tooth group-based risk level.

  9. [Dental caries--therapeutic possibilities].

    Science.gov (United States)

    Perić, Tamara; Marković, Dejan; Zivković, Slavoljub

    2008-01-01

    Contemporary tendencies in dentistry are based on the concept of maximal protection of healthy tooth tissues. Caries removal has been done traditionally with mechanical rotary instruments that are fast and precise. However, conventional cavity preparation has potential adverse effects to the pulp due to heat, pressure and vibrations. Moreover, drilling often causes pain and requires local anaesthesia, and these procedures are frequently perceived as unpleasant. Etiology, development and prevention of dental caries are better understood today and new restorative materials that bond micromechanically and/or chemically to dental tissues have been introduced. Thus, development of a new, less destructive caries removal technique is allowed. In the last decades, many alternative methods have been introduced in an attempt to replace rotary instruments. These are claimed to be efficient and selective for diseased tissues and to offer comfortable treatment to the patients. New methods include air abrasion, air polishing, ultrasonic, polymer burs, enzymes, systems for chemo-mechanical caries removal, and lasers. The aim of this paper was to discuss various caries removal techniques and possibilities of their use in clinical practice. Based on the literature review it can be concluded that none of the new caries removal methods can completely replace conventional rotary instruments.

  10. Clinical effect of photodynamic therapy on primary carious dentin after partial caries removal

    Directory of Open Access Journals (Sweden)

    Pierre Adriano Moreno NEVES

    2016-01-01

    Full Text Available Abstract This study was conducted to assess the clinical effect of photodynamic therapy (PDT in the decontamination of the deep dentin of deciduous molars submitted to partial removal of carious tissue. After cavity preparation, dentin samples were taken from the pulp wall of nineteen deciduous molars before and after PDT application. Remaining dentin was treated with 0.01% methylene blue dye followed by irradiation with an InGaAlP diode laser (λ – 660 nm; 40 mW; 120 J/cm2; 120 s. Dentin samples were microbiologically assessed for the enumeration of total microorganisms, Lactobacillus spp. and mutans streptococci. There was no significant difference in the number of colony-forming units (CFU for any of the microorganisms assessed (p > 0.05. Photodynamic therapy, using 0.01% methylene blue dye at a dosimetry of 120 J/cm2 would not be a viable clinical alternative to reduce bacterial contamination in deep dentin.

  11. What is the role of clinical tests and ultrasound in acetabular labral tear diagnostics?

    DEFF Research Database (Denmark)

    Troelsen, Anders; Mechlenburg, Inger; Gelineck, John;

    2009-01-01

    BACKGROUND AND PURPOSE: An acetabular labral tear is a diagnostic challenge. Various clinical tests have been described, but little is known about their diagnostic sensitivity and specificity. We investigated the diagnostic validity of clinical tests and ultrasound as compared with MR arthrograph...

  12. Optical Assessment of Caries Lesion Structure and Activity

    Science.gov (United States)

    Lee, Robert Chulsung

    New, more sophisticated diagnostic tools are needed for the detection and characterization of caries lesions in the early stages of development. It is not sufficient to simply detect caries lesions, methods are needed to assess the activity of the lesion and determine if chemical or surgical intervention is needed. Previous studies have demonstrated that polarization sensitive optical coherence tomography (PS-OCT) can be used to nondestructively image the subsurface lesion structure and measure the thickness of the highly mineralized surface zone. Other studies have demonstrated that the rate of dehydration can be correlated with the lesion activity and that the rate can be measured using optical methods. The main objective of this work was to test the hypothesis that optical methods can be used to assess lesion activity on tooth coronal and root surfaces. Simulated caries models were used to develop and validate an algorithm for detecting and measuring the highly mineralized surface layer using PS-OCT. This work confirmed that the algorithm was capable of estimating the thickness of the highly mineralized surface layer with high accuracy. Near-infrared (NIR) reflectance and thermal imaging methods were used to assess activity of caries lesions by measuring the state of lesion hydration. NIR reflectance imaging performed the best for artificial enamel and natural coronal caries lesion samples, particularly at wavelengths coincident with the water absorption band at 1460-nm. However, thermal imaging performed the best for artificial dentin and natural root caries lesion samples. These novel optical methods outperformed the conventional methods (ICDAS II) in accurately assessing lesion activity of natural coronal and root caries lesions. Infrared-based imaging methods have shown potential for in-vivo applications to objectively assess caries lesion activity in a single examination. It is likely that if future clinical trials are a success, this novel imaging

  13. Caries-preventive Effect of Supervised Toothbrushing and Sealants

    NARCIS (Netherlands)

    Hilgert, L.A.; Leal, S.C.; Mulder, J.; Creugers, N.H.J.; Frencken, J.E.F.M.

    2015-01-01

    To investigate the effectiveness of 3 caries-preventive measures on high- and low-caries risk occlusal surfaces of first permanent molars over 3 y. This cluster-randomized controlled clinical trial covered 242 schoolchildren, 6 to 7 y old, from low socioeconomic areas. At baseline, caries risk was a

  14. Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease

    Science.gov (United States)

    Kallenberg, K.; Summers, D. M.; Romero, C.; Taratuto, A.; Heinemann, U.; Breithaupt, M.; Varges, D.; Meissner, B.; Ladogana, A.; Schuur, M.; Haik, S.; Collins, S. J.; Jansen, Gerard H.; Stokin, G. B.; Pimentel, J.; Hewer, E.; Collie, D.; Smith, P.; Roberts, H.; Brandel, J. P.; van Duijn, C.; Pocchiari, M.; Begue, C.; Cras, P.; Will, R. G.; Sanchez-Juan, P.

    2009-01-01

    Several molecular subtypes of sporadic Creutzfeldt–Jakob disease have been identified and electroencephalogram and cerebrospinal fluid biomarkers have been reported to support clinical diagnosis but with variable utility according to subtype. In recent years, a series of publications have demonstrated a potentially important role for magnetic resonance imaging in the pre-mortem diagnosis of sporadic Creutzfeldt–Jakob disease. Magnetic resonance imaging signal alterations correlate with distinct sporadic Creutzfeldt–Jakob disease molecular subtypes and thus might contribute to the earlier identification of the whole spectrum of sporadic Creutzfeldt–Jakob disease cases. This multi-centre international study aimed to provide a rationale for the amendment of the clinical diagnostic criteria for sporadic Creutzfeldt–Jakob disease. Patients with sporadic Creutzfeldt–Jakob disease and fluid attenuated inversion recovery or diffusion-weight imaging were recruited from 12 countries. Patients referred as ‘suspected sporadic Creutzfeldt–Jakob disease’ but with an alternative diagnosis after thorough follow up, were analysed as controls. All magnetic resonance imaging scans were assessed for signal changes according to a standard protocol encompassing seven cortical regions, basal ganglia, thalamus and cerebellum. Magnetic resonance imaging scans were evaluated in 436 sporadic Creutzfeldt–Jakob disease patients and 141 controls. The pattern of high signal intensity with the best sensitivity and specificity in the differential diagnosis of sporadic Creutzfeldt–Jakob disease was identified. The optimum diagnostic accuracy in the differential diagnosis of rapid progressive dementia was obtained when either at least two cortical regions (temporal, parietal or occipital) or both caudate nucleus and putamen displayed a high signal in fluid attenuated inversion recovery or diffusion-weight imaging magnetic resonance imaging. Based on our analyses, magnetic

  15. Clinical presentation and diagnostic difficulties in amoebic liver abscess

    Directory of Open Access Journals (Sweden)

    Kaushal D Suthar

    2014-07-01

    Full Text Available Background Amoebic liver abscess (ALA is a common and major health problem in India. ALA has a highly variable presentation, causing diagnostic difficulties. Early and correct diagnosis of Amoebic liver abscess is essential, because delayed diagnosis and treatment leads to complications which has significantly higher morbidity and mortality than uncomplicated disease. Objective To find out different clinical presentation and its differential diagnosis in order to establish early diagnosis of ALA. Patients and Methods This retrospective, observational study was carried out in the Department of Surgery during February 2010 to May 2013. Inclusion criteria were defined. The data of patients were enrolled according to variables in performa predesigned for this study and analyzed. Results 187 cases of ALA were enrolled with male to female ratio of 2.8:1. Right hypochondrial pain occurred in 69.52%, left hypochondrial pain occurred in 6.41%, pain radiating to tip of right shoulder in 8.02%, fever in 86.64%, co-incident diarrhea in 36.37% and concurrent pulmonary symptoms in 12.84%. The most common signs were tender hepatomegaly in 73.74% and jaundice in 17.65%. 3.20% patients had past history of aspiration of ALA. 23.52% patients had ruptured abscess. 11.12% were due to delayed diagnosis and 1.60% was ruptured despite treatment. Mortality rate was 3.20% amongst patients with ruptured ALA. Diabetes, hypertension, AIDS and alcoholism were commonly associated co morbidities. Right lobe (82.36% is commonly involved than left lobe and single abscess (83.42% was more common than multiple abscess. Diagnosis was missed in 30.48% patients particularly those with atypical presentations. Ultrasonography, Computerized tomography (CT scan with diagnostic aspiration were useful in diagnosing ALA. Conclusion The typical features of ALA, which include pain, fever and tender hepatomegaly, are nonspecific. ALA may be missed because of variable clinical features and

  16. Incipient caries lesions: from concept to actual treatment approaches

    OpenAIRE

    Araújo, Diana; Alencar, Marina; Freitas, Maria Cristina; Azevedo, Larissa; Atta, Maria; Wang, Linda

    2014-01-01

    The concepts introduced by the Minimally Invasive Dentistry (MID) allowed the rising of new conservative treatment and assessment system for caries lesions’ classification.  In this context, the approaches of the incipient caries lesions surpass the use of only traditional restorative techniques. The aim of this study was to review the new caries classifications criteria (ICDAS and CAST), the importance of the early diagnosis of caries lesions and the clinical procedures for treatment in MID.

  17. Effectiveness of Two Self-Etchings Bonded Clinically in Caries Affected Dentin with Homogeneous Smear Layer

    Directory of Open Access Journals (Sweden)

    Roberto Pinna

    2015-01-01

    Full Text Available Aim. To examine the interface of two self-etchings in carious affected dentin (CAD, under clinical conditions. Materials and Methods. Class I cavities were prepared in 21 carious premolars, refining them by the use of a fine diamond bur in order to create similar smear layer interference. The mild self-etching Clearfil SE Bond (CSE, pH = 2.0, and the strong Tyrian SPE-One Step Plus (TSO, pH = 0.5, were applied followed by a composite. Teeth were extracted and processed for TEM. The primer’s osmolarity of the self-etchings was also calculated using a microosmometer. Results. CSE hybrid layer retained smear layer residues and scattered crystallites as an effect of the mild acidity. A high presence of hydroxyapatite still protected the affected fibres within the hybrid layer. CSE primer demonstrated values of 3220 mOsm/kg. TSO interdiffusion showed strong demineralization. Resin tags were not formed in the dentinal tubules which remained obstructed by crystals. However, dissolution of peritubular dentin and porosities were observed in the intertubular regions. The osmolarity of TSO was 8200 mOsm/kg. Conclusion. Increasing the acidity and osmolarity of the self-etchings increases interference in the homogeneous reinforcement of CAD, which may predispose the hybrid layer to instability and hydrolytic degradation overtime.

  18. The usefulness of the consensus clinical diagnostic criteria in Brugada syndrome

    NARCIS (Netherlands)

    Sarkozy, A.; Paparella, G.; Boussy, T.; Casado-Arroyo, R.; Yazaki, Y.; Chierchia, G.B.; Asmundis, C. de; Bayrak, F.; Namdar, M.; Richter, S.; Brugada, J.; Brugada, P.

    2013-01-01

    BACKGROUND: Consensus statements were proposed for the diagnosis of Brugada syndrome (BS). The clinical diagnostic criteria were defined as documented ventricular fibrillation or ventricular tachycardia (VT), family history of sudden cardiac death at <45 years, diagnostic ECGs of family members,

  19. Updates on chikungunya epidemiology, clinical disease, and diagnostics.

    Science.gov (United States)

    Sam, I-Ching; Kümmerer, Beate M; Chan, Yoke-Fun; Roques, Pierre; Drosten, Christian; AbuBakar, Sazaly

    2015-04-01

    Chikungunya virus (CHIKV) is an Aedes-borne alphavirus, historically found in Africa and Asia, where it caused sporadic outbreaks. In 2004, CHIKV reemerged in East Africa and spread globally to cause epidemics, including, for the first time, autochthonous transmission in Europe, the Middle East, and Oceania. The epidemic strains were of the East/Central/South African genotype. Strains of the Asian genotype of CHIKV continued to cause outbreaks in Asia and spread to Oceania and, in 2013, to the Americas. Acute disease, mainly comprising fever, rash, and arthralgia, was previously regarded as self-limiting; however, there is growing evidence of severe but rare manifestations, such as neurological disease. Furthermore, CHIKV appears to cause a significant burden of long-term morbidity due to persistent arthralgia. Diagnostic assays have advanced greatly in recent years, although there remains a need for simple, accurate, and affordable tests for the developing countries where CHIKV is most prevalent. This review focuses on recent important work on the epidemiology, clinical disease and diagnostics of CHIKV.

  20. Clinical Applications of the Eosinophilic Esophagitis Diagnostic Panel

    Directory of Open Access Journals (Sweden)

    Ting Wen

    2017-07-01

    Full Text Available Eosinophilic esophagitis (EoE is a recently recognized upper gastrointestinal allergic disorder characterized by esophageal dysfunction (e.g., dysphagia and esophageal eosinophilia of ≥15 eosinophils/high-power field in patients who have persistent esophagitis even on proton pump inhibitor (PPI therapy. The histologic method is the gold standard of EoE diagnosis. However, EoE clinical symptoms do not always correlate with histology, and the histologic method has sensitivity and specificity issues due to the patchiness of EoE and the subjective nature of the method. The “EoE transcriptome” was initially discovered in 2006, which led to the invention of the EoE diagnostic panel (EDP. In addition to providing a definitive EoE diagnosis with high accuracy, the EDP has been useful in elucidating several key elements about the disease including the efficacy of specific drugs such as swallowed glucocorticoids and anti-IL-13 humanized antibody therapy, the relationship between EoE and PPI-responsive esophageal eosinophilia, and predicting the disease course and responsiveness to therapy. The EDP’s long-term potential arises from its plasticity to incorporate new genes and uncover novel disease pathogenesis. We expect that the EDP will be increasingly helpful for personalized medicine approaches and improved diagnostics and disease monitoring.

  1. [Clinical value of scanning laser polarimetry in glaucoma diagnostics].

    Science.gov (United States)

    Kremmer, S; Anastassiou, G; Selbach, J M

    2012-02-01

    The term glaucoma is used as a melting pot of many different diseases which have in common that the retinal ganglion cells and their axons are damaged. Untreated, apoptosis can be induced causing ganglion cell death which subsequently leads to typical glaucomatous damage at the optic nerve head, scotomas of the visual fields, and in the worst case scenario to blindness. It is well known that patients with glaucoma can suffer a 20 to 50 % loss of retinal ganglion cells before a defect becomes evident in standard white on white perimetry. To prevent glaucomatous damage, it is important to detect changes of the retinal ganglion cells and their nerve fibre layer as early as possible and to monitor their follow-up as closely as possible in order to find an adequate treatment of glaucoma, and to control its efficiency. In the past few years, scanning laser polarimetry by means of GDx technology (Carl Zeiss Meditec, Dublin, USA) could be established as a new method to measure the retinal nerve fibre layer not only qualitatively but even quantitatively. Presently, the GDx plays an important role in actual glaucoma diagnostics on account of its high resolution, the comfort for both patient and user, and its highly reproducible measurements. Especially in difficult evaluable optic nerve heads (e. g., micro- and macrodiscs), tilted discs, and optic disc anomalies (e. g., optic nerve drusen) modern nerve fibre diagnostics by means of GDx technology is a helpful enrichment in clinical routine.

  2. Caries prevention by professional fluoride gel application on enamel and dentinal lesions in low-caries children.

    NARCIS (Netherlands)

    Truin, G.J.; Hof, M.A. van 't

    2005-01-01

    In a double-blind randomized controlled clinical trial, the caries-reducing effect of semi-annually applied fluoride gel in a low-caries child population initially aged 4.5-6.5 years (n = 773) has been investigated. Secondary analyses of the data were performed to study the caries reduction includin

  3. Caries prevention by professional fluoride gel application on enamel and dentinal lesions in low-caries children.

    NARCIS (Netherlands)

    Truin, G.J.; Hof, M.A. van 't

    2005-01-01

    In a double-blind randomized controlled clinical trial, the caries-reducing effect of semi-annually applied fluoride gel in a low-caries child population initially aged 4.5-6.5 years (n = 773) has been investigated. Secondary analyses of the data were performed to study the caries reduction includin

  4. Constructing diagnostic likelihood: clinical decisions using subjective versus statistical probability.

    Science.gov (United States)

    Kinnear, John; Jackson, Ruth

    2017-07-01

    Although physicians are highly trained in the application of evidence-based medicine, and are assumed to make rational decisions, there is evidence that their decision making is prone to biases. One of the biases that has been shown to affect accuracy of judgements is that of representativeness and base-rate neglect, where the saliency of a person's features leads to overestimation of their likelihood of belonging to a group. This results in the substitution of 'subjective' probability for statistical probability. This study examines clinicians' propensity to make estimations of subjective probability when presented with clinical information that is considered typical of a medical condition. The strength of the representativeness bias is tested by presenting choices in textual and graphic form. Understanding of statistical probability is also tested by omitting all clinical information. For the questions that included clinical information, 46.7% and 45.5% of clinicians made judgements of statistical probability, respectively. Where the question omitted clinical information, 79.9% of clinicians made a judgement consistent with statistical probability. There was a statistically significant difference in responses to the questions with and without representativeness information (χ2 (1, n=254)=54.45, pstatistical probability. One of the causes for this representativeness bias may be the way clinical medicine is taught where stereotypic presentations are emphasised in diagnostic decision making. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. 氟保护漆预防儿童龋齿的效果观察%The clinical effect of fluoride varnish on preventing the dental caries in children

    Institute of Scientific and Technical Information of China (English)

    谢红

    2016-01-01

    Objective:To investigate the clinical effects of fluor varnish on preventing the dental caries in children. Methods:Seventy children were randomly divided into the control group and observation group(38 cases each group,80 teeth). The dental caries in control group and observation group were prevented using fissure sealant and fluor varnish combined with fissure sealant,respectively. All cases were followed up for 1 to 2 years,the occurrence of dental caries and sealant falling in two groups were observed. Results:The differences of the occurrences of dental caries and interproximal caries between two groups were not statistical significance(P>0. 05). The mean of caries and sealant falling in observation group were lower than those in control group(P 0.05),而龋均值明显低于对照组(P<0.01)。观察组儿童封闭剂脱落程度亦低于对照组(P<0.05)。结论:临床应用氟保护漆联合窝沟封闭术预防儿童龋齿具有较好效果,且氟保护漆可有效保护窝沟封闭剂,避免其脱落,进而可加强预防效果。

  6. Diagnosing dental caries in populations with different levels of dental fluorosis

    DEFF Research Database (Denmark)

    Nyvad, Bente; Machiulskiene, Vita; Fejerskov, Ole

    2009-01-01

    concentrations of 0.3 and 1.1 ppm (0.3 and 1.1 mg/l) fluoride, respectively, 150 children were clinically examined twice, 2 wk apart, for dental fluorosis, using the Thylstrup-Fejerskov index (TF index), and for dental caries using the Nyvad visual-tactile caries criteria. The prevalence of dental fluorosis......The aim of this study was to assess the reliability of the Nyvad visual-tactile caries-diagnostic criteria when used among children who have been lifelong residents in areas with 'optimal' or low concentrations of fluoride in the drinking water. In each of two areas with drinking water fluoride.......72, respectively). When individual DFS counts were compared across examinations using Bland-Altman plots and estimation of prediction intervals for the differences, we observed a greater variability of the differences between recordings among children from the low-fluoride area. Contrary to our expectations...

  7. Clinical Observation of the Effect of Iodine Gel in the Treatment of Dental Caries%伢碘凝胶治疗龋齿的临床探讨

    Institute of Scientific and Technical Information of China (English)

    宋传波

    2015-01-01

    Objective To investigate the clinical therapeutic effect of iodine gel in the treatment of dental caries. Methods 178 cases with dental caries treated by iodine gel and other 178 cases with dental caries treated by turbine drilling in Stomatology Department from January 2012 to December 2014 were selected as the observation group and the control group, respectively. And the therapeutic effects of the two groups were compared. Results The response rate of the observation group was 100%, and that of the control group was 80.3%, the difference between the two groups was statistically significant (P<0.05). Conclusion For the treatment of dental caries, iodine gel has satisfactory clinical effects, which can significantly improve the chewing function, so it is worthy of clinical application and promotion energetically.%目的:探讨伢碘凝胶治疗龋齿的临床治疗效果。方法整群选取牙科2012年1月-2014年12月采用伢碘凝胶治疗龋齿的患者178例为观察组,选取牙科同期采用涡轮机钻牙治疗龋齿的178例患者为对照组,比较两组治疗效果。结果观察组给予伢碘凝胶治疗后,治疗有效率为100%,对照组给予涡轮机钻牙治疗后,治疗有效率为80.3%,两组结果比较具有可比性(P<0.05)。结论伢碘凝胶治疗龋齿临床效果满意,可以明显提高牙齿的咀嚼功能,值得在临床上大力推广应用。

  8. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management.

    Science.gov (United States)

    Windfuhr, Jochen P; Toepfner, Nicole; Steffen, Gregor; Waldfahrer, Frank; Berner, Reinhard

    2016-04-01

    More than 120,000 patients are treated annually in Germany to resolve repeated episodes of acute tonsillitis. Therapy is aiming at symptom regression, avoidance of complications, reduction in the number of disease-related absences in school or at work, increased cost-effectiveness and improved quality of life. The purpose of this part of the guideline is to provide clinicians in any setting with a clinically focused multi-disciplinary guidance through different conservative treatment options in order to reduce inappropriate variation in clinical care, improve clinical outcome and reduce harm. Surgical management in terms of intracapsular as well as extracapsular tonsillectomy (i.e. tonsillotomy) is the subject of part II of this guideline. To estimate the probability of tonsillitis caused by β-hemolytic streptococci, a diagnostic scoring system according to Centor or McIsaac is suggested. If therapy is considered, a positive score of ≥3 should lead to pharyngeal swab or rapid test or culture in order to identify β-hemolytic streptococci. Routinely performed blood tests for acute tonsillitis are not indicated. After acute streptococcal tonsillitis, there is no need to repeat a pharyngeal swab or any other routine blood tests, urine examinations or cardiological diagnostics such as ECG. The determination of the antistreptolysin O-titer (ASLO titer) and other antistreptococcal antibody titers do not have any value in relation to acute tonsillitis with or without pharyngitis and should not be performed. First-line therapy of β-hemolytic streptococci consists of oral penicillin. Instead of phenoxymethylpenicillin-potassium (penicillin V potassium), also phenoxymethlpenicillin-benzathine with a clearly longer half-life can be used. Oral intake for 7 days of one of both the drugs is recommended. Alternative treatment with oral cephalosporins (e.g. cefadroxil, cefalexin) is indicated only in cases of penicillin failure, frequent recurrences, and whenever a more

  9. Clinical diagnostic potentials of thyroid ultrasonography and scintigraphy; An evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Tatsuo; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Konishi, Junji (Kyoto Univ. (Japan). Hospital); Endo, Keigo

    1993-06-01

    This prospective study was designed to evaluate the potential contributions of high resolution ultrasonography (US) and Tc-99m scintigraphy in the routine diagnosis of thyroid disease. The diagnostic impacts of US and Tc-99m scintigraphy results in 177 patients visiting our thyroid clinic were assessed and scored according to the following criteria: when the information provided by either test supported, confirmed or changed the initial clinical diagnosis, they received scores of 2, 3 and 4 respectively, while score 1 was given when the test itself was useless for the differential diagnosis. US identified focal lesions that both palpation and scintigraphy had failed to detect in 14 (12.1%) of 116 patients with diffuse thyroid diseases, suggesting the necessity of Hashimoto's thyroiditis, adenoma, adenocarcinoma and adenomatous goiter, and vice versa in the diagnosis of hyperthyroid and euthyroid Graves's diseases. Thus, the advantages of US over scintigraphy for morphological evaluation were confirmed. US was particularly useful for the differential diagnosis of adenomatous goiter from Hashimoto's thyroiditis or a single nodular disease. In contrast, scintigraphy gave functional images, being especially helpful for the differential diagnosis of thyrotoxicosis. (author).

  10. Diagnostic and clinical classification of autoimmune myasthenia gravis.

    Science.gov (United States)

    Berrih-Aknin, Sonia; Frenkian-Cuvelier, Mélinée; Eymard, Bruno

    2014-01-01

    Myasthenia gravis is characterized by muscle weakness and abnormal fatigability. It is an autoimmune disease caused by the presence of antibodies against components of the muscle membrane localized at the neuromuscular junction. In most cases, the autoantibodies are against the acetylcholine receptor (AChR). Recently, other targets have been described such as the MuSK protein (muscle-specific kinase) or the LRP4 (lipoprotein related protein 4). Myasthenia gravis can be classified according to the profile of the autoantibodies, the location of the affected muscles (ocular versus generalized), the age of onset of symptoms and thymic abnormalities. The disease generally begins with ocular symptoms (ptosis and/or diplopia) and extends to other muscles in 80% of cases. Other features that characterize MG include the following: variability, effort induced worsening, successive periods of exacerbation during the course of the disease, severity dependent on respiratory and swallowing impairment (if rapid worsening occurs, a myasthenic crisis is suspected), and an association with thymoma in 20% of patients and with other autoimmune diseases such as hyperthyroidism and Hashimoto's disease. The diagnosis is based on the clinical features, the benefit of the cholinesterase inhibitors, the detection of specific autoantibodies (anti-AChR, anti-MuSK or anti-LRP4), and significant decrement evidenced by electrophysiological tests. In this review, we briefly describe the history and epidemiology of the disease and the diagnostic and clinical classification. The neonatal form of myasthenia is explained, and finally we discuss the main difficulties of diagnosis.

  11. Filtering Medline for a clinical discipline: diagnostic test assessment framework

    Science.gov (United States)

    Iansavichus, Arthur V; Wilczynski, Nancy L; Kastner, Monika; Baier, Leslie A; Shariff, Salimah Z; Rehman, Faisal; Weir, Matthew; McKibbon, K Ann; Haynes, R Brian

    2009-01-01

    Objective To develop and test a Medline filter that allows clinicians to search for articles within a clinical discipline, rather than searching the entire Medline database. Design Diagnostic test assessment framework with development and validation phases. Setting Sample of 4657 articles published in 2006 from 40 journals. Reviews Each article was manually reviewed, and 19.8% contained information relevant to the discipline of nephrology. The performance of 1 155 087 unique renal filters was compared with the manual review. Main outcome measures Sensitivity, specificity, precision, and accuracy of each filter. Results The best renal filters combined two to 14 terms or phrases and included the terms “kidney” with multiple endings (that is, truncation), “renal replacement therapy”, “renal dialysis”, “kidney function tests”, “renal”, “nephr” truncated, “glomerul” truncated, and “proteinuria”. These filters achieved peak sensitivities of 97.8% and specificities of 98.5%. Performance of filters remained excellent in the validation phase. Conclusions Medline can be filtered for the discipline of nephrology in a reliable manner. Storing these high performance renal filters in PubMed could help clinicians with their everyday searching. Filters can also be developed for other clinical disciplines by using similar methods. PMID:19767336

  12. 氟保护漆预防儿童乳牙龋齿的临床效果%The clinical effect of Fluoride varnish in preventing caries of primary teeth

    Institute of Scientific and Technical Information of China (English)

    李闻博

    2012-01-01

    Objective To investigate the fluoride varnish in preventing caries of primary teeth clinical effect. Methods Two large kindergarten in 600 children were randomly divided into the observation group and the control group.the observation group used fluoride coatings on dental protection, control group were brushing in the morning and evening, mouthwash after meals and other conventional oral care;used once every six months.the experimental period of 2 years.Before and after the experiment on two groups of children dental caries were inspected,the accurate statistics of the two inspection of the prevalence of caries.caries surface and new caries surface. Results Before the experiment of two groups of children with caries rate and caries surface data did not differ significantly,after the experiment group was observed in the rate of caries and caries surface data are significantly lower than the control group.the difference between the two groups (P<0.05) with statistical significance. Conclusion The fluoride varnish on prevention of caries of primary teeth has obvious clinical effect.%目的:探讨氟保护漆预防儿童乳牙龋齿的临床效果.方法:将我市几所大型幼儿园的600名儿童随机分成观察组和对照组,观察组使用含氟涂料对牙齿进行保护,对照组进行早晚刷牙、饭后漱口等常规的口腔护理;每六个月使用一次,实验为期2年.在实验前后分别对两组儿童龋齿情况进行检查,准确统计两次检查的患龋率、龋面均和新增龋面均.结果:实验前两组儿童的患龋率和龋面均数据没有明显差异,实验后观察组的患龋率和龋面均数据明显低于对照组,两组差异(P<0.05)具有统计学意义.结论:氟保护漆对预防儿童乳牙龋齿有明显的临床效果.

  13. Clinical study of the use of the laser fluorescence device DIAGNOdent for detection of occlusal caries in children.

    Science.gov (United States)

    Anttonen, V; Seppä, L; Hausen, H

    2003-01-01

    Diagnosis of non-cavitated occlusal caries is generally considered problematic. The aim of this study was to evaluate the utility of the laser fluorescence device DIAGNOdent as part of routine dental check-ups in children. A total of 613 occlusal surfaces on permanent molars and 436 surfaces on primary molars in children aged 7-8 (n = 55) and 13-14 years (n = 54) were examined visually, using DIAGNOdent and for most 13- to 14-year-olds also using radiographs. The teeth were not cleaned professionally before examination. To provide a gold standard for carious teeth, the depth of the caries lesion was determined in those lesions that were judged visually to need opening by drilling (51 teeth). The higher the visual score, the higher were the mean DIAGNOdent values, but in each visual category the variation among values was large. The presence of a clear sealant did not affect DIAGNOdent measurements. The values for permanent and primary molars differed slightly. For permanent teeth, Youden's index value was highest (60%) at a cut-off value of 30, which indicates that the overall performance for DIAGNOdent in detecting dentinal caries was best at this point. Using this cut-off, sensitivity was 92% and specificity 69% with visual examination for validation, while sensitivity was 92% and specificity 82% with validation by fissure opening. Of the three methods, radiographic examination was the least accurate. In routine dental check-ups of children, DIAGNOdent appears to be useful as an adjunct to visual examination.

  14. Autoimmune liver serology: Current diagnostic and clinical challenges

    Institute of Scientific and Technical Information of China (English)

    Dimitrios P Bogdanos; Pietro Invernizzi; Ian R Mackay; Diego Vergani

    2008-01-01

    Liver-related autoantibodies are crucial for the correct diagnosis and classification of autoimmune liver diseases (AiLD), namely autoimmune hepatitis types 1 and 2 (AIH-1 and 2), primary biliary cirrhosis (PBC),and the sclerosing cholangitis variants in adults and children.AIH-1 is specified by anti-nuclear antibody (ANA) and smooth muscle antibody (SMA). AIH-2 is specified by antibody to liver kidney microsomal antigen type-1 (anti-LKM1) and anti-liver cytosol type 1 (anti-LC1).SMA,ANA and anti-LKM antibodies can be present in de-novo AIH following liver transplantation.PBC is specified by antimitochondrial antibodies (AMA) reacting with enzymes of the 2-oxo-acid dehydrogenase complexes (chiefly pyruvate dehydrogenase complex E2 subunit) and disease-specific ANA mainly reacting with nuclear pore gp210 and nuclear body sp100. Sclerosing cholangitis presents as at least two variants,first the classical primary sclerosing cholangitis (PSC) mostly affecting adult men wherein the only (and nonspecific) reactivity is an atypical perinuclear antineutrophil cytoplasmic antibody (p-ANCA),also termed perinuclear anti-neutrophil nuclear antibodies (p-ANNA) and second the childhood disease called autoimmune sclerosing cholangitis (ASC) with serological features resembling those of type 1 AIH.Liver diagnostic serology is a fast-expanding area of investigation as new purified and recombinant autoantigens,and automated technologies such as ELISAs and bead assays,become available to complement (or even compete with) traditional immunofluorescence procedures.We survey for the first time global trends in quality assurance impacting as it does on (1) manufacturers/purveyors of kits and reagents,(2) diagnostic service laboratories that fulfill clinicians'requirements, and (3) the end-user,the physician providing patient care,who must properly interpret test results in the overall clinical context.

  15. Diagnostic Methods for Bile Acid Malabsorption in Clinical Practice

    Science.gov (United States)

    Vijayvargiya, Priya; Camilleri, Michael; Shin, Andrea; Saenger, Amy

    2013-01-01

    Altered bile acid (BA) concentrations in the colon may cause diarrhea or constipation. BA malabsorption (BAM) accounts for >25% of patients with irritable bowel syndrome (IBS) with diarrhea and chronic diarrhea in Western countries. As BAM is increasingly recognized, proper diagnostic methods are desired in clinical practice to help direct the most effective treatment course for the chronic bowel dysfunction. This review appraises the methodology, advantages and disadvantages of 4 tools that directly measure BAM: 14C-glycocholate breath and stool test, 75Selenium HomotauroCholic Acid Test (SeHCAT), 7 α-hydroxy-4-cholesten-3-one (C4) and fecal BAs. 14C-glycocholate is a laborious test no longer widely utilized. 75SeHCAT is validated, but not available in the United States. Serum C4 is a simple, accurate method that is applicable to a majority of patients, but requires further clinical validation. Fecal measurements to quantify total and individual fecal BAs are technically cumbersome and not widely available. Regrettably, none of these tests are routinely available in the U.S., and a therapeutic trial with a BA binder is used as a surrogate for diagnosis of BAM. Recent data suggest there is an advantage to studying fecal excretion of the individual BAs and their role in BAM; this may constitute a significant advantage of the fecal BA method over the other tests. Fecal BA test could become a routine addition to fecal fat measurement in patients with unexplained diarrhea. In summary, availability determines the choice of test among C4, SeHCAT and fecal BA; more widespread availability of such tests would enhance clinical management of these patients. PMID:23644387

  16. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

    Full Text Available Nonsuicidal self-injury (NSSI is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls. Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

  17. Evaluation of non-microbial salivary caries activity parameters and salivary biochemical indicators in predicting dental caries

    Directory of Open Access Journals (Sweden)

    A Kaur

    2012-01-01

    Full Text Available Aim: The aim of the present study was the evaluation of non-microbial salivary caries activity parameters and salivary biochemical indicators in predicting dental caries. Materials and Methods: The present study was carried out on 60 children, aged 4-6 years, selected from the schools of Panchkula district, Haryana, on the basis of their caries status. Level of hydration, flow rate, pH, buffering capacity, relative viscosity, calcium, phosphorus and alkaline phosphatase levels in caries-free and caries-active children were evaluated. Results: Results showed that 90% of subjects in the caries-free group and 30% of subjects in the caries-active group had normal level of hydration value of less than 60 s and the difference was found to be statistically very highly significant. Normal flow rate of stimulated saliva was found in 90% of the subjects in caries-free group and 33.3% subjects in the caries active group and difference was found to be statistically very highly significant. Adequate salivary pH was found in 100% subjects in caries-free group and 30% in caries-active group and the difference was statistically very highly significant. Conclusion: To conclude, within limitations of this study, it became clear that normal level of hydration and higher values for flow rate, pH, buffering capacity of saliva lead to good oral health and a reduced caries occurrence. Increased salivary viscosity plays a role in increasing caries incidence. Salivary biochemical indicators like calcium, phosphorus and alkaline phosphatase also play their respective role in determining caries susceptibility of an individual. These salivary parameters can be used as diagnostic tool for caries risk assessment.

  18. Developments in caries diagnosis and their relationship to treatment decisions and quality of care - ORCA Saturday Afternoon Symposium 1997

    NARCIS (Netherlands)

    Verdonschot, EH; Angmar-Mansson, B; ten Bosch, JJ; Deery, CH; Huysmans, MCDNJM; Pitts, NB; Waller, E

    1999-01-01

    This symposium report evaluates the achievements made in caries diagnostic research since the previous symposium held in 1992. The symposium aimed at presenting the state of the art of caries diagnostic methods, on presenting the links between caries diagnosis and subsequent treatment decisions and

  19. Biological approach of dental caries management.

    Science.gov (United States)

    Grigalauskienė, Rūta; Slabšinskienė, Eglė; Vasiliauskienė, Ingrida

    2015-01-01

    Dental caries is a disease induced by dental plaque, which can be described as a community of microorganisms (biofilm). Because of genetic and environmental factors a number of changes in the oral microbiome takes place; in case of commensalism and mutualism between biofilm microorganisms and the host, homeostasis in oral microbiome is maintained. However, when a risk factor occurs parasitic relationship starts prevailing and activity of the pathogenic cariogenic microorganisms increases leading to a dental caries. According to the newest technologies of molecular microbiology new cariogenic microorganisms species have been determined. Each individual's oral microbiome is as unique as his/her immune system; therefore, commonly taken caries prevention measures cannot be of the same effectiveness for all individuals. Each person has his own caries risk which is determined by the oral microbiome and immune system influenced by the environmental and genetic factors. Early caries diagnostic, risk assessment and individualized caries prevention plan will allow us to control the disease and achieve a desirable effect. For the dentist the most important thing is not to treat the consequences of the disease - cavities - but be aware of the dental caries as a biological phenomenon.

  20. Genetic factors affecting dental caries risk.

    Science.gov (United States)

    Opal, S; Garg, S; Jain, J; Walia, I

    2015-03-01

    This article reviews the literature on genetic aspects of dental caries and provides a framework for the rapidly changing disease model of caries. The scope is genetic aspects of various dental factors affecting dental caries. The PubMed database was searched for articles with keywords 'caries', 'genetics', 'taste', 'diet' and 'twins'. This was followed by extensive handsearching using reference lists from relevant articles. The post-genomic era will present many opportunities for improvement in oral health care but will also present a multitude of challenges. We can conclude from the literature that genes have a role to play in dental caries; however, both environmental and genetic factors have been implicated in the aetiology of caries. Additional studies will have to be conducted to replicate the findings in a different population. Identification of genetic risk factors will help screen and identify susceptible patients to better understand the contribution of genes in caries aetiopathogenesis. Information derived from these diverse studies will provide new tools to target individuals and/or populations for a more efficient and effective implementation of newer preventive measures and diagnostic and novel therapeutic approaches in the management of this disease.

  1. Early childhood caries: an update.

    Science.gov (United States)

    Ramalingam, Lochana; Messer, Louise Brearley

    2004-12-01

    Early childhood caries is the currently accepted term used to describe dental caries occurring in infants and toddlers. It is a multifactorial, transmissible and infectious disease that has recently been under scrutiny in the literature. The microflora, substrate, saliva and host are key factors involved in the pathogenesis, together with the immature host defence system and developing bacterial flora. Immature enamel surfaces and developmental defects of enamel should also be considered in the aetiology. This paper addresses the controversies of the cariogenicity of bovine milk, human breast milk and infant formulas. Clinical management should be planned according to age, extent of lesions, compliance of primary caregivers and where treatment is rendered (private or public sector). Cases of early childhood caries need comprehensive restorative management and preventive treatment together with the help of other health care professionals.

  2. Etiology of nursing caries: a microbiologic perspective.

    Science.gov (United States)

    Berkowitz, R

    1996-01-01

    A compelling body of scientific evidence supports the concept that nursing caries is an infectious and transmissible disease. This evidence makes a strong case to support the tenet that infants who are colonized by mutans streptococci, and who have feeding habits characterized by frequent and prolonged oral exposure to cariogenic substrates, are likely to have a drastic increase in their oral mutans streptococci populations. Such an increase is associated with a high risk for rampant dental caries. This evidence strongly suggests that the first step in the etiology of nursing caries is primary infection by mutans streptococci; the second step is accumulation of these organisms to pathogenic levels as a consequence of frequent and prolonged oral exposure to cariogenic substrates; and the third step is rapid demineralization and cavitation of enamel resulting in rampant dental caries. This three-step model might provide an important framework for the design of clinical trials targeted at prevention of nursing caries.

  3. Caries risk assessment in young adults

    DEFF Research Database (Denmark)

    Petersson, Gunnel Hänsel; Twetman, Svante

    2015-01-01

    BACKGROUND: To validate baseline caries risk classifications according to the Cariogram model with the actual caries development over a 3-year period in a group of young adults living in Sweden. METHODS: The study group consisted of 1,295 19-year-old patients that completed a comprehensive clinical...... baseline examination, including radiographs and salivary tests. An individual caries risk profile was computed and the patient was placed in one of five risk categories. After 3 years, 982 patients (75.8%) were re-examined and caries increment for each patient was calculated. The outcome was expressed...... as sensitivity, specificity and predictive values and compared with a risk assessment scheme used in Public Dental Service. RESULTS: The drop-outs displayed more risk factors and a significantly higher caries burden at baseline compared with those that remained in the project (p 

  4. [20-year experience with laserofluorescent diagnostics in clinical microbiology].

    Science.gov (United States)

    Aleksandrov, M T; Pashkov, E P; Bykov, A S; Gun'ko, V I; Popov, S N; Ivanchenko, O N; Rodionov, A D; Gizatullin, R M

    2011-01-01

    Results of rapid laser-assisted identification of microorganisms for diagnostics of microbial processes based on auto-fluorescence effect in bacteria-containing materials are summarized. It is proposed to use the auto-fluorescence technique for express diagnostics of pyoinflammatory diseases, evaluation of microflora conditions (eubiosis, dysbiosis) and sensitivity to antibiotics, monitoring and prognostication, assessment of the quality of antibiotic therapy. Priority in the development of this medical technology for laserofluorescent diagnostics and its practical application is protected by 15 patents.

  5. An automated dental caries detection and scoring system for optical images of tooth occlusal surface.

    Science.gov (United States)

    Ghaedi, Leila; Gottlieb, Riki; Sarrett, David C; Ismail, Amid; Belle, Ashwin; Najarian, Kayvan; Hargraves, Rosalyn Hobson

    2014-01-01

    Dental caries are one of the most prevalent chronic diseases. The management of dental caries demands detection of carious lesions at early stages. This study aims to design an automated system to detect and score caries lesions based on optical images of the occlusal tooth surface according to the International Caries Detection and Assessment System (ICDAS) guidelines. The system detects the tooth boundaries and irregular regions, and extracts 77 features from each image. These features include statistical measures of color space, grayscale image, as well as Wavelet Transform and Fourier Transform based features. Used in this study were 88 occlusal surface photographs of extracted teeth examined and scored by ICDAS experts. Seven ICDAS codes which show the different stages in caries development were collapsed into three classes: score 0, scores 1 and 2, and scores 3 to 6. The system shows accuracy of 86.3%, specificity of 91.7%, and sensitivity of 83.0% in ten-fold cross validation in classification of the tooth images. While the system needs further improvement and validation using larger datasets, it presents promising potential for clinical diagnostics with high accuracy and minimal cost. This is a notable advantage over existing systems requiring expensive imaging and external hardware.

  6. CLINICAL PICTURE, DIAGNOSTICS AND TREATMENT OF GIARDIASIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    E.A. Kornienko

    2009-01-01

    Full Text Available According to the WHO, giardiasis incidence rate in children in the world is 15 to 20%. In Russia, over 130,000 cases of giardiasis are registered annually, of which children under 14 years account for more than 70%. The study of 124 children with giardiasis conducted by the authors has shown that giardiasis in children always triggers development of chronic duodenitis, in 55% of cases that coupled with lymphostasis, in 45% — that with atrophy of duodenum mucous lining. In 40% of cases, chronic duodenitis with giardiasis is accompanied with duodenogastric reflux, in 88% — with development of lactase deficiency, in 81% — by functional biliary system distress and in all cases with intestinal tract microbiocenosis distress. Along with clinical manifestations of the disease, the researchers have studied immunological modifications in children with giardiasis, and have evaluated the information content of various diagnostic techniques, efficiency of medication. The authors have demonstrated that mono therapy with any of anti giardiasis drugs (metronidazole, nifuratel, albendozole has low efficiency. Saccharomyces boulardii have a powerful comprehensive effect on many links of giardiasis pathogenesis.Key words: giardiasis, infestation, scatoscopy, Saccharomyces boulardii.

  7. Utility and effectiveness of computer-aided diagnosis of dental caries.

    Science.gov (United States)

    Tracy, Kyle D; Dykstra, Bradley A; Gakenheimer, David C; Scheetz, James P; Lacina, Stephani; Scarfe, William C; Farman, Allan G

    2011-01-01

    Digital radiography has created a growing opportunity for computer-aided diagnostic (CAD) tools. The Logicon Caries Detector (LCD), with upgraded CAD software based on user feedback, was re-evaluated for its effectiveness via a retrospective clinical study. Using the upgraded LCD software, 12 dentists (evaluators) blindly assessed 17 radiographs taken by another (attending) dentist, who restored 28 proximal surfaces. The attending dentist confirmed the presence of early dentinal caries, as well as identifying 48 surfaces as caries-free or with enamel caries only subject to noninvasive treatment. The radiographs, imported into the software using a digital imaging and communications in medicine (DICOM) reader, were visually assessed under typical operatory lighting conditions, then with the aid of the software's density analysis tool. The effectiveness of the evaluators was gauged by calculating two measures of performance, sensitivity and specificity, for the detection and classification of dentinal caries. Sensitivity among all evaluator dentists was 30% with the initial image; 34% with the brightness and contrast adjusted image; 39% when the image was sharpened; and 69% when the density analysis tool was utilized. Specificity was found to be 97% with the initial image; 95% with the brightness and contrast adjusted image; 93% with the sharpened image; and 94% when the density analysis tool was used. Compared to the unaided eye, the LCD can significantly improve dentists' ability to detect and classify caries. Dentists may be able to find twice as much early dentinal caries requiring restoration (or at least aggressive noninvasive treatment) than previously, while not unnecessarily restoring additional healthy teeth. The LCD enables dentists to obtain more information from dental digital radiography than is possible with the unaided eye, leading to improved patient care.

  8. Generalized anxiety disorder: clinical presentation, diagnostic features, and guidelines for clinical practice.

    Science.gov (United States)

    van der Heiden, Colin; Methorst, Gerda; Muris, Peter; van der Molen, Henk T

    2011-01-01

    Generalized anxiety disorder (GAD) is a prevalent and disabling disorder characterised by persistent worrying, anxiety symptoms, and tension. General practitioners and mental healthcare professionals frequently misdiagnose the presenting symptoms. This article addresses the clinical presentation of GAD and provides guidelines for discriminating GAD from other disorders, based on theoretical considerations and clinical experience. Debate relating to the validity of the definition of GAD is discussed, and suggestions are made for improving the criteria for GAD, which may guide future versions of classification systems such as the Diagnostic and Statistical Manual.

  9. Computer-assisted Diagnostic Checklist in Clinical Neurology.

    Science.gov (United States)

    Finelli, Pasquale F; McCabe, Andrew L

    2016-03-01

    Considering computers are more efficient at processing large amounts of information than the human brain, speaks to the need to explore more intelligent computer-assisted diagnostic approaches. Two diagnostic checklist programs, one for single key term entry (NeurologyINDEX), and another, with more advanced algorithms to process multiple key terms and perform additional functions (NeurologicDx) are discussed. Both programs are internet based, access the same database, and are designed to generate diagnostic checklists and disease profiles accessible with hand-held or other computer device. The development of systems that use "smart algorithms" to generate valid diagnostic checklists is the goal.

  10. Effects of Lactobacillus salivarius-containing tablets on caries risk factors: a randomized open-label clinical trial.

    Science.gov (United States)

    Nishihara, Tetsuyo; Suzuki, Nao; Yoneda, Masahiro; Hirofuji, Takao

    2014-09-02

    To evaluate the effects of the lactic acid bacterium Lactobacillus salivarius on caries risk factors. The study was performed in 64 healthy volunteers to evaluate the effects of L. salivarius-containing tablets on caries risk factors. The participants were divided randomly into four groups, and took tablets containing L. salivarius WB21, L. salivarius TI 2711, Ovalgen® DC (antibody against glucosyltransferase from Streptococcus mutans), or xylitol. Levels of mutans streptococci and lactobacilli, amount of salivary flow, salivary pH, and salivary buffering capacity were assessed before and after taking the tablets. Subsequently, a short-term administration trial using L. salivarius WB21-containing tablets was performed in eight healthy volunteers. The participants took L. salivarius WB21-containing tablets (2.0 × 10(9) colony forming units/day) for 2 weeks, and the numbers of mutans streptococci in saliva were counted. The levels of mutans streptococci seemed to decrease in the L. salivarius WB21, TI 2711, and Ovalgen® DC groups compared to the xylitol group, with no significant differences between the groups. Lactobacilli levels significantly increased in the L. salivarius WB21 and TI 2711 groups compared to the other groups. Concerning salivary flow and salivary pH, no significant differences were observed between the groups. The salivary buffering capacity significantly increased in the L. salivarius TI 2711 group (P = 0.003) and Ovalgen® DC group (P = 0.002) compared to the xylitol group. The short-term administration trial showed that the L. salivarius WB21-containing tablets significantly decreased the number of mutans streptococci (P = 0.039). L. salivarius-containing tablets were suggested to increase resistance to caries risk factors. UMIN000013160 (registration date: February 14, 2014).

  11. Detection and Proportion of Very Early Dental Caries in Independent Living Older Adults

    Science.gov (United States)

    Holtzman, Jennifer S.; Kohanchi, Daniel; Biren-Fetz, John; Fontana, Margherita; Ramchandani, Manisha; Osann, Kathryn; Hallajian, Lucy; Mansour, Stephanie; Nabelsi, Tasneem; Chung, Na Eun; Wilder-Smith, Petra

    2015-01-01

    Background and Objectives Dental caries is an important healthcare challenge in adults over 65 years of age. Integration of oral health screening into non-dental primary care practice may improve access to preventive dental care for vulnerable populations such as the elderly. Such integration would require easy, fast, and accurate early caries detection tools. Primary goal of this study was to evaluate the diagnostic performance of optical coherence tomography (OCT) imaging for detecting very early caries in the elderly living in community-based settings. The International Caries Detection and Assessment System (ICDAS) served as gold standard. Secondary goal of this study was to provide baseline prevalence data of very early caries lesions in independent living adults aged 65+ years. Materials and Methods Seventy-two subjects were recruited from three sites in Southern California: a retirement community, a senior health fair, and a convalescent hospital. Clinical examination was performed using the ICDAS visual criteria and this was followed by OCT imaging. The two-dimensional OCT images (B-scan) were analyzed with simple software. Locations with a log of back-scattered light intensity (BSLI) below 2.9 were scored as sound, and areas equaling or exceeding 2.9 BSLI were considered carious. Diagnostic performance of OCT imaging was compared with ICDAS score. Results OCT-based diagnosis demonstrated very good sensitivity (95.1%) and good specificity (85.8%). 54.7% of dentate subjects had at least one tooth with very early coronal caries. Conclusions Early coronal decay is prevalent in the unrestored pits and fissures of coronal surfaces of teeth in independent living adults aged 65+ years. Though OCT imaging coupled with a simple diagnostic algorithm can accurately detect areas of very early caries in community-based settings, existing devices are expensive and not well-suited for use by non-dental health care providers. Simple, inexpensive, fast, and accurate tools

  12. Validation of computerized diagnostic information in a clinical database from a national equine clinic network

    Directory of Open Access Journals (Sweden)

    Egenvall Agneta

    2009-12-01

    Full Text Available Abstract Background Computerized diagnostic information offers potential for epidemiological research; however data accuracy must be addressed. The principal aim of this study was to evaluate the completeness and correctness of diagnostic information in a computerized equine clinical database compared to corresponding hand written veterinary clinical records, used as gold standard, and to assess factors related to correctness. Further, the aim was to investigate completeness (epidemiologic sensitivity, correctness (positive predictive value, specificity and prevalence for diagnoses for four body systems and correctness for affected limb information for four joint diseases. Methods A random sample of 450 visits over the year 2002 (nvisits = 49,591 was taken from 18 nation wide clinics headed under one company. Computerized information for the visits selected and copies of the corresponding veterinary clinical records were retrieved. Completeness and correctness were determined using semi-subjective criteria. Logistic regression was used to examine factors associated with correctness for diagnosis. Results Three hundred and ninety six visits had veterinary clinical notes that were retrievable. The overall completeness and correctness were 91% and 92%, respectively; both values considered high. Descriptive analyses showed significantly higher degree of correctness for first visits compared to follow up visits and for cases with a diagnostic code recorded in the veterinary records compared to those with no code noted. The correctness was similar regardless of usage category (leisure/sport horse, racing trotter and racing thoroughbred or gender. For the four body systems selected (joints, skin and hooves, respiratory, skeletal the completeness varied between 71% (respiration and 91% (joints and the correctness ranged from 87% (skin and hooves to 96% (respiration, whereas the specificity was >95% for all systems. Logistic regression showed that

  13. Dental caries vaccine

    Directory of Open Access Journals (Sweden)

    Shivakumar K

    2009-01-01

    Full Text Available Dental caries is one of the most common diseases in humans. In modern times, it has reached epidemic proportions. Dental caries is an infectious microbiologic disease of the teeth that results in localized dissolution and destruction of the calcified tissue. Dental caries is a mulitifactorial disease, which is caused by host, agent, and environmental factors. The time factor is important for the development and progression of dental caries. A wide group of microorganisms are identified from carious lesions of which S. mutans , Lactobacillus acidophilus , and Actinomyces viscosus are the main pathogenic species involved in the initiation and development of dental caries. In India, surveys done on school children showed caries prevalence of approximately 58%. Surveys among the U.S. population showed an incidence of 45.3% in children and 93.8% in adults with either past or present coronal caries. Huge amounts of money and time are spent in treating dental caries. Hence, the prevention and control of dental caries is the main aim of public health, eventually the ultimate objective of public health is the elimination of the disease itself. Recently, dental caries vaccines have been developed for the prevention of dental caries. These dental caries vaccines are still in the early stages.

  14. Nonnutritive, Low Caloric Substitutes for Food Sugars: Clinical Implications for Addressing the Incidence of Dental Caries and Overweight/Obesity

    Directory of Open Access Journals (Sweden)

    Michael W. Roberts

    2012-01-01

    Full Text Available Caries and obesity are two common conditions affecting children in the United States and other developed countries. Caries in the teeth of susceptible children have often been associated with frequent ingestion of fermentable sugars such as sucrose, fructose, glucose, and maltose. Increased calorie intake associated with sugars and carbohydrates, especially when associated with physical inactivity, has been implicated in childhood obesity. Fortunately, nonnutritive artificial alternatives and non-/low-caloric natural sugars have been developed as alternatives to fermentable sugars and have shown promise in partially addressing these health issues. Diet counseling is an important adjunct to oral health instruction. Although there are only five artificial sweeteners that have been approved as food additives by the Food and Drug Administration (FDA, there are additional five non-/low caloric sweeteners that have FDA GRAS (Generally Recognized as Safe designation. Given the health impact of sugars and other carbohydrates, dental professionals should be aware of the nonnutritive non-/low caloric sweeteners available on the market and both their benefits and potential risks. Dental health professionals should also be proactive in helping identify patients at risk for obesity and provide counseling and referral when appropriate.

  15. [Diagnostics in clinically occult, radiologically suspect breast lesions more often surgery than needle diagnostics with image monitoring

    NARCIS (Netherlands)

    Pijnappel, R.M.; Peeters, P.M.; Rinkes, M.J.; Peterse, J.L.; Holland, R.; Mali, W.P.Th.

    2001-01-01

    OBJECTIVE: To inventory the diagnostic methods used in patients with clinically occult, radiologically suspect breast lesions. DESIGN: Enquiry. METHOD: The departments of radiology of all Dutch hospitals were sent a list in January 2000 containing questions concerning the number of thread localizati

  16. Dietary pattern of Finnish children with low high caries experience.

    Science.gov (United States)

    Kleemola-Kujala, E; Räsänen, L

    1979-08-01

    The correlations between dietary patterns and caries were studied in a series consisting of 534, 5-, 9- and 13-year-old Finnish rural children from low-fluoride areas (0.10-0.46 parts/10(6)). The food consumption of the children was assessed by the 24-hour recall method. The consumption of sweets was estimated by the dietary history method. Caries was diagnosed by clinical inspection. Children with a low and children with a high caries experience were compared with regard to food and nutrient intakes per 1000 kcal. The intakes of most foods and nutrients were similar in the low-caries and in the high-caries groups. However, the diet of the high-caries groups of 5- and 13-year-olds contained less iron, thiamine and ascorbic acid than the diet of the low-caries groups. The intake of sugar and sugar-containing products per unit of energy was higher in the high-caries groups. This was true for soft drinks in particular. Among the 9-year-olds the proportion of sugar consumed as such was greater in the high-caries than in the low-caries children. With regard to the total monthly consumption of sweets no significant differences were observed between the high- and low-caries groups. Analysis of the energy-standardized consumption of food and nutrients thus showed that the relative proportion of sugar and sugar-containing products was somewhat greater in the diet of the high-caries children than in the diet of the low-caries children, but not as high as could be expected. These products replaced foods with a higher nutritive value with the result that the diet of the high-caries groups was on the whole more refined than the diet of the low-caries groups.

  17. PRIMARY CARIES: AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    Gaurav Solanki

    2012-01-01

    Full Text Available Primary caries is an initial lesions produced by direct extension from an external surface. Dental caries is called as tooth decay or a cavity is a disease in which bacterial processes changes carbohydrate to acid which than dematerializes the hard tooth structure like enamel, dentin and cementum. Streptococcus mutans and Lactobacillus are the bacteria responsible for the dental caries by acid production. This article throws light on the dental caries disease, its sign and symptoms, treatment and prevention of it. A review of some patents on dental caries is also provided that summarizes the recent technical advancements taken place in this area.

  18. The Analysis of the Clinical Treatment of Non-caries Dental Pulp Disease%非龋性牙髓病的临床治疗分析

    Institute of Scientific and Technical Information of China (English)

    李敏

    2015-01-01

    目的:探讨非龋性牙髓病患者的临床治疗以及疗效分析。方法选取我科收治的非龋性牙髓病患者86例作为研究对象,根据患者的不同病情采取合适的治疗方案,观察患者的临床治疗效果,以及并发症发生情况。结果患者治疗后痊愈55例,好转31例,总治疗有效率达到100%。没有严重的并发症或不良反应发生,仅有5例患者出现轻微胀痛,没有采取措施胀痛自行消失。结论非龋性牙髓病患者包括牙折、牙隐裂、楔状缺损、牙周病、牙体磨损、畸形中央尖等多种类型,采用合适的治疗方案能够提高治愈率,减少并发症和不良反应的发生,其中根管充填术是最为常用的治疗方案。%Objective To study the clinical treatment effect of non-caries dental pulp disease. Methods 86 cases of non-caries dental pulp disease from our department were selected. According to the different condition of patients, we took appropriate treatment and observed the clinical therapeutic effect and complications of patients. Results After the treatment, 55 patients were cured, 31 patients were improved, the total treatment effective rate reached 100%. No serious complications or adverse reactions took place. Only 5 patients had mild pain, but without any measures the pain went away. Conclusion The dental pulp disease including fractured tooth, tooth caries sex cracked, wedge-shaped defects, periodontal disease, tooth wear, deformed a variety of types such as the central point. Using appropriate treatment can improve the cure rate and reduce the occurrence of complications and adverse reactions. While the root canal iflling technique is most commonly used.

  19. Prevalence and Measurement of Dental Caries in Young Children.

    Science.gov (United States)

    Dye, Bruce A; Hsu, Kuei-Ling C; Afful, Joseph

    2015-01-01

    Dental caries in preschool children was historically considered to have a unique and more intense pattern of decay and was known by a variety of terms. In 1999, the term early childhood caries (ECC), along with a classification system, was proposed to facilitate epidemiologic research of dental caries in young children. The purpose of this study was to assess the impact of those early childhood caries recommendations on the prevalence and measurement of caries in preschool children. A systematic search of the MEDLINE database was performed. Key search words included: ECC, dental decay, dental caries, carious dentin, baby bottle tooth decay, nursing caries, maxillary anterior caries, and labial caries. English language studies and studies on more than 100 children younger than six years old were eligible for selection. National Health and Nutrition Examination Survey data collected from 1988 to 1994, 1999 to 2004, and 2011 to 2012 were used to assess ECC prevalence using different operational definitions. There were 87 articles selected for this review. The term ECC was used in 55 percent of the selected articles as the primary outcome measure. The majority of studies used a cross-section study design, but diagnostic criteria varied greatly. Caries experience in young children may be shifting away from majority of untreated surfaces to a majority of restored surfaces. Little difference was observed by dental surface type in the distribution of decayed and filled surfaces in primary teeth. Although the term early childhood caries is widely used, varied use of diagnostic criteria and operational definitions continue to limit comparability across studies. Emerging changes in the proportion of decayed and filled surfaces in the United States also raises questions regarding the ECC case definition limiting our ability to understand the epidemiology of dental caries in preschool children.

  20. A chemomechanical method for caries removal.

    Science.gov (United States)

    Morrow, L A; Hassall, D C; Watts, D C; Wilson, N H

    2000-10-01

    Over recent years the dental profession has shifted towards practising preventive dentistry and adopting more conservative and tooth-preserving procedures. Such progression is considered to be a response to the decline in the level of dental caries and advances in materials science. This shift in caries management will no doubt continue over the coming decades, based on rational clinical and scientific principles. Chemomechanical caries removal involves the application of a solution that selectively softens the carious dentine, thus facilitating its removal. This limits the removal of sound tooth structure, the cutting of open dentinal tubules, pulpal irritation and pain compared with conventional mechanical methods.

  1. Occlusal caries detection and quantification by DIAGNOdent and Electronic Caries Monitor: in vitro comparison.

    Science.gov (United States)

    Bamzahim, Mohammad; Shi, Xie-Qi; Angmar-Månsson, Birgit

    2002-12-01

    The Electronic Caries Monitor (ECM) and the recently introduced laser-based KaVo DIAGNOdent have been developed as clinical diagnostic aids in the detection and quantification of occlusal carious lesions. The aim of this in vitro study was to compare their reproducibility and validity. The ability of DIAGNOdent to retrieve sites of occlusal carious lesions without reference to photographs or drawings from previous assessments was also tested. The material comprised 87 premolar teeth: the occlusal surfaces were sound or exhibited non-cavity carious lesions of varying severity. All were photographed and measured by DIAGNOdent and ECM on 2 occasions, 2 weeks apart. The teeth were then sectioned into 300 microm thick slices. Two observers independently classified the sections according to the histopathology, into 5 categories, ranging from sound to dentinal caries in the inner part of the dentin. Statistical analysis comprised intra-class correlation coefficients (ICC) to test reproducibility and regression analysis of validity. Sensitivity and specificity were also calculated for detection of D3 lesions for both devices. DIAGNOdent recorded maximum readings at identical sites on both occasions in 89% of the teeth. The ICC for readings on 2 separate occasions was 0.97 for DIAGNOdent and 0.71 for ECM. The correlations with histology were r = 0.93 and 0.83, for DIAGNOdent and ECM, respectively. For detection of D3 lesions, the sensitivity and specificity were 0.8 and 1 for DIAGNOdent and 0.75 and 0.88 for ECM. In this in vitro study, DIAGNOdent was superior to ECM for occlusal caries detection.

  2. [Diagnostic and clinical behaviour with Tarlov cyst in gynaecology practice].

    Science.gov (United States)

    Hristova, R; Hadjidekov, G

    2011-01-01

    The following presents cases from the gynaecological practice which resulted in a surgical intervention due to the detection of cystic formations of origin out of the reproductive system. Although rare, Tarlov cyst has its place in the differential diagnostic plan of ovarian formations. MRI scan remains an alternative to the ultrasound imagery and is the main diagnostic method for obtaining the right diagnosis. This further aids the set of actions appropriate with patients suffering from Tarlov cyst. Thus, unnecessary abdominal surgical interventions are not to be undertaken.

  3. [Clinical decision making and critical thinking in the nursing diagnostic process].

    Science.gov (United States)

    Müller-Staub, Maria

    2006-10-01

    The daily routine requires complex thinking processes of nurses, but clinical decision making and critical thinking are underestimated in nursing. A great demand for educational measures in clinical judgement related with the diagnostic process was found in nurses. The German literature hardly describes nursing diagnoses as clinical judgements about human reactions on health problems / life processes. Critical thinking is described as an intellectual, disciplined process of active conceptualisation, application and synthesis of information. It is gained through observation, experience, reflection and communication and leads thinking and action. Critical thinking influences the aspects of clinical decision making a) diagnostic judgement, b) therapeutic reasoning and c) ethical decision making. Human reactions are complex processes and in their course, human behavior is interpreted in the focus of health. Therefore, more attention should be given to the nursing diagnostic process. This article presents the theoretical framework of the paper "Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies".

  4. Sugar Alcohols, Caries Incidence, and Remineralization of Caries Lesions: A Literature Review

    Directory of Open Access Journals (Sweden)

    Kauko K. Mäkinen

    2010-01-01

    Full Text Available Remineralization of minor enamel defects is a normal physiological process that is well known to clinicians and researchers in dentistry and oral biology. This process can be facilitated by various dietary and oral hygiene procedures and may also concern dentin caries lesions. Dental caries is reversible if detected and treated sufficiently early. Habitual use of xylitol, a sugar alcohol of the pentitol type, can be associated with significant reduction in caries incidence and with tooth remineralization. Other dietary polyols that can remarkably lower the incidence of caries include erythritol which is a tetritol-type alditol. Based on known molecular parameters of simple dietary alditols, it is conceivable to predict that their efficacy in caries prevention will follow the homologous series, that is, that the number of OH-groups present in the alditol molecule will determine the efficacy as follows: erythritol≥xylitol>sorbitol. The possible difference between erythritol and xylitol must be confirmed in future clinical trials.

  5. Comparison of clinical judgment and diagnostic ultrasonography in the diagnosis of acute appendicitis

    DEFF Research Database (Denmark)

    Jahn, H; Mathiesen, F K; Neckelmann, K

    1997-01-01

    OBJECTIVE: To evaluate the diagnostic accuracy of clinical judgment and diagnostic ultrasonography (US) used routinely and to create a scoring system to aid diagnosis. DESIGN: Prospective, double-blind study. SETTING: University hospital, Denmark. SUBJECTS: 222 Consecutive patients suspected...... to create a scoring system. MAIN OUTCOME MEASURES: Results of surgical pathological findings, clinical outcome (observed group), diagnostic US, and values of diagnostic score. RESULTS: The decision to operate was made by a junior surgeon solely on the clinical examination, which yielded a diagnostic......%. Of the 21 predictive factors for acute appendicitis 11 were significant (p 10 x 10[9]/1), migration of pain to the right lower quadrant, gradual onset of pain, increasing intensity of pain, pain aggravated by movement, pain aggravated by coughing, anorexia, vomiting...

  6. A clinical study on relationship of dental caries and removable partial denture of the aged patients%老年患者基牙龋病与可摘局部义齿关系的临床研究

    Institute of Scientific and Technical Information of China (English)

    李行懿; 陈娜; 刘聪

    2011-01-01

    Objective To characterize (patterns of caries after placing RPD. Methods A total of 95 patients were included in this study. A clinical examination of caries lesions on abutment teeth was conducted by me. Results The incidence of caries on abutment teeth and on nonabutment teeth were respectively 23. 67% and 3. 45%. ( P < 0.05). 27.49% of abutment teeth had new caries on the posterior oral cavity, onlyl3.89% of that on the anterior oral cavity. (P<0. 05). The incidence of caries on proximal surfaces adjacent to dentures was 25. 72% , under denture rests was 9. 33% , on root surfaces was 3. 02% , on tooth surfaces in contact with denture clasps was 1. 36% . The incidence of caries on abutment teeth of three groups classified by the oral hygienic habit were respectively 8. 91% 、24. 09%、44. 29% (P<0.01). Conclusion RPD wearers had more caries incidence. Abutment teeth had a higher of incidence of caries than nonabutment teeth. On the posterior oral cavity, abutment teeth had more caries incidence. Proximal surfaces adjacent to dentures abutment teeth had more caries incidence. Proximal surfaces adjacent to dentures were at highest risk of being decayed, surfaces under denture rests were next. The incidence of root caries on abutment teeth significantly increased. The incidence of caries on tooth surfaces in contact with denture clasps was not high.%目的 观察老年患者戴用可摘局部义齿2-3年后的龋病发病情况及其临床特点.方法 对95例戴用可摘局部义齿2-3年患者的基牙和非基牙的龋齿发病情况进行检查.结果 基牙龋齿发病率23.67%高于非基牙3.45%(P<0.05).口腔后部基牙龋齿发病率27.49%高于口腔前部基牙13.89%(P<0.05).基牙邻接面龋发病率25.72%,支托窝龋发病率9.33%,根面龋发病率3.02%,卡环龋发病率1.36%.口腔卫生习惯优、良、差三级的基牙龋齿发病率分别为8.91%、24.09%、44.29%,差异有显著性(P<0.01).结论 患者戴用可摘局部义齿后易患龋

  7. Emerging technologies for diagnosis of dental caries: The road so far

    Science.gov (United States)

    Amaechi, Bennett T.

    2009-05-01

    It is now universally recognized that the development of new technologies for early detection and quantitative monitoring of dental decay at an early stage of formation could provide health and economic benefits ranging from timely preventive interventions to reduction in the time required for clinical trials of anticaries agents. The use of technologies as adjunct to clinical visual examination for caries diagnosis will facilitate preventive care in dentistry to lower treatment cost as well as reduce the cost and time for testing potential anticaries agents. This article describes the various technologies available to aid the dental practitioners in detecting dental caries at the earliest stage of its formation, assessing the activities of the detected carious lesion, and quantitatively or qualitatively monitoring of the lesion over time. The need and the importance of these technologies were also discussed. The data discussed are primarily based on published scientific studies and reviews from case reports, clinical trials, and in vitro and in vivo studies. References have been traced manually by MEDLINE® or through manufacturer's websites. While some of the devices are fully developed and commercially available, others are still under development. The devices vary in their modes of action as well as their capability as caries diagnostic aids. It is clear that the differences in caries presentations and behavior in different anatomical sites make it unlikely that any one diagnostic modality will have adequate sensitivity and specificity of detection of carious lesions for all sites; a combination of diagnostic tools will help us diagnose lesions earlier and detect failing restorations sooner, all to avoid more costly, destructive dental procedures and truly take dentistry into the preventive rather than the reactive mode.

  8. A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries

    Science.gov (United States)

    2012-01-01

    Background Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. Discussion The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. Trial registration ACTRN12612000712808 PMID:22909327

  9. A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries

    Directory of Open Access Journals (Sweden)

    Blinkhorn Fiona

    2012-08-01

    Full Text Available Abstract Background Early Childhood Caries (ECC is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. Discussion The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. Trial registration ACTRN12612000712808

  10. The Added Value of the Combined Use of the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule: Diagnostic Validity in a Clinical Swedish Sample of Toddlers and Young Preschoolers

    Science.gov (United States)

    Zander, Eric; Sturm, Harald; Bölte, Sven

    2015-01-01

    The diagnostic validity of the new research algorithms of the Autism Diagnostic Interview-Revised and the revised algorithms of the Autism Diagnostic Observation Schedule was examined in a clinical sample of children aged 18-47 months. Validity was determined for each instrument separately and their combination against a clinical consensus…

  11. Protease activity measurement in milk as a diagnostic test for clinical mastitis in dairy cows

    NARCIS (Netherlands)

    Koop, G.; Werven, van T.; Roffel, S.; Hogeveen, H.; Nazmi, K.; Bikker, F.J.

    2015-01-01

    Due to the increasing use of automated milking systems, automated detection of clinical mastitis is becoming more important. Various in- or on-line diagnostic tests are in use, but generally suffer from false mastitis alerts. In this study, we explored a new diagnostic approach based on measureme

  12. Companion diagnostics and molecular imaging-enhanced approaches for oncology clinical trials.

    Science.gov (United States)

    Van Heertum, Ronald L; Scarimbolo, Robert; Ford, Robert; Berdougo, Eli; O'Neal, Michael

    2015-01-01

    In the era of personalized medicine, diagnostic approaches are helping pharmaceutical and biotechnology sponsors streamline the clinical trial process. Molecular assays and diagnostic imaging are routinely being used to stratify patients for treatment, monitor disease, and provide reliable early clinical phase assessments. The importance of diagnostic approaches in drug development is highlighted by the rapidly expanding global cancer diagnostics market and the emergent attention of regulatory agencies worldwide, who are beginning to offer more structured platforms and guidance for this area. In this paper, we highlight the key benefits of using companion diagnostics and diagnostic imaging with a focus on oncology clinical trials. Nuclear imaging using widely available radiopharmaceuticals in conjunction with molecular imaging of oncology targets has opened the door to more accurate disease assessment and the modernization of standard criteria for the evaluation, staging, and treatment responses of cancer patients. Furthermore, the introduction and validation of quantitative molecular imaging continues to drive and optimize the field of oncology diagnostics. Given their pivotal role in disease assessment and treatment, the validation and commercialization of diagnostic tools will continue to advance oncology clinical trials, support new oncology drugs, and promote better patient outcomes.

  13. Validity of the Research Diagnostic Criteria for Temporomandibular Disorders Axis I in clinical and research settings.

    NARCIS (Netherlands)

    Steenks, M.H.; Wijer, A. de

    2009-01-01

    The lack of standardized diagnostic criteria for defining clinical subtypes of temporomandibular disorders (TMD) was the main motive to create the Research Diagnostic Criteria for TMD (RDC/TMD), which were provided to allow standardization and replication of research into the most common forms of mu

  14. The value of clinical and laboratory diagnostics for chest pain patients at the emergency department

    NARCIS (Netherlands)

    Jellema, Laurens-Jan C.; Backus, Barbra E.; Six, A. Jacob; Braam, Richard; Groenemeijer, Bjorn; van der Zaag-Loonen, Hester J.; Tio, Rene; van Suijlen, Jeroen D. E.

    2014-01-01

    Background: The focus during the diagnostic process for patients with acute chest pain is to discriminate patients who can be safely discharged from those who are at risk for an acute coronary syndrome (ACS). In this study the diagnostic value of the clinical examination is compared with laboratory

  15. Adjunct methods for caries detection

    DEFF Research Database (Denmark)

    Twetman, Svante; Axelsson, Susanna Bihari; Dahlén, Gunnar

    2012-01-01

    evidence for diagnostic accuracy regarding fiber-optic methods and quantitative light-induced fluorescence (+OOO). The electrical methods and laser fluorescence could be useful adjuncts to visual-tactile and radiographic examinations, especially on occlusal surfaces in permanent and primary molars......Abstract Objective. To assess the diagnostic accuracy of adjunct methods used to detect and quantify dental caries. Study design. A systematic literature search for relevant papers was conducted with pre-determined inclusion and exclusion criteria. Abstracts and full text articles were assessed...... independently by two reviewers. The study characteristics were compiled in tables and quality graded according to the QUADAS tool. The level of evidence for each diagnostic technology (fiber-optic methods, fluorescence methods, electrical methods) was based on studies of high or moderate quality according...

  16. Developing computational model-based diagnostics to analyse clinical chemistry data

    NARCIS (Netherlands)

    Schalkwijk, D.B. van; Bochove, K. van; Ommen, B. van; Freidig, A.P.; Someren, E.P. van; Greef, J. van der; Graaf, A.A. de

    2010-01-01

    This article provides methodological and technical considerations to researchers starting to develop computational model-based diagnostics using clinical chemistry data.These models are of increasing importance, since novel metabolomics and proteomics measuring technologies are able to produce large

  17. Using the Revised Bloom's Taxonomy in the clinical laboratory: thinking skills involved in diagnostic reasoning.

    Science.gov (United States)

    Su, Whei Ming; Osisek, Paul J; Starnes, Beth

    2005-01-01

    Achieving effective transfer of theoretical knowledge to clinical practice requires knowledge of thinking paradigms in relation to specific nursing content. It is a challenge to develop instructional designs for teaching and assessing implicit thought processes involved in clinical reasoning. The authors demonstrate the use of the Revised Bloom's Taxonomy to teach thinking skills involved in diagnostic reasoning in a clinical laboratory.

  18. Implementation of a companion diagnostic in the clinical laboratory

    DEFF Research Database (Denmark)

    Mancini, Irene; Pinzani, Pamela; Simi, Lisa

    2015-01-01

    A companion diagnostic test provides information that is essential for the safe and effective use of a corresponding therapeutic product as indicated in the drug instructions. The implementation of a companion diagnostic follows the rules of a molecular test for somatic mutations in a routine...... of mutation under study, the sample to be assayed and its preparation procedure. In addition, the results of a molecular assay require a complex interpretation process of the analytical data as the patient's genotype, the translation of the identified variant into a predicted phenotype and knowledge......, as an example, the BRAF genotype analysis in tumor tissue samples for identification of melanoma patients that can benefit treatment with BRAF inhibitors. The manuscript is focused on the following aspects: i) medical rationale, ii) methodologies of analysis, iii) laboratory performance evaluation and iv...

  19. Interesting clinical presentation of anterior knee pain causing diagnostic dilemma.

    Science.gov (United States)

    Morgan, Samer S; Balasubramanian, S; Teanby, D

    2009-09-01

    A diverse variety of lesions may occasionally occur in the patella. In this case report, we are presenting an interesting case of anterior knee pain in middle aged gentleman. Initial investigations including Magnetic Resonance Imaging not showed any abnormality. Due to prolonged continued pain he had bone scan and MRI, which confirmed the diagnosis of Brodie's abscess. We are presenting this case of Brodie's abscess of the patella causing diagnostic dilemma because of its rarity.

  20. Prevention, diagnosis and minimally invasive treatment of dental caries

    OpenAIRE

    Lai, Gianfranco

    2016-01-01

    Aim: Study the news overtures to prevention, diagnosis and therapy of caries disease. Methods: We conducted one randomized controlled clinical trial (RCT), one cross-sectional study and one systematic review with meta-analysis. The RCT evaluated the efficacy of the Carisolv and CeraBur. In the cross-sectional study we evaluated the efficacy of a new device to detect caries lesions: DIAGNOcam. The systematic review of the literature was conducted to evaluate efficacy of polyols in caries pr...

  1. [THE RESULTS OF CLINICAL AND PSYCHOPATHOLOGICAL AND PSYCHOLOGICAL DIAGNOSTIC INVESTIGATIONS EMPLOYEES OF FINANCIAL INSTITUTIONS WHICH WERE IDENTIFIED NEUROTIC DISORDERS].

    Science.gov (United States)

    Solovyova, M

    2014-12-01

    The article presents the results of the clinical and psychopathological and psychological diagnostic, investigations mental health employees of financial institutions, description and analysis of clinical forms identified disorders.

  2. Exploratory Randomized Clinical Trial of an Experimental Gel-to-Foam Fluoride Dentifrice Formulation Using an In Situ Caries Model.

    Science.gov (United States)

    Barlow, Ashley; Butler, Andrew; Mason, Stephen; Zero, Domenick

    2015-01-01

    To evaluate the in situ caries performance and safety of two experimental fluoride dentifrice formulations (1450 ppm fluoride) with and without 2% isopentane as an excipient, in comparison to a positive control, currently marketed dentifrice (1450 ppm fluoride) and a negative control dentifrice (0 ppm fluoride). This was a single-center, examiner-blind, randomized, controlled, four-treatment cross-over study. During each treatment period, the subject wore a modified mandibular partial denture fitted with two gauze-covered, partially demineralized human enamel specimens, and brushed at home for one timed minute, twice daily, for two weeks. At the end of each treatment period, the enamel specimens were removed from the dentures for analysis. During the week between treatment periods, subjects returned to their usual dental hygiene practices for four to five days, received a dental prophylaxis, and used a study-designated non-fluoride dentifrice for two to three days before starting the next treatment. Treatment effect on enamel specimen remineralization was assessed by surface microhardness (SMH). Enamel fluoride uptake was assessed using microdrill enamel biopsy. All fluoride-containing dentifrices demonstrated significant, superior SMH recovery and levels of fluoride uptake compared to the negative control dentifrice. No significant differences were observed for either efficacy variable between the experimental dentifrice formulations and the positive control dentifrice. No significant difference was observed between the 2% isopentane dentifrice and the 0% isopentane dentifrice for SMH recovery. The addition of 2% isopentane did not positively or negatively affect fluoride efficacy in this model.

  3. Dental caries prevalence and treatment needs among 12- and 15- Year old schoolchildren in Shimla city, Himachal Pradesh, India.

    Science.gov (United States)

    Shailee, Fotedar; Sogi, G M; Sharma, K R; Nidhi, Pruthi

    2012-01-01

    Dental caries is one of the commonest oral diseases in children. Despite this fact, not many studies have been done on this issue among school children in Shimla. To assess the prevalence of dental caries and treatment needs among schoolchildren aged 12 years and 15 years in Shimla city, Himachal Pradesh, India. With this study we also aimed to establish reliable baseline data. Cross-sectional study. This study was conducted among 12 - and 15 - year old schoolchildren in Shimla city, Himachal Pradesh-India. A sample of 1011 schoolchildren was selected by a two-stage cluster sampling method. Clinical recording of dental caries, was done according to WHO diagnostic criteria (1997). The statistical tests used were the t- test, and the Chi-square test. The prevalence of dental caries was 32.6% and 42.2% at 12 years and 15 years respectively. At 12 years of age, the mean Decayed Missing Filled Teeth was 0.62 ± 1.42 and it was 1.06 ± 2.93 at 15 years of age. Females had higher level of caries than males at both the ages. Dental caries was higher in children from government schools as compared to those from private schools. The 'decayed' component was the biggest contributor to the DMFT index. The highest treatment need at both ages was one surface restoration. The caries experience of 12- and 15- year-old children was low compared to WHO - 'recommended' values. Effective oral health promotion strategies need to be implemented to further improve the dental health of school children in Shimla city.

  4. Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation

    Directory of Open Access Journals (Sweden)

    Sefer Varol

    2015-12-01

    Full Text Available ABSTRACT Objective Facial diplegia (FD is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS (11, Bickerstaff’s brainstem encephalitis (1, neurosarcoidosis (1, non-Hodgkin’s Lymphoma (1, tuberculous meningitis (1 herpes simplex reactivation (1 and idiopathic (1. In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

  5. Caries risk assessment models in caries prediction

    Directory of Open Access Journals (Sweden)

    Amila Zukanović

    2013-11-01

    Full Text Available Objective. The aim of this research was to assess the efficiency of different multifactor models in caries prediction. Material and methods. Data from the questionnaire and objective examination of 109 examinees was entered into the Cariogram, Previser and Caries-Risk Assessment Tool (CAT multifactor risk assessment models. Caries risk was assessed with the help of all three models for each patient, classifying them as low, medium or high-risk patients. The development of new caries lesions over a period of three years [Decay Missing Filled Tooth (DMFT increment = difference between Decay Missing Filled Tooth Surface (DMFTS index at baseline and follow up], provided for examination of the predictive capacity concerning different multifactor models. Results. The data gathered showed that different multifactor risk assessment models give significantly different results (Friedman test: Chi square = 100.073, p=0.000. Cariogram is the model which identified the majority of examinees as medium risk patients (70%. The other two models were more radical in risk assessment, giving more unfavorable risk –profiles for patients. In only 12% of the patients did the three multifactor models assess the risk in the same way. Previser and CAT gave the same results in 63% of cases – the Wilcoxon test showed that there is no statistically significant difference in caries risk assessment between these two models (Z = -1.805, p=0.071. Conclusions. Evaluation of three different multifactor caries risk assessment models (Cariogram, PreViser and CAT showed that only the Cariogram can successfully predict new caries development in 12-year-old Bosnian children.

  6. The efficacy of the reverse contrast mode in digital radiography for the detection of proximal dentinal caries

    Energy Technology Data Exchange (ETDEWEB)

    Miri, Shimasadat [Dept. of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Mehrailzadeh, Sandra; Sadri, Donya [School of Dentistry, Islamic Azad University, Tehran (Iran, Islamic Republic of); Motamedi, Mahmood Reza Kalantar [Dept. of Research, School of Dentistry, Isfahan Branch, Islamic Azad University, Isfahan (Iran, Islamic Republic of); Soltani, Parisa [Dental Students Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan (Iran, Islamic Republic of)

    2015-09-15

    This study evaluated the diagnostic accuracy of the reverse contrast mode in intraoral digital radiography for the detection of proximal dentinal caries, in comparison with the original digital radiographs. Eighty extracted premolars with no clinically apparent caries were selected, and digital radiographs of them were taken separately in standard conditions. Four observers examined the original radiographs and the same radiographs in the reverse contrast mode with the goal of identifying proximal dentinal caries. Microscopic sections 5 µm in thickness were prepared from the teeth in the mesiodistal direction. Four slides prepared from each sample used as the diagnostic gold standard. The data were analyzed using SPSS (α=0.05). Our results showed that the original radiographs in order to identify proximal dentinal caries had the following values for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, respectively: 72.5%, 90%, 87.2%, 76.5%, and 80.9%. For the reverse contrast mode, however, the corresponding values were 63.1%, 89.4%, 87.1%, 73.5%, and 78.8%, respectively. The sensitivity of original digital radiograph for detecting proximal dentinal caries was significantly higher than that of reverse contrast mode (p<0.05). However, no statistically significant differences were found regarding specificity, positive predictive value, negative predictive value, or accuracy (p>0.05). The sensitivity of the original digital radiograph for detecting proximal dentinal caries was significantly higher than that of the reversed contrast images. However, no statistically significant differences were found between these techniques regarding specificity, positive predictive value, negative predictive value, or accuracy.

  7. Validation of the clinical diagnostic criteria for temporomandibular disorders for the diagnostic subgroup of degenerative joint disease.

    Science.gov (United States)

    Brandlmaier, I; Grüner, S; Rudisch, A; Bertram, S; Emshoff, R

    2003-04-01

    Research is needed to assess the validity of the Clinical Diagnostic Criteria for Temporomandibular Disorders (CDC/TMD). The purpose of this study was to test the reliability of the clinical diagnosis of temporomandibular joint (TMJ) degenerative joint disease (DJD) as compared with the magnetic resonance imaging (MRI) 'gold standard'. The TMJ DJD group comprised 48 joints in 24 consecutive patients who were assigned a clinical bilateral diagnosis of TMJ DJD. The TMJ non-DJD group consisted of 82 joints in 41 consecutive patients without a TMJ-related diagnosis of TMD. Bilateral sagittal and coronal MR images were obtained subsequently to establish the corresponding diagnosis of degenerative joint changes. An MRI diagnosis of osteoarthrosis (OA) was defined by the presence of flattening, subchondral sclerosis, surface irregularities, and erosion of the condyle or presence of condylar deformities associated with flattening, subchondral sclerosis, surface irregularities, erosion and osteophyte. For the CDC/TMD interpretations, the positive predictive of DJD for OA was 67%, and for the presence of degenerative joint changes 88%. The overall diagnostic agreement for DJD was 44.6% with a corresponding K-value of 0.01. Most of the disagreement was due to false-negative interpretations of asymptomatic joints. The results suggest CDC/TMD to be predictive for degenerative joint changes but insufficient for determination of OA. Patients assigned a clinical TMJ-related diagnosis of DJD may need to be supplemented by evidence from MRI to determine the presence or absence of OA.

  8. Clinical presentation and diagnostic approach in cases of genitourinary tuberculosis

    Directory of Open Access Journals (Sweden)

    Rakesh Kapoor

    2008-01-01

    Full Text Available Objective: We herein describe the various modes of presentation in genitourinary tuberculosis (GUTB and a simple diagnostic approach to it. Materials and Methods: We made a literature search through Medline database and various other peer-reviewed online journals to study the various modes of presentation in GUTB. We reviewed over 100 articles published in the last 10 years (1998 -- 2007, which were tracked through the key words like GUTB and extrapulmonary tuberculosis. Results: GUTB has varied presentation and the most common way of presentation is in the form of irritative voiding symptoms, which are found in more than 50% of the patients. The usual frequency of organ involvement is: kidney, bladder, fallopian tube, and scrotum. The usual tests used to diagnose GUTB are the demonstration of mycobacterium in urine or body fluid and radiographic examination. Intravenous urography (IVU has been considered to be one of the most useful tests for the anatomical as well as the functional details of kidneys and ureters. In cases of renal failure, MRI can be used. Newer examinations such as radiometric liquid culture systems (i.e., BACTEC ® , Becton Dickinson,USA and polymerase chain reaction (PCR give rapid results and are highly sensitive in the identification of mycobacterium. Conclusion: GUTB can involve any part of the genitourinary system and presentation may vary from vague urinary symptoms to chronic kidney disease. Newer tests like radiometric liquid culture systems and polymerase chain reaction give rapid results and carry high diagnostic value.

  9. Topical fluoride for caries prevention

    Science.gov (United States)

    Weyant, Robert J.; Tracy, Sharon L.; Anselmo, Theresa (Tracy); Beltrán-Aguilar, Eugenio D.; Donly, Kevin J.; Frese, William A.; Hujoel, Philippe P.; Iafolla, Timothy; Kohn, William; Kumar, Jayanth; Levy, Steven M.; Tinanoff, Norman; Wright, J. Timothy; Zero, Domenick; Aravamudhan, Krishna; Frantsve-Hawley, Julie; Meyer, Daniel M.

    2015-01-01

    Background A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies. Types of Studies Reviewed The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents—including mouthrinses, varnishes, gels, foams and pastes—with caries increment outcomes published in English through October 2012. Results The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride caries-preventive agents. The panel makes recommendations for further research. Practical Implications The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.5 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from “in favor” to “expert opinion for.” As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. PMID:24177407

  10. Enamel remineralization: controlling the caries disease or treating early caries lesions?

    Directory of Open Access Journals (Sweden)

    Jaime Aparecido Cury

    2009-06-01

    Full Text Available The emphasis currently given to new technologies for enamel remineralization suggests that the changes in the understanding of the dental caries disease, which occurred in the last century, were either not yet adopted or were forgotten. Just like in the past, when the disease was "treated" by restoring cavities, there is presently a misunderstanding on the concept of incipient lesion remineralization. The aim of this paper was to review some concepts about caries, the natural phenomenon of enamel remineralization and the effect of fluoride (F on it, and also to discuss the clinical relevance of remineralizing products recently launched in the marketplace aiming to "treat early caries lesions".

  11. Occlusal Caries: Biological Approach for Its Diagnosis and Management

    DEFF Research Database (Denmark)

    Christina Carvalho, Joana; Dige, Irene; Machiulskiene, Vita

    2016-01-01

    the assessment of the occlusal biofilm and the stage of tooth eruption. Careful clinical examination of non-cavitated lesions, including assessment of the lesion activity status, remains the major tool to determine the immediate treatment need and to follow on the non-operative treatment outcome. Even medium...... caries should explore the relationship between the function and the structural composition of these biofilms to understand the role of occlusal biofilms in caries development. State-of-the-art measures to evaluate risk for occlusal caries lesion activity, caries incidence, and progression should include...

  12. Diagnostic Consideration for Sinonasal Wegener's Granulomatosis Clinically Mistaken for Carcinoma

    Science.gov (United States)

    La Rosa, Cristina; Emmanuele, Carmela; Tranchina, Maria Grazia; Ippolito, Massimo; Cosentino, Sebastiano; Saita, Vincenzo; Fraggetta, Filippo

    2013-01-01

    We report a case of Wegener's granulomatosis clinically mistaken for carcinoma in a 21-year-old girl presenting with an ulcerated mass of the nasopharynx associated with enlarged laterocervical nodes. The lesion was clinically suspected as malignant on the basis of clinical and radiological findings (namely, computed tomography scan and positron emission tomography). However, multiple biopsies were not conclusive for malignancy showing histological change suggestive of Wegener's granulomatosis. A serum determination of cANCA supported the diagnosis of Wegener's granulomatosis. Clinical findings and image studies suggested an erroneous diagnosis of malignancy whereas a definitive diagnosis of Wegener's granulomatosis was achieved only after repeated biopsies thus leading to a correct therapeutic approach. The Wegener granulomatosis must be added to the list of the differential diagnoses of the masses of the nasopharynx associated with or without enlarged laterocervical nodes. PMID:24106630

  13. Modern approaches to caries management of the primary dentition.

    Science.gov (United States)

    Innes, N P T; Evans, D J P

    2013-06-01

    When prevention of dental caries fails, and a child is exposed to the risk of pain and infection, the disease must be managed to reduce this risk. There is growing evidence supporting more 'biological' and fewer 'surgical' approaches to managing dental caries in primary teeth. These biological methods include partial and stepwise caries removal procedures, as well as techniques where no caries is removed. An overview of clinical trials comparing these biological methods to complete caries removal shows that they perform as well as traditional methods and have the advantage of reducing the incidence of iatrogenic pulpal exposures. The Hall Technique is one biological approach to managing caries in primary molars which involves sealing caries beneath preformed metal (stainless steel) crowns. The crown is cemented over the tooth without caries removal, tooth preparation or use of local anaesthesia. The clinical steps for the Hall Technique are straightforward but, as with all dental care provision, appropriate treatment planning for the procedure requires skill. The Hall Technique offers another method of managing early to moderately advanced, active carious lesions in primary molars, with good evidence of effectiveness and acceptability. This evidence aligns with the positive findings of other studies on biological strategies for managing caries in primary teeth.

  14. Caries og drikkevandets kvalitet

    DEFF Research Database (Denmark)

    Arvin, Erik; Bardow, Allan; Bruvo, Maja;

    2011-01-01

    Drikkevandskvaliteten har stor betydning for forekomsten af caries blandt 15 årige skolebørn, også selv om de bruger fluoridholdigt tandpasta. Ud over den kendte effekt af fluorid har vi vist, at calcium også har en væsentlig betydning. Begge ioner forebygger caries. Denne viden har væsentlig...

  15. Effect of fluoride varnish on caries prevention of partially erupted of permanent molar in high caries risk.

    Science.gov (United States)

    Suwansingha, Orawan; Rirattanapong, Praphasri

    2012-05-01

    The objective of this study was to measure the effectiveness of fluoride varnish as a public health intervention to prevent caries on partially erupted first and second permanent molars among 6-11 year old children at high risk for caries. In a six-month clinical trial, 105 children were randomly divided into a fluoride varnish (Duraphat) group (117 molars) or a control group (117 molars). The chi-square test used to compare caries occurrence in each group with a 95% level of confidence (pfluoride varnish resulted in 79% and 77.5% caries reduction in partially erupted permanent molars at 3 and 6 months, respectively. There were statistically significant differences in caries progression between the groups at 3 and 6 months. Fluoride varnish significantly reduced carious lesions in partially erupted molars at six months among high caries risk children.

  16. Dental caries in Victorian nursing homes.

    Science.gov (United States)

    Silva, M; Hopcraft, M; Morgan, M

    2014-09-01

    The poor oral health of nursing home residents is the cause of substantial morbidity and has major implications relating to health care policy. The aim of this study was to measure dental caries experience in Australians living in nursing homes, and investigate associations with resident characteristics. Clinical dental examinations were conducted on 243 residents from 19 nursing homes in Melbourne. Resident characteristics were obtained from nursing home records and interviews with residents, family and nursing home staff. Two dental examiners assessed coronal and root dental caries using standard ICDAS-II criteria. Residents were elderly, medically compromised and functionally impaired. Most required assistance with oral hygiene and professional dental care was rarely utilized. Residents had high rates of coronal and root caries, with a mean 2.8 teeth with untreated coronal caries and 5.0 root surfaces with untreated root caries. Functional impairment and irregular professional dental care were associated with higher rates of untreated tooth decay. There were no significant associations with medical conditions or the number of medications taken. Nursing home residents have high levels of untreated coronal and root caries, particularly those with high needs due to functional impairment but poor access to professional services. © 2014 Australian Dental Association.

  17. An artifical neural network for detection of simulated dental caries

    Energy Technology Data Exchange (ETDEWEB)

    Kositbowornchai, S. [Khon Kaen Univ. (Thailand). Dept. of Oral Diagnosis; Siriteptawee, S.; Plermkamon, S.; Bureerat, S. [Khon Kaen Univ. (Thailand). Dept. of Mechanical Engineering; Chetchotsak, D. [Khon Kaen Univ. (Thailand). Dept. of Industrial Engineering

    2006-08-15

    Objects: A neural network was developed to diagnose artificial dental caries using images from a charged-coupled device (CCD)camera and intra-oral digital radiography. The diagnostic performance of this neural network was evaluated against a gold standard. Materials and methods: The neural network design was the Learning Vector Quantization (LVQ) used to classify a tooth surface as sound or as having dental caries. The depth of the dental caries was indicated on a graphic user interface (GUI) screen developed by Matlab programming. Forty-nine images of both sound and simulated dental caries, derived from a CCD camera and by digital radiography, were used to 'train' an artificial neural network. After the 'training' process, a separate test-set comprising 322 unseen images was evaluated. Tooth sections and microscopic examinations were used to confirm the actual dental caries status.The performance of neural network was evaluated using diagnostic test. Results: The sensitivity (95%CI)/specificity (95%CI) of dental caries detection by the CCD camera and digital radiography were 0.77(0.68-0.85)/0.85(0.75-0.92) and 0.81(0.72-0.88)/0.93(0.84-0.97), respectively. The accuracy of caries depth-detection by the CCD camera and digital radiography was 58 and 40%, respectively. Conclusions: The model neural network used in this study could be a prototype for caries detection but should be improved for classifying caries depth. Our study suggests an artificial neural network can be trained to make the correct interpretations of dental caries. (orig.)

  18. Early Childhood Caries

    Directory of Open Access Journals (Sweden)

    Yumiko Kawashita

    2011-01-01

    Full Text Available Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with fluoride and diet counseling. However, these strategies alone are not sufficient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suffering from dental caries.

  19. The clinical features of mania and their representation in modern diagnostic criteria.

    Science.gov (United States)

    Kendler, K S

    2017-04-01

    This review seeks to determine the degree to which modern operationalized diagnostic criteria for mania reflect the clinical features of mania described historically by expert textbook authors. Clinical descriptions of mania appearing in 18 textbooks published between 1899 and 1956 were reviewed and compared to the criteria for mania from six modern operationalized diagnostic systems. Twenty-two prominent symptoms and signs were reported by five or more authors. Two symptoms (elevated mood and grandiosity) and four signs (hyperactivity, pressured speech, irritability, and new activities with painful consequences) were reported by every author. A strong relationship was seen between the frequency with which the clinical features were reported and the likelihood of their inclusion in modern diagnostic systems. However, many symptoms and signs including impulsivity, hypersexuality, mood lability, altered moral standards, increased humor, hypergraphia, and a vigorous physical appearance were not included in any modern criteria. Indeed, DSM-5 contains only eight of the historically noted clinical features. We conclude that modern operationalized criteria for mania well reflect symptoms and signs frequently reported by historical experts. This suggests that the clinical construct of mania has been relatively stable in western Psychiatry since the turn of the 20th century. However, many useful clinical features of mania described in these textbooks are missing from these criteria thereby illustrating the limitations of clinical evaluations restricted to the assessment of only current diagnostic criteria. The disorders we study and treat are considerably richer clinically than is reflected in the DSM criteria which we use to diagnose them.

  20. A closer look at diagnosis in clinical dental practice: part 5. Emerging technologies for caries detection and diagnosis.

    Science.gov (United States)

    Pretty, Iain A; Maupomé, Gerardo

    2004-09-01

    Parts 5 and 6 of this series examine innovations in diagnostic and management procedures and assess their potential to become everyday tools of the dental clinician. This paper examines some of the diagnostic tools supporting a philosophical shift in mainstream dental practice from concern with extensively decayed teeth to a focus on detecting incipient demineralized tissues. With the latter approach, the incipient carious process can be reversed by promoting enamel remineralization and thus eliminating the need for restorative intervention. Numerous methods and devices have been developed to detect, diagnose and monitor such lesions, and several have been produced in versions that may appeal to dental practitioners. This paper considers 3 of these methods and devices: the DIAGNODent laser device, quantitative light-induced fluorescence and the Digital Imaging Fiber-Optic Transillumination device. Each technique is illustrated, the research on its effectiveness is assessed to determine usefulness to the practitioner, and the comparative advantages of the 3 adjunct tools are discussed.

  1. Primary hyperparathyroidism: epidemiology, clinical features, diagnostic tools and current management

    Directory of Open Access Journals (Sweden)

    Andrea Percivale

    2015-12-01

    Full Text Available Primary hyperparathyroidism (PHPT is a clinical condition characterized by overactive parathyroid gland secretion of parathyroid hormone with concurrent alteration of the phosphocalcemic metabolism. We present a literature review on primary hyperparathyroidism addressing key on clinical presentation, causes, medical and surgical treatment at the best of our knowledge. Based on this review we confirm the role of serum calcium and serum level examination, as well as we define the definitive treatment for PHPT being parathyroidectomy. In case of contraindication for surgery, medical treatment can play a relevant role.

  2. Schizoaffective disorder-- the reliability of its clinical diagnostic use

    DEFF Research Database (Denmark)

    Vollmer-Larsen, Anne; Jacobsen, TB; Hemmingsen, R;

    2006-01-01

    OBJECTIVE: Patients with psychoses often suffer from affective symptoms. The originally broad concept of schizoaffective disorder (SAD) has been significantly narrowed, transformed into a convoluted set of criteria both in the ICD-10 and DSM-IV. We examined the reliability of the clinical use....... Diagnoses were allocated by OPCRIT algorithm and by consensus of two psychiatrists. RESULTS: No patients fulfilled the SAD lifetime diagnosis according to DSM-IV criteria and the raters diagnosed only six patients as possible ICD-10 SAD. CONCLUSION: A moratorium on the clinical use of the SAD diagnosis...

  3. Cavity lining after excavating caries lesions

    DEFF Research Database (Denmark)

    Schwendicke, Falk; Göstemeyer, Gerd; Gluud, Christian

    2015-01-01

    OBJECTIVES: After removal of dentin caries lesions, cavity lining has been advocated. Non-clinical data support this approach, but clinical data are sparse and ambiguous. We aimed at evaluating the benefits and harms of cavity lining using meta-analysis and Trial Sequential Analysis. DATA: We...... included randomized clinical trials comparing restorations without versus with cavity lining for treating primary caries lesions. Only trials reporting failure (defined as need to re-retreat) after ≥1 year follow-up were included. Trial selection, data extraction, and risk of bias assessment were conducted....... STUDY SELECTION: From 128 studies, three randomized trials (89/130 patients or teeth), all treating primary teeth, were included. The trials had high risk of bias. All trials compared no lining versus calcium hydroxide lining after selective caries removal followed by adhesive restoration. Follow...

  4. Dental caries in Rome, 50-100 AD

    DEFF Research Database (Denmark)

    Fejerskov, O; Guldager Bilde, P; Bizzarro, Martin

    2012-01-01

    Scarce information exists on the clinical features of dental caries in the Imperial Roman population and no structural data on caries lesions from this period have so far been published. We report on the findings of 86 teeth (50-100 AD) found during archaeological excavations of the temple...

  5. Fluorine profiling after application of various anti-caries gels

    Energy Technology Data Exchange (ETDEWEB)

    Zschau, H.E.; Plier, F.; Otto, G. (Karl-Marx-Universitaet, Leipzig (German Democratic Republic). Wissenschaftsbereich Angewandte Kernphysik); Wyrwich, C.; Treide, A. (Karl-Marx-Universitaet, Leipzig (German Democratic Republic). Poliklinik fuer Orthopaedische und Kinderstomatologie)

    1990-04-01

    Two newly developed caries-preventing gels were tested together with Elmex on pre-school children over a time of 3 years. Proton-induced gamma-ray emission spectrometry (PIGE) was used to measure the fluorine profiles in milk teeth (incisors). In accordance with the clinical statement the results allow to produce a new anti-caries drug. (orig.).

  6. Diagnostic value of urinary dysmorphic erythrocytes in clinical practice

    NARCIS (Netherlands)

    M.J. Crop (Meindert); Y.B. de Rijke (Yolanda); P.C.M.S. Verhagen (Paul); K. Cransberg (Karlien); R. Zietse (Bob)

    2010-01-01

    textabstractBackground: In clinical practice, discriminating between glomerular and nonglomerular causes of hematuria is often difficult. Dysmorphic red blood cells (dRBC) in the urinary sediment are claimed to be effective, but the cutoff points in the literature vary. This follow-up study aimed to

  7. Schizoaffective disorder-- the reliability of its clinical diagnostic use

    DEFF Research Database (Denmark)

    Vollmer-Larsen, Anne; Jacobsen, TB; Hemmingsen, R

    2006-01-01

    OBJECTIVE: Patients with psychoses often suffer from affective symptoms. The originally broad concept of schizoaffective disorder (SAD) has been significantly narrowed, transformed into a convoluted set of criteria both in the ICD-10 and DSM-IV. We examined the reliability of the clinical use...

  8. Subjective experiences in psychotic disorders: diagnostic value and clinical correlates.

    Science.gov (United States)

    Peralta, V; Cuesta, M J

    1998-01-01

    This study evaluated the prevalence and clinical correlates of abnormal subjective experiences across functional psychotic disorders. Patients were recruited from consecutive admissions with the following diagnoses; schizophrenia (n = 40), schizophreniform disorder (n = 40), schizoaffective disorder (n = 21), mood disorder (n = 18), brief reactive psychosis (n = 15), and atypical psychosis (n = 16). Subjective experiences were assessed using the Frankfurt Complaint Questionnaire (FCQ), and the clinical status was assessed with the Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS) and the Manual for the Assessment and Documentation of Psychopathology (AMDP). Neither the FCQ total score nor individual subjective experiences displayed significant differences across diagnoses. When the clinical predictors of subjective experiences were studied by multiple regression analyses, a different pattern resulted for individual psychotic disorders. In schizophrenic patients, subjective experiences were predicted by female gender, euphoria, lack of insight, greater illness severity, and more positive symptoms. The only predictors of subjective experiences in the schizophreniform disorder group were the negative symptoms. Within the affective disorders group, subjective experiences had no clinical predictors.

  9. Influence of fruit consumption and fluoride application on the prevalence of caries and erosion in vegetarians--a controlled clinical trial.

    Science.gov (United States)

    Staufenbiel, I; Adam, K; Deac, A; Geurtsen, W; Günay, H

    2015-10-01

    Caries and erosion are common diseases of the dental hard tissues. The influence of vegetarianism on the development of caries and erosion has scarcely been investigated in the past. The aim of the present study was to evaluate the influence of fruit consumption and topical fluoride application on the prevalence of caries and erosion in vegetarians. In 100 vegetarians and 100 nonvegetarians, a dental examination was performed. The indices for decayed, missing, filled teeth (DMFT) and surfaces (DMFS) were determined. DMFT and DMFS were subdivided into decayed teeth (DT), filled teeth (FT), decayed surfaces (DS) and filled surfaces (FS). In addition, the hygiene index and the number of teeth with dental erosion (DE), root caries (RC) and overhanging restoration margins (ORM) were recorded. A questionnaire assessed patients' eating habits, frequency of oral hygiene, dentist visits and topical fluoride application. For statistical analysis, unpaired t-test, Mann-Whitney test and Pearson's chi-square test were applied. Vegetarians had significantly more DT (Pvegetarians compared with nonvegetarians. In particular, fluoride-containing toothpaste (Pvegetarians. The presented data suggest that vegetarians have an increased risk for caries and erosion. Topical fluoride application was shown to be effective in preventing caries, but not in preventing erosion.

  10. Clinical and diagnostic aspects of gluten related disorders.

    Science.gov (United States)

    Tovoli, Francesco; Masi, Chiara; Guidetti, Elena; Negrini, Giulia; Paterini, Paola; Bolondi, Luigi

    2015-03-16

    Gluten is one of the most abundant and widely distributed components of food in many areas. It can be included in wheat, barley, rye, and grains such as oats, barley, spelt, kamut, and triticale. Gluten-containing grains are widely consumed; in particular, wheat is one of the world's primary sources of food, providing up to 50% of the caloric intake in both industrialized and developing countries. Until two decades ago, celiac disease (CD) and other gluten-related disorders were believed to be exceedingly rare outside of Europe and were relatively ignored by health professionals and the global media. In recent years, however, the discovery of important diagnostic and pathogenic milestones led CD from obscurity to global prominence. In addition, interestingly, people feeding themselves with gluten-free products greatly outnumber patients affected by CD, fuelling a global consumption of gluten-free foods with approximately $2.5 billion in United States sales each year. The acknowledgment of other medical conditions related to gluten that has arisen as health problems, providing a wide spectrum of gluten-related disorders. In February 2011, a new nomenclature for gluten-related disorders was created at a consensus conference in London. In this review, we analyse innovations in the field of research that emerged after the creation of the new classification, with particular attention to the new European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines for CD and the most recent research about non-celiac gluten sensitivity.

  11. High-throughput cell analysis and sorting technologies for clinical diagnostics and therapeutics

    Science.gov (United States)

    Leary, James F.; Reece, Lisa M.; Szaniszlo, Peter; Prow, Tarl W.; Wang, Nan

    2001-05-01

    A number of theoretical and practical limits of high-speed flow cytometry/cell sorting are important for clinical diagnostics and therapeutics. Three applications include: (1) stem cell isolation with tumor purging for minimal residual disease monitoring and treatment, (2) identification and isolation of human fetal cells from maternal blood for prenatal diagnostics and in-vitro therapeutics, and (3) high-speed library screening for recombinant vaccine production against unknown pathogens.

  12. Evaluating next-generation sequencing for direct clinical diagnostics in diarrhoeal disease.

    Science.gov (United States)

    Joensen, K G; Engsbro, A L Ø; Lukjancenko, O; Kaas, R S; Lund, O; Westh, H; Aarestrup, F M

    2017-03-11

    The accurate microbiological diagnosis of diarrhoea involves numerous laboratory tests and, often, the pathogen is not identified in time to guide clinical management. With next-generation sequencing (NGS) becoming cheaper, it has huge potential in routine diagnostics. The aim of this study was to evaluate the potential of NGS-based diagnostics through direct sequencing of faecal samples. Fifty-eight clinical faecal samples were obtained from patients with diarrhoea as part of the routine diagnostics at Hvidovre University Hospital, Denmark. Ten samples from healthy individuals were also included. DNA was extracted from faecal samples and sequenced on the Illumina MiSeq system. Species distribution was determined with MGmapper and NGS-based diagnostic prediction was performed based on the relative abundance of pathogenic bacteria and Giardia and detection of pathogen-specific virulence genes. NGS-based diagnostic results were compared to conventional findings for 55 of the diarrhoeal samples; 38 conventionally positive for bacterial pathogens, two positive for Giardia, four positive for virus and 11 conventionally negative. The NGS-based approach enabled detection of the same bacterial pathogens as the classical approach in 34 of the 38 conventionally positive bacterial samples and predicted the responsible pathogens in five of the 11 conventionally negative samples. Overall, the NGS-based approach enabled pathogen detection comparable to conventional diagnostics and the approach has potential to be extended for the detection of all pathogens. At present, however, this approach is too expensive and time-consuming for routine diagnostics.

  13. Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of heterogeneity.

    Directory of Open Access Journals (Sweden)

    Thais Gimenez

    Full Text Available BACKGROUND: Fluorescence-based methods have been proposed to aid caries lesion detection. Summarizing and analysing findings of studies about fluorescence-based methods could clarify their real benefits. OBJECTIVE: We aimed to perform a comprehensive systematic review and meta-analysis to evaluate the accuracy of fluorescence-based methods in detecting caries lesions. DATA SOURCE: Two independent reviewers searched PubMed, Embase and Scopus through June 2012 to identify papers/articles published. Other sources were checked to identify non-published literature. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND DIAGNOSTIC METHODS: The eligibility criteria were studies that: (1 have assessed the accuracy of fluorescence-based methods of detecting caries lesions on occlusal, approximal or smooth surfaces, in both primary or permanent human teeth, in the laboratory or clinical setting; (2 have used a reference standard; and (3 have reported sufficient data relating to the sample size and the accuracy of methods. STUDY APPRAISAL AND SYNTHESIS METHODS: A diagnostic 2×2 table was extracted from included studies to calculate the pooled sensitivity, specificity and overall accuracy parameters (Diagnostic Odds Ratio and Summary Receiver-Operating curve. The analyses were performed separately for each method and different characteristics of the studies. The quality of the studies and heterogeneity were also evaluated. RESULTS: Seventy five studies met the inclusion criteria from the 434 articles initially identified. The search of the grey or non-published literature did not identify any further studies. In general, the analysis demonstrated that the fluorescence-based method tend to have similar accuracy for all types of teeth, dental surfaces or settings. There was a trend of better performance of fluorescence methods in detecting more advanced caries lesions. We also observed moderate to high heterogeneity and evidenced publication bias. CONCLUSIONS

  14. Caries remineralisation and arresting effect in children by professionally applied fluoride treatment – a systematic review

    OpenAIRE

    Gao, Sherry Shiqian; Zhang, Shinan; Mei, May Lei; Lo, Edward Chin-Man; Chu, Chun-Hung

    2016-01-01

    Background As a low-cost and easily operated treatment, the use of professionally applied topical fluoride was approved for preventing dental caries and remineralising early enamel caries or white spot lesions. It is also used to arrest dentine caries. The aim of this study is to investigate the clinical efficacy of professional fluoride therapy in remineralising and arresting caries in children. Method A systematic search of publications from 1948 to 2014 was conducted using four databases: ...

  15. CLINICAL DIAGNOSTIC VALUE OF AUTOANTIBODIES IN THE DIAGNOSIS OF AUTOIMMUNE LIVER DISEASES

    Directory of Open Access Journals (Sweden)

    V. V. Bazarnyi

    2015-01-01

    Full Text Available We are studied the 15 patients with autoimmune liver diseases and 36 patients without autoimmune pathology found the diagnostic value of antinuclear and antimitochondrial autoantibodies (AMA-M2 tests, and antibodies to asialoglycoprotein receptor (anti-ASGPR. Based on the ROC analysis showed that the diagnostic sensitivity and diagnostic specificity of AMA-M2 was 73% and 100% and for anti-ASGPR – 60% and 77%, respectively. Therefore, the test for anti-ASGPR in autoimmune diseases of the liver showed no advantages over standart tests, and its using in clinical practice requires clarification. 

  16. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear

    DEFF Research Database (Denmark)

    Reiman, M P; Goode, A P; Cook, C E;

    2015-01-01

    to summarise sensitivities (SN), specificities (SP), diagnostic odds ratio (DOR) and respective confidence intervals (CI). RESULTS: The employed search strategy revealed 21 potential articles, with one demonstrating high quality. Nine articles qualified for meta-analysis. The meta-analysis demonstrated...... surgical decision-making. OBJECTIVE: Summarise/evaluate the current diagnostic accuracy of various clinical tests germane to hip FAI/ALT pathology. METHODS: A computer-assisted literature search of MEDLINE, CINAHL and EMBASE databases using keywords related to diagnostic accuracy of the hip joint, as well...

  17. Bacteriophages in clinical samples can interfere with microbiological diagnostic tools.

    Science.gov (United States)

    Brown-Jaque, Maryury; Muniesa, Maite; Navarro, Ferran

    2016-09-09

    Bacteriophages are viruses that infect bacteria, and they are found everywhere their bacterial hosts are present, including the human body. To explore the presence of phages in clinical samples, we assessed 65 clinical samples (blood, ascitic fluid, urine, cerebrospinal fluid, and serum). Infectious tailed phages were detected in >45% of ascitic fluid and urine samples. Three examples of phage interference with bacterial isolation were observed. Phages prevented the confluent bacterial growth required for an antibiogram assay when the inoculum was taken from an agar plate containing lysis plaques, but not when taken from a single colony in a phage-free area. In addition, bacteria were isolated directly from ascitic fluid, but not after liquid enrichment culture of the same samples, since phage propagation lysed the bacteria. Lastly, Gram-negative bacilli observed in a urine sample did not grow on agar plates due to the high densities of infectious phages in the sample.

  18. Clinical and neuropathological picture of ethylmalonic aciduria - diagnostic dilemma.

    Science.gov (United States)

    Jamroz, Ewa; Paprocka, Justyna; Adamek, Dariusz; Pytel, Justyna; Szczechowska, Katarzyna; Grabska, Natalia; Malec, Michalina; Głuszkiewicz, Ewa; Daab, Michał; Wodołażski, Anatolij

    2011-01-01

    Increased ethylmalonic acid (EMA) in urine is a non-specific finding, and is observed in a number of inborn errors of metabolism, as well as in individuals who carry one of two common polymorphisms identified in the SCAD coding region. The authors present an 8-month-old girl with a suspicion of neuroinfection, although the clinical presentation led to diagnosis of ethylmalonic aciduria. From the neuropathological point of view the most remarkable changes were observed in the brain cortex, which was diffusely damaged practically in all regions of the brain. Of note, the most severe destruction was observed in the deepest regions of the sulci. The cortex of the affected regions showed no normal stratification and its structure was almost totally replaced by a form of "granulation tissue" with a markedly increased number of capillaries. To the authors' knowledge this is the first clinical report of ethylmalonic aciduria with brain autopsy findings.

  19. Bacteriophages in clinical samples can interfere with microbiological diagnostic tools

    Science.gov (United States)

    Brown-Jaque, Maryury; Muniesa, Maite; Navarro, Ferran

    2016-01-01

    Bacteriophages are viruses that infect bacteria, and they are found everywhere their bacterial hosts are present, including the human body. To explore the presence of phages in clinical samples, we assessed 65 clinical samples (blood, ascitic fluid, urine, cerebrospinal fluid, and serum). Infectious tailed phages were detected in >45% of ascitic fluid and urine samples. Three examples of phage interference with bacterial isolation were observed. Phages prevented the confluent bacterial growth required for an antibiogram assay when the inoculum was taken from an agar plate containing lysis plaques, but not when taken from a single colony in a phage-free area. In addition, bacteria were isolated directly from ascitic fluid, but not after liquid enrichment culture of the same samples, since phage propagation lysed the bacteria. Lastly, Gram-negative bacilli observed in a urine sample did not grow on agar plates due to the high densities of infectious phages in the sample. PMID:27609086

  20. Schizoaffective disorder-- the reliability of its clinical diagnostic use

    DEFF Research Database (Denmark)

    Vollmer-Larsen, Anne; Jacobsen, TB; Hemmingsen, R

    2006-01-01

    OBJECTIVE: Patients with psychoses often suffer from affective symptoms. The originally broad concept of schizoaffective disorder (SAD) has been significantly narrowed, transformed into a convoluted set of criteria both in the ICD-10 and DSM-IV. We examined the reliability of the clinical use...... of this diagnosis in university settings. METHOD: All patients discharged from two university hospitals in Copenhagen in year 2002 with a diagnosis of ICD-10 SAD (n = 59) were re-evaluated using the Operational Criteria (OPCRIT) checklist expanded by additional items and applied to hospital chart material....... Diagnoses were allocated by OPCRIT algorithm and by consensus of two psychiatrists. RESULTS: No patients fulfilled the SAD lifetime diagnosis according to DSM-IV criteria and the raters diagnosed only six patients as possible ICD-10 SAD. CONCLUSION: A moratorium on the clinical use of the SAD diagnosis...

  1. Clinical aspects of MR colonography as a diagnostic tool

    DEFF Research Database (Denmark)

    Achiam, Michael

    2010-01-01

    Since first described in 1997, MR colonography (MRC) has since been labelled as a promising new, non-invasive technique for examining the colon. At present time, the examination is ready to be implemented as a supplement to incomplete colonoscopy or preoperative colonic evaluation. Furthermore, MRC...... and that polypectomy might be curative. Colonoscopy remains the gold standard for full colon evaluation. However, the result of our studies can justify clinical use of MRC on selected indications, e.g. in the cases where colonoscopy is incomplete or technically difficult. Since up to 54% of all preoperative colon...... evaluations in patients with colorectal cancer and up to 17-23% of regular colonoscopies are incomplete, the clinical potential of MRC is evident. Furthermore, in our studies we have shown the insufficiency of preoperative colonic evaluation by CC. In addition, considering the invasiveness, the serious...

  2. High diagnostic yield of clinical exome sequencing in Middle Eastern patients with Mendelian disorders.

    Science.gov (United States)

    Yavarna, Tarunashree; Al-Dewik, Nader; Al-Mureikhi, Mariam; Ali, Rehab; Al-Mesaifri, Fatma; Mahmoud, Laila; Shahbeck, Noora; Lakhani, Shenela; AlMulla, Mariam; Nawaz, Zafar; Vitazka, Patrik; Alkuraya, Fowzan S; Ben-Omran, Tawfeg

    2015-09-01

    Clinical exome sequencing (CES) has become an increasingly popular diagnostic tool in patients with heterogeneous genetic disorders, especially in those with neurocognitive phenotypes. Utility of CES in consanguineous populations has not yet been determined on a large scale. A clinical cohort of 149 probands from Qatar with suspected Mendelian, mainly neurocognitive phenotypes, underwent CES from July 2012 to June 2014. Intellectual disability and global developmental delay were the most common clinical presentations but our cohort displayed other phenotypes, such as epilepsy, dysmorphism, microcephaly and other structural brain anomalies and autism. A pathogenic or likely pathogenic mutation, including pathogenic CNVs, was identified in 89 probands for a diagnostic yield of 60%. Consanguinity and positive family history predicted a higher diagnostic yield. In 5% (7/149) of cases, CES implicated novel candidate disease genes (MANF, GJA9, GLG1, COL15A1, SLC35F5, MAGE4, NEUROG1). CES uncovered two coexisting genetic disorders in 4% (6/149) and actionable incidental findings in 2% (3/149) of cases. Average time to diagnosis was reduced from 27 to 5 months. CES, which already has the highest diagnostic yield among all available diagnostic tools in the setting of Mendelian disorders, appears to be particularly helpful diagnostically in the highly consanguineous Middle Eastern population.

  3. Kinematic Measures during a Clinical Diagnostic Technique for Human Neck Disorder: Inter- and Intraexaminer Comparisons

    Directory of Open Access Journals (Sweden)

    Joseph Vorro

    2013-01-01

    Full Text Available Diagnoses of human musculoskeletal dysfunction of the cervical spine are indicated by palpable clues of a patient’s structural compliance/noncompliance as this body segment responds to diagnostic motion demands applied by a clinician. This process includes assessments of motion range, motion performance, and changes in tissue responses. However, biomechanical quantification of these diagnostic actions and their reproducible components is lacking. As a result, this study sought to use objective kinematic measures to capture aspects of the diagnostic process to compare inter- and intraexaminer motion behaviors when performing a specific clinical diagnostic protocol. Pain-free volunteers and a group determined to be symptomatic based on a psychometric pain score were examined by two clinicians while three-dimensional kinematic data were collected. Intraexaminer diagnostic motion ranges of cervical lateral flexion and secondary rotations were consistent for each examiner and for each subject group. However, interexaminer comparisons for motion range, secondary rotations, and average velocities yielded consistently larger measures for one examiner for both subject groups (P<0.05. This research demonstrates that fundamental aspects of the clinical diagnostic process for human neck disorders can be identified and measured using kinematic parameters. Further, these objective data have the potential to be linked to clinical decision making.

  4. Transillumination and reflectance probes for in vivo near-IR imaging of dental caries

    Science.gov (United States)

    Simon, Jacob C.; Lucas, Seth A.; Staninec, Michal; Tom, Henry; Chan, Kenneth H.; Darling, Cynthia L.; Fried, Daniel

    2014-02-01

    Previous studies have demonstrated the utility of near infrared (NIR) imaging for caries detection employing transillumination and reflectance imaging geometries. Three intra-oral NIR imaging probes were fabricated for the acquisition of in vivo, real time videos using a high definition InGaAs SWIR camera and near-IR broadband light sources. Two transillumination probes provide occlusal and interproximal images using 1300-nm light where water absorption is low and enamel manifests the highest transparency. A third reflectance probe utilizes cross polarization and operates at >1500-nm, where water absorption is higher which reduces the reflectivity of sound tissues, significantly increasing lesion contrast. These probes are being used in an ongoing clinical study to assess the diagnostic performance of NIR imaging for the detection of caries lesions in teeth scheduled for extraction for orthodontic reasons.

  5. Clinics in diagnostic imaging (58). Chronic cerebral paragonimiasis.

    Science.gov (United States)

    Kaw, G J; Sitoh, Y Y

    2001-02-01

    A 36-year-old Korean man presented with a history of epilepsy. MR imaging of the brain revealed multiple conglomerated round nodules that were hypointense on both T1-and-T2 weighted images. These were located at the left temporal and occipital lobes and had surrounding encephalomalacia. CT scan confirmed the presence of large calcified nodules in the corresponding regions. These imaging findings were typical of chronic cerebral paragonimiasis. The clinical, CT and MR features of cerebral paragonimiasis are reviewed.

  6. Clinics in diagnostic imaging (82). Lesser trochanter metastasis.

    Science.gov (United States)

    Peh, W C G; Muttarak, M

    2003-02-01

    A 73-year-old woman who had previous mastectomy for breast carcinoma presented with persistent pain over the left hip area for two to three months. Pelvic radiograph showed an expanded osteolytic lesion involving the lesser trochanter of the left femur, with adjacent ill-defined destructive changes. She subsequently developed a displaced pathological fracture through the lesser trochanteric metastasis. The clinical features and pathophysiology of bone metastases are discussed. The role of imaging, with additional illustrative examples, is emphasised.

  7. Caries status in young Colombian children expressed by the ICCMS™ visual/radiographic combined caries staging system

    DEFF Research Database (Denmark)

    Cortes, Andrea; Ekstrand, Kim Rud; Gamboa, Luis Fernando

    2017-01-01

    OBJECTIVE: To report (1) the caries experience prevalence and mean, and the caries severity and distribution patterns, expressed clinically and combined with radiographs with the conventional and ICCMS™ systems in young children from Bogotá, Colombia; (2) the contribution of including radiographs...

  8. Epidemiological, clinical and diagnostic aspects of sheep conidiobolomycosis in Brazil

    Directory of Open Access Journals (Sweden)

    Carla Weiblen

    2016-05-01

    Full Text Available ABSTRACT: Conidiobolomycosis is an emerging disease caused by fungi of the cosmopolitan genus Conidiobolus . Particular strains of Conidiobolus coronatus, Conidiobolus incongruus and Conidiobolus lamprauges , mainly from tropical or sub-tropical origin, cause the mycosis in humans and animals, domestic or wild. Lesions are usually granulomatous and necrotic in character, presenting two clinical forms: rhinofacial and nasopharyngeal. This review includes the main features of the disease in sheep, with an emphasis on the epidemiology, clinical aspects, and diagnosis of infections caused by Conidiobolus spp. in Brazil. In this country, the disease is endemic in the Northeast and Midwest, affecting predominantly woolless sheep breeds and occasioning death in the majority of the studied cases. The species responsible for infections of sheep are C. coronatus and C. lamprauges and the predominant clinical presentation is nasopharyngeal. These fungal infections are very important, since they compromise the health status of the sheep flock and cause serious economic losses to the sheep industry. Thus, research is needed to investigate faster tools for diagnosis and effective methods for the control and treatment of conidiobolomycosis.

  9. Clinical and diagnostic characteristics of hyperprolactinemia in childhood and adolescence.

    Science.gov (United States)

    Catli, Gonul; Abaci, Ayhan; Bober, Ece; Büyükgebiz, Atilla

    2013-01-01

    Pituitary adenoma is the most common cause of hyperprolactinemia, which is a rare endocrine disorder encountered in pediatric patient care. Epidemiological and clinical information about hyperprolactinemia in childhood and adolescence is limited. Clinical signs of hyperprolactinemia are very heterogeneous. In girls, disturbances in menstrual function and galactorrhea may be seen, whereas in boys, headache, visual disturbances, delayed pubertal development and hypogonadism are often present. Owing to the ease of ordering a serum prolactin measurement, an evidence-based, cost-effective approach to the management of this endocrine disorder is required. Before a diagnosis of hyperprolactinemia is made, drug use, renal insufficiency, hypothyroidism, and parasellar tumors should be excluded. The main objectives of treatment are normalization of prolactin level, adenoma shrinkage, and recovery from clinical signs related to hyperprolactinemia. In patients with microadenoma, invasive or non-invasive macroadenoma, and even in patients with visual field defects, dopamine agonists are the first-line treatment. Surgical treatment is indicated in patients who are unresponsive or intolerant to medical treatment or who have persistent neurological signs. Radiotherapy should be considered as a supportive treatment for patients in whom surgery fails or medical response is not achieved.

  10. A novel LED-based device for occlusal caries detection.

    Science.gov (United States)

    Aktan, Ali Murat; Cebe, Mehmet Ata; Ciftçi, Mehmet Ertuğrul; Sirin Karaarslan, Emine

    2012-11-01

    The aim of this in-vitro study was to compare the performance of laser-based (DIAGNOdent, KaVo, Biberach, Germany) and LED-based (Midwest Caries I.D., DENTSPLY Professional, New York, USA) caries detectors in the detection of occlusal caries in permanent molars. The study consisted of 129 visually sound or non-cavitated pits or fissures in 82 extracted permanent human molar teeth. Two trained examiners used the laser-based and LED-based caries detectors to examine the fissures for caries. The teeth were then sectioned at the surfaces suspected of containing occlusal caries and histologically evaluated using stereomicroscopy as a gold standard. Inter-examiner reliability of the caries detector examination was assessed using Cohen's Kappa statistics. The sensitivity, specificity, and accuracy in diagnosing occlusal caries using the two devices were calculated according to appropriate cut-off scores. Receiver operating characteristic (ROC) curves were also determined to compare the diagnostic performance of the devices in occlusal caries diagnosis. The cut-off level of significance was taken as p = 0.005. Cohen's Kappa showed substantial agreement for the laser-based caries detector (0.74), and almost perfect agreement for the LED-based (0.89) caries detector. The specificity of the laser-based device varied from 0.49 to 0.97 at T1 and T2. Its sensitivity varied from 0.33 to 0.65 at T1 and T2. The specificity of the LED-based device varied from 0.48 to 0.56 at T1 and T2. Its sensitivity varied from 0.65 to 0.84 at T1 and from 0.80 to 0.84 at T2. Taking the limitations of the current study into consideration, the DIAGNOdent laser pen was more accurate in determining when teeth were free of occlusal caries than was the Midwest Caries I.D. LED-based device, although the Midwest Caries I.D. device more often revealed the presence of occlusal caries than did the DIAGNOdent pen.

  11. Spectroscopic Detection of Caries Lesions

    OpenAIRE

    Mika Ruohonen; Katri Palo; Jarmo Alander

    2013-01-01

    Background. A caries lesion causes changes in the optical properties of the affected tissue. Currently a caries lesion can be detected only at a relatively late stage of development. Caries diagnosis also suffers from high interobserver variance. Methods. This is a pilot study to test the suitability of an optical diffuse reflectance spectroscopy for caries diagnosis. Reflectance visible/near-infrared spectroscopy (VIS/NIRS) was used to measure caries lesions and healthy enamel on extracted h...

  12. Identification of Microbial and Proteomic Biomarkers in Early Childhood Caries

    Directory of Open Access Journals (Sweden)

    Thomas C. Hart

    2011-01-01

    Full Text Available The purpose of this study was to provide a univariate and multivariate analysis of genomic microbial data and salivary mass-spectrometry proteomic profiles for dental caries outcomes. In order to determine potential useful biomarkers for dental caries, a multivariate classification analysis was employed to build predictive models capable of classifying microbial and salivary sample profiles with generalization performance. We used high-throughput methodologies including multiplexed microbial arrays and SELDI-TOF-MS profiling to characterize the oral flora and salivary proteome in 204 children aged 1–8 years (n=118 caries-free, n=86 caries-active. The population received little dental care and was deemed at high risk for childhood caries. Findings of the study indicate that models incorporating both microbial and proteomic data are superior to models of only microbial or salivary data alone. Comparison of results for the combined and independent data suggests that the combination of proteomic and microbial sources is beneficial for the classification accuracy and that combined data lead to improved predictive models for caries-active and caries-free patients. The best predictive model had a 6% test error, >92% sensitivity, and >95% specificity. These findings suggest that further characterization of the oral microflora and the salivary proteome associated with health and caries may provide clinically useful biomarkers to better predict future caries experience.

  13. [Modern clinical and radiological approach to diagnostics of odontogenic sinusitis].

    Science.gov (United States)

    Khomutova, E Yu; Ignat'ev, Yu T; Demyanchuk, A N; Demyanchuk, A B

    2015-01-01

    Inflammatory diseases of the maxillary sinuses affect up to 70% of the adult population. Odontogenic maxillary sinusitis represents 13-86% of the inflammatory processes of maxillofacial area, with the incidence range being explained rather by varying diagnosis criteria than the true incidence difference of odontogenic lesions. The aim of the study was to summarize the clinical and radiological characteristics of odontogenic sinusitis according to patients records in the Department of Maxillofacial Surgery of Omsk Clinical Hospital No11 and the oral surgery department of BUZ GKSP No1 in 2009-2014. A total of 948 records of patient (aged 17 to 68 years) with maxillary sinusitis were identified. X-ray examinations were performed by CT PISASSO TRIO ("KoYo", South Korea) and MSCT Brillians 6 and Brillians 64 ((Philips HealthCare), Netherlands). Images were obtained in axial projection with slice thickness of 0.2-0.6 mm with multiplanar reconstructions (MPR) in a variety of direct and oblique projections. Altogether 664 patients were diagnosed with foreign bodies in the maxillary sinuses (filling material in 569 cases, roots or root fragments? implants, rubber drains, fragments of endodontic instruments in 95 cases). In 284 persons odontogenic cysts were found. Almost every fifth case was complicated by mycotic infection. Analysis of the results showed that only a multidisciplinary approach including dentists, maxillofacial surgeons, otolaryngologists and radiologists, as well as dental volumetric tomography or multislice CT can ensure the correct clinical and radiological approaches to determine the tactics of treatment in patients with sinusitis, reduce the incidence of relapses and chronic inflammatory processes in the maxillary sinuses.

  14. Clinics in diagnostic imaging (114). Rupture of the right testis.

    Science.gov (United States)

    Muttarak, M; Thinyu, S; Lojanapiwat, B

    2007-03-01

    A 22-year-old man, who was kicked in the scrotum during Thai kickboxing, presented with a painful swelling of the right hemiscrotum. Scrotal ultrasonography (US) showed an enlarged right testis with heterogeneous echogenicity and irregular contours. Colour Doppler US showed vascularity in the upper pole of the right testis and avascularity in the lower pole. Emergency exploration of the right hemiscrotum revealed laceration of the lower pole of the right testis. Debridement and repair of the right testis were performed. The clinical manifestations, role of US and US findings of scrotal trauma are discussed.

  15. Clinics in diagnostic imaging (112). Perinatal lethal hypophosphatasia (PLH).

    Science.gov (United States)

    Kritsaneepaiboon, S; Jaruratanasirikul, S; Dissaneevate, S

    2006-11-01

    A two-hour-old female infant presented with respiratory distress and short limbs. Neonatal radiographs showed micromelic dwarfism and generalised demineralisation, especially at the ribs, long bones of both forearms and both fibulae. The spine showed a flattened shape. All long bones showed metaphyseal irregularities and flaring. Normal serum calcium and elevated serum phosphorus were found, while serum alkaline phosphatase was markedly reduced. A diagnosis of perinatal lethal hypophosphatasia was made. The aetiology, clinical manifestations, radiographical findings, laboratory assays, prenatal diagnosis and treatment of hypophosphatasia are discussed.

  16. 50 years LASERS: in vitro diagnostics, clinical applications and perspectives.

    Science.gov (United States)

    Spyropoulos, Basile

    2011-01-01

    1960 Theodore Maiman built the first Ruby-LASER, starting-point for half a century of R&D on Biomedical LASER continuous improvement. The purpose of this paper is to contribute a review of the often disregarded, however, extremely important Industrial Property documents of LASER-based in vitro Diagnostics devices. It is an attempt to sketch-out the patent-trail leading towards the modern Biomedical Laboratory and to offer an introduction to the employment of "exotic" systems, such as the Free Electron LASER (FEL), that are expected to focus on the fundamental processes of life, following chemical reactions and biological processes as they happen, on unprecedented time and size scales. There are various in vitro LASER applications, however, the most important ones include: Hybrid Coulter Principle-LASER Hematology Analyzers. Flow Cytometry systems. Fluorescent in situ Hybridization (FISH Techniques). Confocal LASER Scanning Microscopy and Cytometry. From the first fluorescence-based flow Cytometry device developed in 1968 by Wolfgang Göhde until nowadays, numerous improvements and new features related to these devices appeared. The relevant industrial property milestone-documents and their overall numeral trends are presented. In 1971, J. Madey invented and developed the Free Electron LASER (FEL), a vacuum-tube that uses a beam of relativistic electrons passing through a periodic, transverse magnetic field (wiggler) to produce coherent radiation, contained in an optical cavity defined by mirrors. A resonance condition that involves the energy of the electron beam, the strength of the magnetic field, and the periodicity of the magnet determines the wavelength of the radiation. The FEL Coherent Light Sources like the Linac Coherent Light Source (LCLS) at Stanford, CA, USA or the Xray Free Electron LASER (XFEL) at Hamburg, Germany, will work much like a high-speed (LASERS. If the diodes brought a LASER into almost everyone's pocket, the above-mentioned super

  17. Clinical and diagnostic characteristics of patients with suspected polyneuropathy

    Directory of Open Access Journals (Sweden)

    Mikhailova Е.V.

    2013-09-01

    Full Text Available Objective: to study the causes and clinical manifestations of disease in children referred for hospitalization in children infectious diseases hospital in Saratov with a diagnosis of «acute flaccid paralysis». Material and methods: 157 children with the diagnosis on admission of the guide «acute flaccid paralysis». Conducted clinical examination and laboratory tests included a general analysis of cerebrospinal fluid, urine, virological examination of nasal swabs and faeces, with the definition of a serological ELISA method and RPHA immunoglobulins to influenza, rubella, and enterovirus, immunological study of blood, cerebrospinal fluid PCR, electromyography of the affected limbs. Results. 77 patients (49% with the disease associated with the violation of the musculoskeletal system were registered. In the other cases revealed polyneuropathy was not of poliovirus etiology. Etiological nature of the disease could be explained by 54% of patients. In 37 (46% patients the diagnosis was formulated in accordance with the severity of paralysis. One child was diagnosed with a vaccine-associated poliomyelitis. Conclusion. The diagnosis of «acute flaccid paralysis» used as administered requires a detailed interpretation in a hospital.

  18. CLINICAL AND MORPHOLOGICAL DIAGNOSTIC INTRAHEPATIC BILE DUCTS PAUCITY

    Directory of Open Access Journals (Sweden)

    O. E. Iryshkin

    2013-01-01

    Full Text Available Aim. To study the clinica-morphological features of syndromatic and nonsyndromatic paucity of intrahepatic bile ducts in pediatric liver transplant recipients. Methods and results. The clinical records were analyzed and histological studies of native livers of 20 children, who had suffered from paucity of intrahepatic bile ducts and to whom liver transplantation were made, were completed. The obtained data indicate higher levels of AST in patients with nonsyndromatic paucity of intrahepaticbile ducts (p = 0,023. Ductopenia was the more frequent indication of syndromatic form of paucity of intrahepatic bile ducts (p = 0,01, while ductular proliferations, which form «ductular structure», were discovered more often in nonsyndromatic paucity of intrahepaticbile ducts (p = 0,03. The extent of inflammatory-destructive changes was more expressed in nonsyndromatic pauci- ty of intrahepatic bile ducts (p = 0,01. Fibrosis or cirrhosis was formed more often in nonsyndromatic paucity of intrahepatic bile ducts (p = 0,008. Conclusion. Our results indicate more severe clinical and morphological manifestations in nonsyndromatic paucity of intrahepatic bile ducts. These findings may suggest about heavier liver condition in patient with nonsyndromatic form of paucity of intrahepatic bile ducts. 

  19. [The integrated approach to diagnostics of metabolic syndrome in clinical practice].

    Science.gov (United States)

    Roĭtberg, G E; Ushakova, T I; Sharkhun, O O; Dorosh, Zh V

    2012-01-01

    Basic criteria of diagnostics and definitions of metabolic syndrome recommended by various international associations and expert groups are discussed. Permanent changes of criteria and usage of various approaches to diagnostics influence prevalence of metabolic syndrome among populations and estimation of its association with unfavorable outcomes. Some definitions of metabolic syndrome are more sensitive in detection of risk groups for cardiovascular diseases, and others in - detection of persons with high risk of type 2 diabetes mellitus. New integrated definition of metabolic syndrome which unites pathophysiological and clinical epidemiological approaches for assessment of metabolic disorders and detection of high risk groups of patients applicable for use in everyday clinical practice is presented.

  20. Clinical characteristics and diagnostic imaging of cranial osteoblastoma.

    Science.gov (United States)

    Pelargos, Panayiotis E; Nagasawa, Daniel T; Ung, Nolan; Chung, Lawrance K; Thill, Kimberly; Tenn, Stephen; Gopen, Quinton; Yang, Isaac

    2015-03-01

    Benign osteoblastoma is a rare, vascular, osteoid-forming bone tumor that occurs even less frequently in the cranial bones. Benign osteoblastoma of the cranium affects women slightly more often than men and typically presents in the first three decades of life. Although clinical presentation can vary depending on location, cranial osteoblastoma usually presents as a painful, non-mobile, subcutaneous mass or swelling. On CT scan, it generally presents as a well-demarcated, mixed lytic and sclerotic lesion, with enlarged diploe, thinning outer and/or inner tables, and varying degrees of calcification. It is hypo to isointense on T1-weighted MRI and has variable presentation on T2-weighted MRI. Gross total resection is the definitive treatment, while subtotal resection is utilized when it is necessary to preserve critical adjacent neurovascular structures.

  1. Caries-related factors and bacterial composition of supragingival plaques in caries free and caries active Algerian adults

    Institute of Scientific and Technical Information of China (English)

    Amina Hoceini; Nihel Klouche Khelil; Ilhem Ben-Yelles; Amine Mesli; Sara Ziouani; Lotfi Ghellai; Nadia Aissaoui; Fatima Nas; Mounia Arab

    2016-01-01

    Objective: To compare oral hygiene practices, education and social background, food intake and oral malodor of Algerian adults suffering from dental caries with normal controls, and to determine and compare the bacterial composition of the supragingival plaques from the above-mentioned groups.Methods: Participants completed a questionnaire and were clinically examined for dental caries using decayed, missing and filled teeth index according to the criteria laid down by the World Health Organization. Supragingival plaque samples were collected from 50 caries-free adults(CF) and 50 caries-active adults(CA). Standard procedures of culture and identification of aerobic and anaerobic bacteria were used. Data were analyzed using Chi-square test.Results: A total of 117 bacterial strains were isolated from supragingival plaques in CF group subjects, 76(64.96%) of them belonged to 9 aerobic genera, and 41(35.04%) to 9anaerobic genera(P < 0.05). While in the second group, 199 strains were isolated, 119(59.80%) of the strains belonged to 10 aerobic genera and 80(40.20%) to 10 anaerobic bacteria(P < 0.05). Streptococcus mutans, Enterococcus faecium, Aerococcus viridans,Actinomyces meyeri, Lactobacillus acidophilus and Eubacterium limosum showed a significantly higher prevalence in the CA group(P < 0.05). The findings revealed that CA group had a high sugar intake(80%). A significantly higher frequency of tooth brushing(P < 0.000) and a significantly less self-reported oral malodor(P < 0.000) and tooth pain(P < 0.000) were found in CF group, while there was no association of socioeconomic levels and intake of meal snacks with dental caries.Conclusions: This study confirms the association of some aciduric bacteria with caries formation, and a direct association of sugar intake and cultural level with dental caries.Furthermore, oral hygiene practices minimize the prevalence of tooth decay.

  2. Diagnostic tests for influenza and other respiratory viruses: determining performance specifications based on clinical setting.

    Science.gov (United States)

    Takahashi, Hiroshi; Otsuka, Yoshihito; Patterson, Bruce K

    2010-06-01

    The lack of sensitivity of rapid immunoassays in detecting the novel 2009 H1N1 influenza virus infection has led to recommendations on influenza diagnostic testing for clinicians treating patients as well as advising clinicians on testing decisions. Studies have also shown that rapid immunoassays for seasonal influenza virus show considerable variability in performance characteristics, based on age of patient, prevalence of disease, course of infection, and the quality of the kit used. While public health authorities are currently focused on influenza virus diagnostics, a lack of sensitivity of rapid immunoassays for other viral respiratory pathogens has been widely reported, such as the very limited value of rapid immunoassays for the detection of respiratory syncytial virus in adults. In light of the lack of sensitivity of diagnostic tests for suspected 2009 H1N1 influenza virus infection, as well as their variable performance characteristics for seasonal influenza virus, a number of recommendations have been made by public health authorities advising clinicians on the need for clinical judgment as an important part of testing and treatment decisions as well as reliance on local epidemiologic and surveillance data. With the availability of new molecular methodologies that are user-friendly and allow the front-line physician as well as hospital infection control programs to significantly improve respiratory viral diagnostics, there is a need to carefully determine the most optimal diagnostic testing methodology based on the clinical setting. This review will describe the historical, current, and changing dynamics of respiratory virus infection diagnostics.

  3. Noninvasive cross-sectional imaging of proximal caries using swept-source optical coherence tomography (SS-OCT) in vivo.

    Science.gov (United States)

    Shimada, Yasushi; Nakagawa, Hisaichi; Sadr, Alireza; Wada, Ikumi; Nakajima, Masatoshi; Nikaido, Toru; Otsuki, Masayuki; Tagami, Junji; Sumi, Yasunori

    2014-07-01

    The aim of this study was to determine the diagnostic accuracy of swept-source optical coherent tomography (SS-OCT) in detecting and estimating the depth of proximal caries in posterior teeth in vivo. SS-OCT images and bitewing radiographs were obtained from 86 proximal surfaces of 53 patients. Six examiners scored the locations according to a caries lesion depth scale (0-4) using SS-OCT and the radiographs. The results were compared with clinical observations obtained after the treatment. SS-OCT could detect the presence of proximal caries in tomograms that were synthesized based on the backscatter signal obtained from the proximal carious lesion through occlusal enamel. SS-OCT showed significantly higher sensitivity and larger area under the receiver operating characteristic curve than radiographs for the detection of cavitated enamel lesions and dentin caries (Student's t -test, p SS-OCT appears to be a more reliable and accurate method than bitewing radiographs for the detection and estimation of the depth of proximal lesions in the clinical environment.

  4. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF FIVE METHODS FOR EARLY DIAGNOSIS OF OCCLUSAL CARIES LESIONS – in vitro study.

    Directory of Open Access Journals (Sweden)

    Mirela Marinova-Takorova

    2014-07-01

    Full Text Available Purpose: The aim of the presented in vitro study was to evaluate the effectiveness of the device DIAGNOcam and the laser fluorescence device DIAGNOdent for early diagnosis of occlusal caries and to compare it with three traditional methods – visual and tactile, dye and radiographic examination. Material and methods: The sample consisted of 60 extracted human teeth. Three clinicians diagnosed independently the presence or absence of early occlusal surface caries with the visible tactile method,DIAGNOcam andDIAGNOdent. Then X-rays were taken and the dentists viewed them separately, without magnification.Fuchsine was applied for 30 sec. and then washed under running water for 20 min. Places where dye was present were registered. Statistical analysis was performed with SPSS package of Windows. Results: The results showed high level of correspondence between the authors for all the diagnostic methods. Concerning different methods applied for caries diagnosis there was a correlation between the methods, but it was diverging for the different methods. No correlation between radiographic exam and data obtained with DIAGNOdent and dye staining was observed. Conclusions: Based on the obtained results we may conclude that the least sensitive method for fissure caries diagnosis was the dye staining, followed by the radiographic exam. The results, obtained by DIAGNOdent and DIAGNOcam were very close, but DIAGNOcams’ data was better correlating with the clinical results.DIAGNOcam procedure can be judged as equivalent in the detection of occlusal dentine lesions when compared to clinical results.

  5. Leveraging arthropod-borne disease surveillance assays for clinical diagnostic use.

    Science.gov (United States)

    Melanson, Vanessa R; Scheirer, Jessica L; Van de Wyngaerde, Marshall T; Bourzac, Kevin; Wu, Shuenn-Jue; Kochel, Tadeusz; McAvin, James C

    2014-11-01

    Researchers at the Walter Reed Army Institute of Research have taken a joint service approach to filling an identified diagnostic capability gap by leveraging a vector surveillance assay. Specifically, the Army took a field-stable real-time polymerase chain reaction assay, developed by the Air Force, for dengue virus surveillance in arthropod vectors and collaborated with Navy researchers for utility in human diagnostics. As current Department of Defense diagnostic PCR assays employ the Joint Biological Agent Identification and Diagnostic System, the dengue assay was tested for use on this platform. The low rates of false negative and false positive dengue samples in clinical matrices demonstrate excellent utility as a human diagnostic assay. Overall, converting an arboviral vector surveillance assay to human diagnostic assay and potentially vice versa is both cost effective and labor reducing. Codevelopment with harmonization of vector surveillance and diagnostics offers monetary and resource advantages to the Department of Defense and should be considered as a path forward in times when downsizing threatens assay development and pathogen discovery. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  6. Effect of caries preventive measures directed to expectant mothers on caries experience in their children

    Directory of Open Access Journals (Sweden)

    Zanata Régia Luzia

    2003-01-01

    Full Text Available The aim of this prospective study was to determine the effectiveness of caries preventive measures started during pregnancy on the caries experience of first-time mothers and their infants. Eighty-one pregnant women with low social background were selected on the basis of the presence of active carious lesions and were randomly divided into control (38 and experimental (43 groups. The initial dental status (DMFS and white spot lesions was established through clinical examination. The prophylactic measures were repeated during pregnancy and 6 and 12 months after delivery. Both groups received primary care intervention. They were instructed in relation to the etiologic factors of dental caries and received oral hygiene kits. Oral hygiene instructions were reinforced through interactive brushing. The experimental group also received antimicrobial treatment (topical application of NaF and iodine solution immediately after prophylaxis and 3 and 5 days later and restorative care using glass ionomer cement. By the time the children were 2 years of age, 33.3% of the infants in the control group and 14.7% in the experimental group had caries activity. A significant difference in caries prevalence was observed between children with and without visible dental plaque. The mean number of tooth surfaces with carious lesions (including areas of demineralization was higher among the children in the control group compared to the experimental group (6.3 x 3.2, however, with no statistical significance. Maternal caries increase was a significant factor influencing the caries experience of the children. These data support the evidence of an association between caries prevalence in young children and clinical (dental plaque and maternal factors.

  7. [Diagnostics of the genetic causes of autism spectrum disorders - a clinical geneticist's view].

    Science.gov (United States)

    Szczaluba, Krzysztof

    2014-01-01

    Explanation of the genetic basis of autism spectrum disorders has, for many decades, been a part of interest of researchers and clinicians. In recent years, thanks to modern molecular and cytogenetic techniques, a significant progress has been achieved in the diagnosis of genetic causes of autism. This applies particularly, but not exclusively, to those cases of autism that are accompanied by other clinical signs (i. e. complex phenotypes). The important clinical markers belong to different categories, and include congenital defects/anomalies, dysmorphism and macro-/microcephaly, to name the few. Thus, the choice of the diagnostic strategy depends on the clinical and pedigree information and, under Polish circumstances, the availability of specific diagnostic techniques and the amount of reimbursement under the National Health Service. Overall, the identification of the genetic causes of autism spectrum disorders is possible in about 10-30% of patients. In this paper the practical aspects of the use of different diagnostic techniques are briefly described. Some clinical examples and current recommendations for the diagnosis of patients with autism spectrum disorders are also presented. The point of view of a specialist in clinical genetics, increasingly involved, as part of the multidisciplinary care team, in the diagnostics of an autistic child has been demonstrated.

  8. A Diagnostic Approach to Autoimmune Disorders: Clinical Manifestations: Part 1.

    Science.gov (United States)

    Sahai, Shashi; Adams, Matthew; Kamat, Deepak

    2016-06-01

    Autoimmune disorders are not commonly encountered in a general pediatric practice, but they may mimic many other disorders. Although they occur infrequently, it is always important to pause and consider an autoimmune disorder in the differential diagnosis. A detailed history and careful physical examination play an important role in guiding laboratory evaluation for these disorders. Many autoimmune disorders present with symptoms that involve multiple organ systems. The common symptoms that may make one consider a rheumatic disorder in the differential diagnosis are fever, fatigue, joint pain, rash, ulcers, and muscle weakness. The most common reason for referral to a pediatric rheumatologist is joint pain. A good joint examination may be performed by the use of the pediatric Gait, Arms, Legs, Spine screen, which is a validated screening tool. A small portion of children with fever of unknown origin may have an autoimmune disorder, with a majority of them having an infectious disease. Some patients with undiagnosed rheumatic disorders may present to the emergency. department. The characteristics of historic and clinical examination features of various autoimmune disorders are discussed in this article. [Pediatr Ann. 2016;45(6):e223-e229.].

  9. [Vasculitic Peripheral Neuropathies: Clinical Features and Diagnostic Laboratory Tests].

    Science.gov (United States)

    Ogata, Katsuhisa

    2016-03-01

    Vasculitic peripheral neuropathy (VPN) occurs due to ischemic changes of peripheral nerves, resulting from a deficit of vascular blood supply due to damaged vasa nervorum leading to vasculitis. VPN usually manifests as sensorimotor or sensory disturbances accompanied by pain, presenting as a type of multiple mononeuropathy, with a scattered distribution in distal limbs. VPN may also present as a mononeuropathy, distal symmetric polyneuropathy, plexopathy, or radiculopathy. The rapidity of VPN is variable, ranging from days to months, with symptoms occasionally changing with the appearance of new lesions. Careful history taking and neurological examination provides an exact diagnosis. The most common cause of VPN is primary vasculitis predominantly affecting small vessels, including vasa nervorum, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, and polyarteritis nodosa. Similar vasculitic processes can also result from a systemic collagen disorder or secondary vasculitis. Electrophysiological studies and pathological investigation of biopsied peripheral nerves and muscles are important for diagnosis of vasculitis. Serological tests, including ANCA, are useful for diagnosis of vasculitis. Accurate neurological examinations are essential for diagnosis and evaluation of clinical course.

  10. Lead intoxication: clinic and diagnostic evaluation in children

    Directory of Open Access Journals (Sweden)

    Martínez-Riera Nora

    2012-03-01

    Full Text Available Poverty, poor nutrition, environmental and social injustice prevailing in Latin America are factorsthat determine the action of pollutants on children. Lead poisoning and pollution constitute apublic health problem throughout the world. Lead affects multiple organs: nervous system particularly,hematopoietic, renal, endocrine, bone and others. Objective: to assess clinical, biochemicaland vascular effects in children exposed to known source of lead. Materials and methods: Sevenchildren with defined source lead exposure were studied, general and specific lead laboratorywere made. Endothelial function and electrocardiographic parameters were assessed. Statistic:descriptive. Results: Age average was 6,2 years (DE± 1, 6, average haematocrit 31% (DE±0,02;hemoglobin average 10,2 g/dl (DE± 0,78. 100% presented hypochromia, microcitosis, anemiaand marked anisocytosis. Lead average: 37,9 ug/dl (DE±6,22, ALA-D average: 8,9 U/L (DE±4,5.No changes were found in lipid profile and kidney function. All presented microalbuminuriaand endothelial dysfunction. Conclusion: These results show the effects of environmental leadexposure that can result in children not occupationally exposed.

  11. Xilitol and dental caries.

    NARCIS (Netherlands)

    Smits, Marten Titus

    1987-01-01

    Dental caries is a widespread multifactoral disease. The main sympthons are minaral loss from tooth enemal and dentine, eventually leading to total destruction of the teeth, pain, impairment of mastication and problems with facial esthetics. ... Zie: Summary

  12. Xilitol and dental caries.

    NARCIS (Netherlands)

    Smits, Marten Titus

    1987-01-01

    Dental caries is a widespread multifactoral disease. The main sympthons are minaral loss from tooth enemal and dentine, eventually leading to total destruction of the teeth, pain, impairment of mastication and problems with facial esthetics. ... Zie: Summary

  13. HYPOPARATHYROIDISM: ETIOLOGY, CLINICAL MANIFESTATION, CURRENT DIAGNOSTICS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    N. G. Mokrysheva

    2016-01-01

    treatment with recombinant PTH is not widely used. Replacement therapy with recombinant human PTH is a  promising area, especially in severe clinical cases, refractory to conventional treatment.

  14. Adolescent rampant caries

    OpenAIRE

    Namita; Rita Rai

    2012-01-01

    Adolescent rampant caries is a new and growing challenge in Conservative Dentistry. It has the same etiology and pattern as that of nursing bottle syndrome. Herein, a case is presented in which the main cause of rampant caries is the patient′s habit of keeping cariogenic food in her mouth and going to sleep. Educating this etiology and introduction of preventive strategies not only assists in meeting the special oral needs of the adolescent population, but also helps to establish lifelong hea...

  15. Reliability and diagnostic efficiency of the abbreviated-diagnostic interview for borderlines in an adolescent clinical population.

    Science.gov (United States)

    Guilé, Jean Marc; Greenfield, Brian; Berthiaume, Claude; Chapdelaine, Cimon; Bergeron, Lise

    2009-09-01

    Examine the reliability as well as the concurrent validity and diagnostic efficiency of the Abbreviated version of the diagnostic interview for borderlines revised (Ab-DIB) as a screening measure of borderline psychopathology in an adolescent clinical population. The Ab-DIB is a DIB-R-derived self-report covering the impulsiveness as well as the affect and cognitive components of the borderline construct. Its administration lasts 10 min. The Ab-DIB was tested on 139 suicidal youths for reliability and concurrent validity against the DIB-R and the Columbia Impairment Scale (CIS). Internal consistencies and test-retest Intra-Class-Correlations ranged from 0.80 to 0.86 and 0.77 to 0.95, respectively. ROC analysis yielded an area under the curve of 0.87 (p < 0.001). Sensitivity was 0.88 and specificity ranged from 0.82 to 0.73 depending on the age-range. Correlation of the Ab-DIB's continuous score with the CIS was 0.42 (p < 0.001). In conclusion, The Ab-DIB's brief duration and psychometric properties suggest its utility in time-limited settings.

  16. Complement analysis 2016: Clinical indications, laboratory diagnostics and quality control.

    Science.gov (United States)

    Prohászka, Zoltán; Nilsson, Bo; Frazer-Abel, Ashley; Kirschfink, Michael

    2016-11-01

    In recent years, complement analysis of body fluids and biopsies, going far beyond C3 and C4, has significantly enhanced our understanding of the disease process. Such expanded complement analysis allows for a more precise differential diagnosis and for critical monitoring of complement-targeted therapy. These changes are a result of the growing understanding of the involvement of complement in a diverse set of disorders. To appreciate the importance of proper complement analysis, it is important to understand the role it plays in disease. Historically, it was the absence of complement as manifested in severe infection that was noted. Since then complement has been connected to a variety of inflammatory disorders, such as autoimmune diseases and hereditary angioedema. While the role of complement in the rejection of renal grafts has been known longer, the significant impact of complement. In certain nephropathies has now led to the reclassification of some rare kidney diseases and an increased role for complement analysis in diagnosis. Even more unexpected is that complement has also been implicated in neural, ophtalmological and dermatological disorders. With this level of involvement in some varied and impactful health issues proper complement testing is clearly important; however, analysis of the complement system varies widely among laboratories. Except for a few proteins, such as C3 and C4, there are neither well-characterized standard preparations nor calibrated assays available. This is especially true for the inter-laboratory variation of tests which assess classical, alternative, or lectin pathway function. In addition, there is a need for the standardization of the measurement of complement activation products that are so critical in determining whether clinically relevant complement activation has occurred in vivo. Finally, autoantibodies to complement proteins (e.g. anti-C1q), C3 and C4 convertases (C3 and C4 nephritic factor) or to regulatory proteins

  17. Comparative Capabilities of Clinical Assessment, Diagnostic Criteria, and Polysomnography in Detecting Sleep Bruxism

    Science.gov (United States)

    Palinkas, Marcelo; De Luca Canto, Graziela; Rodrigues, Laíse Angélica Mendes; Bataglion, César; Siéssere, Selma; Semprini, Marisa; Regalo, Simone Cecilio Hallak

    2015-01-01

    Objective: To evaluate the diagnostic capability of signs and symptoms of sleep bruxism (SB) as per the American Academy of Sleep Medicine (AASM) criteria and a diagnostic grading system proposed by international experts for assessing SB. Methods: The study was conducted in three phases (interview, physical examination, and sleep studies). Subjects were asked about self-reported tooth grinding sounds occurring during sleep, muscle fatigue, temporal headaches, jaw muscle pain, and jaw locking. A visual examination was conducted to check for presence of abnormal tooth wear. A full-night polysomnography (PSG) was performed. After three phases, the subjects were divided into two groups matched by age and gender: Case Group, 45 SB subjects, and Control Group, 45 non-SB subjects. Diagnostic accuracy measurements were calculated for each sign or symptom individually and for the two diagnostic criteria analyzed. Results: Muscle fatigue, temporal headaches, and AASM criteria were associated with highest sensitivity (78%, 67%, 58%, respectively) and also with highest diagnostic odds ratio (OR = 9.63, 9.25, 6.33, respectively). Jaw locking, muscle pain, and the criterion of “probable SB” were associated with the worst sensitivity (16%, 18%, 22%, respectively). Conclusions: Presence of muscle fatigue and temporal headaches can be considered good tools to screen SB patients. None of the diagnostic criteria evaluated was able to accurately identify patients with SB. AASM criteria had the strongest diagnostic capabilities and—although they do not attain diagnostic values high enough to replace the current gold standard (PSG)—should be used as a screening tool to identify SB. Citation: Palinkas M, De Luca Canto G, Rodrigues LA, Bataglion C, Siéssere S, Semprini M, Regalo SC. Comparative capabilities of clinical assessment, diagnostic criteria, and polysomnography in detecting sleep bruxism. J Clin Sleep Med 2015;11(11):1319–1325. PMID:26235152

  18. Use of saliva as a diagnostic fluid in dentistry

    Directory of Open Access Journals (Sweden)

    Todorović Tatjana

    2005-01-01

    Full Text Available Saliva is a secretion of the salivary and mucous glands and is of major importance in the maintainance of oral health. Over the last few decades, saliva has been evaluated as a diagnostic fluid in medicine for determining systemic disease markers as well as for monitoring numerous drugs, narcotics, and hormones. The biochemical analysis of saliva is particularly important in dentistry. The estimation of the risk of appearance and diagnosis of disease, monitoring of disease progression, evaluation of therapy efficacy for caries, periodontitis, premalignant and malignant oral lesions, as well as infectious diseases of the oral cavity, can be assessed by analyzing different constituent: of saliva, individuals at risk of caries can be identified using test: that determine saliva flow rate, saliva buffer capacity, and colonization of the oral cavity by cariogenic bacteria. Today, these rapid and simple diagnostic tests are used routinely in caries risk determination. The study and use of saliva-based diagnostics have increased over the last few decades. Clinical testing of saliva shows much promise. However, there is a need for much additional research in this area, before the true clinical value of saliva as a diagnostic fluid in dentistry can be determined.

  19. [Use of saliva as a diagnostic fluid in dentistry].

    Science.gov (United States)

    Todorović, Tatjana; Dozić, Ivan; Pavlica, Dusan; Marković, Dejan; Brajović, Gavrilo; Ivanović, Mirjana; Stevanović, Gordana; Mirković, Silvija; Andjelski, Biljana

    2005-01-01

    Saliva is a secretion of the salivary and mucous glands and is of major importance in the maintainance of oral health. Over the last few decades, saliva has been evaluated as a diagnostic fluid in medicine for determining systemic disease markers as well as for monitoring numerous drugs, narcotics, and hormones. The biochemical analysis of saliva is particularly important in dentistry. The estimation of the risk of appearance and diagnosis of disease, monitoring of disease progression, evaluation of therapy efficacy for caries, periodontitis, premalignant and malignant oral lesions, as well as infectious diseases of the oral cavity, can be assessed by analysing different constituents of saliva. Individuals at risk of caries can be identified using tests that determine saliva flow rate, saliva buffer capacity, and colonisation of the oral cavity by cariogenic bacteria. Today, these rapid and simple diagnostic tests are used routinely in caries risk determination. The study and use of saliva-based diagnostics have increased over the last few decades. Clinical testing of saliva shows much promise. However, there is a need for much additional research in this area, before the true clinical value of saliva as a diagnostic fluid in dentistry can be determined.

  20. Biopsies of colorectal clinical polyps--emergence of diagnostic information on deeper levels

    DEFF Research Database (Denmark)

    Warnecke, Mads; Engel, Ulla; Bernstein, Inge;

    2009-01-01

    Although the occasional appearance of a normal histology of biopsies from endoscopic colorectal (CR) polyps is generally held knowledge, its prevalence has rarely been focused on, and the yield of additional sections in such cases has been previously addressed in merely four communications....... Hitherto, this issue has not been discussed in the context of the clinical setting. The prime aim of this study was to evaluate the yield of step sectioning CR biopsies, considered non-diagnostic (non-diagnostic biopsies (NDB)) on routine sections. The results are correlated with the indications...... for endoscopy. Additionally, an appropriate, cost-effective approach for handling NDB was sought. Biopsies from 480 clinical polyps were prospectively evaluated by one of three gastrointestinal pathologists and classified as (a) diagnostic biopsies (DB), comprising neoplastic polyps, hyperplastic polyps (HP...

  1. A randomized clinical trial of the anti-caries efficacy of 5,000 compared to 1,450 ppm fluoridated toothpaste on root caries lesions in elderly disabled nursing home residents

    DEFF Research Database (Denmark)

    Ekstrand, K.R.; Poulsen, J.E.; Hede, B.

    2013-01-01

    months. Elderly disabled residents (n = 176) in 6 nursing homes in the Copenhagen area consented to take part in the study. They were randomly assigned to use one of the two toothpastes. Both groups had their teeth brushed twice a day by the nursing staff. A total of 125 residents completed the study...... of partial or full dentures in one of the jaws, occurrence of plaque and active (2.61 vs. 2.67; SD, 1.7 vs.1.8) or arrested lesions (0.62 vs. 0.63; SD, 1.7 vs. 1.7) between the 5,000 and the 1,450 ppm fluoride groups, respectively. Mean numbers of active root caries lesions at the follow-up examination were...

  2. Diagnostic performance of amyloid A protein quantification in fat tissue of patients with clinical AA amyloidosis

    NARCIS (Netherlands)

    Hazenberg, Bouke P. C.; Bijzet, Johannes; Limburg, Pieter C.; Skinner, Martha; Hawkins, Philip N.; Butrimiene, Irena; Livneh, Avi; Lesnyak, Olga; Nasonov, Evgeney L.; Filipowicz-Sosnowska, Anna; Guel, Ahmet; Merlini, Giampaolo; Wiland, Piotr; Oezdogan, Huri; Gorevic, Peter D.; Ben Maiz, Hedi; Benson, Merrill D.; Direskeneli, Haner; Kaarela, Kalevi; Garceau, Denis; Hauck, Wendy; van Rijswijk, Martin

    2007-01-01

    Objective. Amyloid A protein quantification in fat tissue is a new immunochemical method for detecting AA amyloidosis, a rare but serious disease. The objective was to assess diagnostic performance in clinical AA amyloidosis. Methods. Abdominal subcutaneous fat tissue of patients with AA amyloidosis

  3. Sharing the Diagnostic Process in the Clinical Teaching Environment: A Case Study

    Science.gov (United States)

    Cuello-Garcia; Carlos

    2005-01-01

    Revealing or visualizing the thinking involved in making clinical decisions is a challenge. A case study is presented with a visual implement for sharing the diagnostic process. This technique adapts the Bayesian approach to the case presentation. Pretest probabilities and likelihood ratios are gathered to obtain post-test probabilities of every…

  4. Prediction of 6-yr symptom course trajectories of anxiety disorders by diagnostic, clinical and psychological variables

    NARCIS (Netherlands)

    Spinhoven, Philip; Batelaan, Neeltje; Rhebergen, Didi; van Balkom, Anton; Schoevers, Robert; Penninx, Brenda W.

    2016-01-01

    This study aimed to identify course trajectories of anxiety disorder using a data-driven method and to determine the incremental predictive value of clinical and psychological variables over and above diagnostic categories. 703 patients with DSM-IV panic disorder with or without agoraphobia, agoraph

  5. Impact of molecular imaging on the diagnostic process in a memory clinic

    NARCIS (Netherlands)

    Ossenkoppele, R.; Prins, N.D.; Pijnenburg, Y.A.; Lemstra, A.W.; Flier, W.M. van der; Adriaanse, S.F.; Windhorst, A.D.; Handels, R.L.; Wolfs, C.A.; Aalten, P.; Verhey, F.R.J.; Verbeek, M.M.; Buchem, M.A. van; Hoekstra, O.S.; Lammertsma, A.A.; Scheltens, P.; Berckel, B.N. van

    2013-01-01

    BACKGROUND: [(11)C]Pittsburgh compound B ([(11)C]PIB) and [(18)F]-2-fluoro-2-deoxy-D-glucose ([(18)F]FDG) PET measure fibrillar amyloid-beta load and glucose metabolism, respectively. We evaluated the impact of these tracers on the diagnostic process in a memory clinic population. METHODS: One hundr

  6. Targeted next-generation sequencing can replace Sanger sequencing in clinical diagnostics

    NARCIS (Netherlands)

    Sikkema-Raddatz, B.; Johansson, L.F.; de Boer, E.N.; Almomani, R.; Boven, L.G.; van den Berg, M.P.; van Spaendonck-Zwarts, K.Y.; van Tintelen, J.P.; Sijmons, R.H.; Jongbloed, J.D.H.; Sinke, R.J.

    2013-01-01

    Mutation detection through exome sequencing allows simultaneous analysis of all coding sequences of genes. However, it cannot yet replace Sanger sequencing (SS) in diagnostics because of incomplete representation and coverage of exons leading to missing clinically relevant mutations. Targeted next-g

  7. Towards a rapid molecular diagnostic for melioidosis: comparison of DNA extraction methods from clinical specimens

    Science.gov (United States)

    Richardson, Leisha J; Kaestli, Mirjam; Mayo, Mark; Bowers, Jolene R; Tuanyok, Apichai; Schupp, Jim; Engelthaler, David; Wagner, David M; Keim, Paul S; Currie, Bart J

    2011-01-01

    Optimising DNA extraction from clinical samples for Burkholderia pseudomallei Type III secretion system real-time PCR in suspected melioidosis patients confirmed that urine and sputum are useful diagnostic samples. Direct testing on blood remains problematic; testing DNA extracted from plasma was superior to DNA from whole blood or buffy coat. PMID:22108495

  8. Diagnostic performance of amyloid A protein quantification in fat tissue of patients with clinical AA amyloidosis

    NARCIS (Netherlands)

    Hazenberg, Bouke P. C.; Bijzet, Johannes; Limburg, Pieter C.; Skinner, Martha; Hawkins, Philip N.; Butrimiene, Irena; Livneh, Avi; Lesnyak, Olga; Nasonov, Evgeney L.; Filipowicz-Sosnowska, Anna; Guel, Ahmet; Merlini, Giampaolo; Wiland, Piotr; Oezdogan, Huri; Gorevic, Peter D.; Ben Maiz, Hedi; Benson, Merrill D.; Direskeneli, Haner; Kaarela, Kalevi; Garceau, Denis; Hauck, Wendy; van Rijswijk, Martin

    2007-01-01

    Objective. Amyloid A protein quantification in fat tissue is a new immunochemical method for detecting AA amyloidosis, a rare but serious disease. The objective was to assess diagnostic performance in clinical AA amyloidosis. Methods. Abdominal subcutaneous fat tissue of patients with AA amyloidosis

  9. Clinical guidelines development and usage: a critical insight and literature review: thyroid disease diagnostic algorithms.

    Science.gov (United States)

    Murgić, Jure; Salopek, Daniela; Prpić, Marin; Jukić, Tomislav; Kusić, Zvonko

    2008-12-01

    Clinical guidelines have been increasingly used in medicine. They represent a system of recommendations for the conduction of specific procedures used in fields from public health to different diagnostic and therapeutic procedures in clinical medicine. Guidelines are designed to facilitate to medical practitioners the adoption, evaluation and application of an increasing body of evidence and arising number of expert opinions regarding the presently best treatment and to help in delivering proper decision for the management of a patient or condition. Clinical guidelines represent a part of complementary activity by which research is implemented into praxis, standards are defined and clinical excellence is promoted in all health care fields. There are specific conditions which quality guidelines should meet. First of all, they need to be founded on comprehensive literature review, apart from clinical studies and trials in the target field. Also, there are more systems for analyzing and grading the strength of clinical evidence and the level of recommendation emerging from it. Algorithms are used to organize and summarize guidelines. The algorithm itself has a form of an informatic record and a logical flow. Algorithms, especially in case of clinical uncertainty, must be used for the improvement of health care, increasing it's availability and integration of the newest scientific knowledge. They should have an important role in the health care rationalisation, fight against non-rational diagnostics manifested as diagnostic procedures with no clinical indications, it's unnecessary repetition and wrong sequence. Several diagnostic algorithms used in the field of thyroid diseases are presented, since they have been proved to be of great use.

  10. Clinical reasoning in the real world is mediated by bounded rationality: implications for diagnostic clinical practice guidelines.

    Directory of Open Access Journals (Sweden)

    Ana Paula Ribeiro Bonilauri Ferreira

    Full Text Available BACKGROUND: Little is known about the reasoning mechanisms used by physicians in decision-making and how this compares to diagnostic clinical practice guidelines. We explored the clinical reasoning process in a real life environment. METHOD: This is a qualitative study evaluating transcriptions of sixteen physicians' reasoning during appointments with patients, clinical discussions between specialists, and personal interviews with physicians affiliated to a hospital in Brazil. RESULTS: FOUR MAIN THEMES WERE IDENTIFIED: simple and robust heuristics, extensive use of social environment rationality, attempts to prove diagnostic and therapeutic hypothesis while refuting potential contradictions using positive test strategy, and reaching the saturation point. Physicians constantly attempted to prove their initial hypothesis while trying to refute any contradictions. While social environment rationality was the main factor in the determination of all steps of the clinical reasoning process, factors such as referral letters and number of contradictions associated with the initial hypothesis had influence on physicians' confidence and determination of the threshold to reach a final decision. DISCUSSION: Physicians rely on simple heuristics associated with environmental factors. This model allows for robustness, simplicity, and cognitive energy saving. Since this model does not fit into current diagnostic clinical practice guidelines, we make some propositions to help its integration.

  11. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy

    DEFF Research Database (Denmark)

    Bjørndal, Lars; Reit, Claes; Bruun, Gitte Hoffmann

    2010-01-01

    Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had...... capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1 yr [31.8% and 34.5%; difference: 2.7%, 95% CI (-22.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared...

  12. [A recent observation of clinical effects by combined application of lanthanum,cerium and fluoride-contained gel on root surface caries

    Science.gov (United States)

    Pan, Y H; Yi, N

    1999-09-01

    OBJECTIVE:The present study was to investigate the effects of combined application of lanthanum,cerium and fluoride-contained gel on root surface caries.METHODS:2000ppm lanthanum.cerium and fluoride-contained gels were used by various procedures to treat 164 teeth with root surface caries.RESULTS:The six months follow-up data revealed that combined procedure showed a better effect than each kind of trace element used alone.CONCLUSION:The study indicated that combined F/La(Ce) applying procedure has a potential value on the carious resisted root surface.

  13. Relation Between Past and Present Dietary Sugar Intake and Dental Caries in A High Caries Population

    Directory of Open Access Journals (Sweden)

    T. Malek Mohammadi

    2008-06-01

    Full Text Available Objective: The main objective of this study was to investigate relationship between re-ported dietary habits and dental caries in five and six-year-old children referred for dental extractions.Materials and Methods: Two hundred children were examined using standard caries di-agnostic criteria. The numbers of decayed, missing and filled deciduous teeth were re-corded. A food frequency table was completed by the parents of each child and analyzedthrough weighting the cariogenic potentialby the frequency of consumption, and summing the two scores.Results: The mean number of decayed, missing and filled teeth (dmft was 7.1 (SD=3.29. There was no statistically significant correlation between the reported dietary intake and the caries rate in the study population P=0.07.Use of bottles with sugared drinks during infancy was associated with increased caries levels (P<0.01.Conclusion: Poor infant feeding practices promote caries in childhood. A method of diet assessment which would evaluate diet-related health education is required.

  14. Efficacy of Two Caries Detector Dyes in the Diagnosis of Dental Caries

    Directory of Open Access Journals (Sweden)

    Sh. Etemad-Moghadam

    2010-06-01

    Full Text Available Objective: The aim of the present study was to evaluate the efficacy of two caries detector dyes in the diagnosis of dental caries.Materials and Methods: Twenty extracted human posterior teeth without pulpal exposure were sectioned mesiodistally through the center of the lesions using a water-cooled disk.The tooth halves were randomly divided into two groups and treated with Caries Detector (CD and Caries Check (CC detector dyes. Access cavities were prepared followed by caries removal and dye application. All cavities were arbitrarily divided into two right and left sections and excavation of the stained areas was performed on the left parts, while the right sections remained untouched. Bacterial penetration into dentinal tubules was evaluated using Gram-stained decalcified sections under light microscopy. Sensitivity and specificity of both dyes were calculated.Results: The sensitivity of CD and CC were 74% and 71%,respectively. The specificity obtained for both dyes was 100%.Conclusion: Considering the low sensitivity of the dyes evaluated in the present study, it seems that they may not be reliable when used as the sole diagnostic technique for detection of carious lesions in posterior teeth.

  15. Implementing the K-SADS-PL as a standard diagnostic tool: Effects on clinical diagnoses.

    Science.gov (United States)

    Matuschek, Tina; Jaeger, Sonia; Stadelmann, Stephanie; Dölling, Katrin; Grunewald, Madlen; Weis, Steffi; von Klitzing, Kai; Döhnert, Mirko

    2016-02-28

    Diagnostic interviews are valuable tools for generating reliable and valid psychiatric diagnoses. However, little is known about the diagnostic effects of implementing such an interview into the standard diagnostic procedure of a child psychiatric clinic. Therefore, we reviewed discharge diagnoses of psychiatric patients (age: 8-12 years; combined sample of inpatients and day hospital patients) over two intervals before and after implementing the semi-structured diagnostic interview K-SADS-PL as a diagnostic tool during intake. Each interval was a two year period spanning from 2009-2010 (pre sample; n=177) and from 2012-2013 (post sample; n=132). The number of diagnoses per patient and the co-morbidity rate increased significantly in the post sample. Furthermore, the percentage of children with a nonspecific diagnosis "other mixed disorders of conduct and emotions" (ICD-10: F92.8) decreased significantly after using the K-SADS-PL. Regarding the main diagnostic categories, a significant increase in the number of anxiety disorders and stress-related and somatoform disorders was found in the post sample. The results suggest that implementing a semi-structured interview into the daily routine of child psychiatry may have a substantial impact on discharge diagnoses. Practical implications are discussed and ideas for future research are given.

  16. Visual Inspection for Caries Detection: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Gimenez, T; Piovesan, C; Braga, M M; Raggio, D P; Deery, C; Ricketts, D N; Ekstrand, K R; Mendes, F M

    2015-07-01

    We aimed to perform a systematic review including a meta-analysis to evaluate the overall accuracy of visual methods for detecting carious lesions and to identify possible sources of heterogeneity among the studies included. Two reviewers searched PubMed, Embase, Scopus, and other sources through July 2014 to identify published and nonpublished studies in English. Studies of visual inspection were included that 1) assessed accuracy of the method in detecting caries lesions; 2) were performed on occlusal, proximal, or free smooth surfaces in primary or permanent teeth; 3) had a reference standard; and 4) reported sufficient data about sample size and accuracy of methods. The data were used to calculate the pooled sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristics curve. Heterogeneity of the studies was also assessed. A total of 102 manuscripts (from 5,808 articles initially identified) and 1 abstract (from 168) met the inclusion criteria. In general, the analysis demonstrated that the visual method had good accuracy for detecting caries lesions. Although laboratory and clinical studies have presented similar accuracy, clinically obtained specificity was higher. We also observed moderate to high heterogeneity and evidence of publication bias in most papers. Moreover, studies employing widely recognized visual scoring systems presented significantly better accuracy as compared to studies that used their own criteria. In conclusion, visual caries detection method has good overall performance. Furthermore, although the identified studies had high heterogeneity and risk of bias, the use of detailed and validated indices seems to improve the accuracy of the method.

  17. Comparison of novel clinically applicable methodology for sensitive diagnostics of cartilage degeneration

    Directory of Open Access Journals (Sweden)

    P Kiviranta

    2007-04-01

    Full Text Available In order efficiently to target therapies intending to stop or reverse degenerative processes of articular cartilage, it would be crucial to diagnose osteoarthritis (OA earlier and more sensitively than is possible with the existing clinical methods. Unfortunately, current clinical methods for OA diagnostics are insensitive for detecting the early degenerative changes, e.g., arising from collagen network damage or proteoglycan depletion. We have recently investigated several novel quantitative biophysical methods, including ultrasound indentation, quantitative ultrasound techniques and magnetic resonance imaging, for diagnosing the degenerative changes of articular cartilage, typical for OA. In this study, the combined results of these novel diagnostic methods were compared with histological (Mankin score, MS, compositional (proteoglycan, collagen and water content and mechanical (dynamic and equilibrium moduli reference measurements of the same bovine cartilage samples. Receiver operating characteristics (ROC analysis was conducted to judge the diagnostic performance of each technique. Indentation and ultrasound techniques provided the most sensitive measures to differentiate samples of intact appearance (MS=0 from early (13 degeneration. Furthermore, these techniques were good predictors of tissue composition and mechanical properties. The specificity and sensitivity analyses revealed that the mechano-acoustic methods, when further developed for in vivo use, may provide more sensitive probes for OA diagnostics than the prevailing qualitative X-ray and arthroscopic techniques. Noninvasive quantitative MRI measurements showed slightly lower diagnostic performance than mechano-acoustic techniques. The compared methods could possibly also be used for the quantitative monitoring of success of cartilage repair.

  18. Diagnostic Approaches to Sjögren’s Syndrome: a Literature Review and Own Clinical Experience

    Directory of Open Access Journals (Sweden)

    Pedro de Sousa Gomes

    2012-03-01

    Full Text Available Objectives: The purpose of present paper is to critically address the recent advances on diagnostic procedures of Sjögren’s syndrome, taking into account the attained local and systemic features of the disease. Material and Methods: A comprehensive review of the available literature regarding to the diagnostic approaches to Sjögren’s syndrome was conducted. Eligible studies were identified by searching the electronic literature PubMed, Medline, Embase, and ScienceDirect databases for relevant reports (last search update January 2012 combining the MESH heading term “Sjögren’s syndrome”, with the words "diagnosis, diagnostic procedures, salivary gland function, ocular tests, histopathology, salivary gland imaging, serology". The authors checked the references of the selected articles to identify additional eligible publications and contacted the authors, if necessary. Results: Presented article addresses the established diagnostic criteria for Sjögren’s syndrome and critically evaluates the most commonly used diagnostic procedures, presenting data from author’s own clinical experience. Diagnostic criteria for Sjögren’s syndrome are required both by healthcare professionals and patients, namely in order to provide a rational basis for the assessment of the symptoms, establish an individual disease prognosis, and orientate the therapeutic intervention. Conclusions: Sjögren’s syndrome is quite a common autoimmune disease of which the diagnosis and treatment are not easily established. Due to its systemic involvement, it can exhibit a wide range of clinical manifestations that contribute to confusion and delay in diagnosis. The use of proper diagnostic modalities will help to reduce the time to diagnosis and preserve the health and quality of life of patients with Sjögren’s syndrome.

  19. Caries experience in schoolchildren in Bucharest, Romania

    DEFF Research Database (Denmark)

    Funieru, Cristian; Twetman, Svante; Funieru, Elena;

    2014-01-01

    OBJECTIVE: This cross-sectional study aimed to investigate the prevalence and experience of dental caries among children from public middle schools in Bucharest in relation to socioeconomic status and access to school-based dental care. METHODS: Clinical data were collected from 1,595 schoolchild...

  20. Antimicrobial efficacy of an indigenously prepared caries removing gel.

    Science.gov (United States)

    Subramaniam, Priya; Gilhotra, K

    2011-01-01

    The aim of this study was to assess the anti-microbial efficacy of an indigenously prepared caries removing gel, in primary molars. Twenty teeth with broad occlusal cavitated lesions that fulfilled the clinical and radiographic criteria formed the study group. These teeth were subjected to chemomechanical method of caries removal, using an indigenously prepared caries removing gel. Prior to and following caries removal, the dentin samples were analyzed for total viable count and lactobacilli count. The percentage of reduction in the total viable count was 92.4% and in the lactobacilli count it was 94.1%, which was statistically highly significant. Removal of carious tissue with a caries removing gel, a natural plant extract, proved to be efficient, easy to perform, and comfortable for the patient.

  1. Antimicrobial efficacy of an indigenously prepared caries removing gel

    Directory of Open Access Journals (Sweden)

    Priya Subramaniam

    2011-01-01

    Full Text Available Objective: The aim of this study was to assess the anti-microbial efficacy of an indigenously prepared caries removing gel, in primary molars. Materials and Methods: Twenty teeth with broad occlusal cavitated lesions that fulfilled the clinical and radiographic criteria formed the study group. These teeth were subjected to chemomechanical method of caries removal, using an indigenously prepared caries removing gel. Prior to and following caries removal, the dentin samples were analyzed for total viable count and lactobacilli count. Results: The percentage of reduction in the total viable count was 92.4% and in the lactobacilli count it was 94.1%, which was statistically highly significant. Conclusion: Removal of carious tissue with a caries removing gel, a natural plant extract, proved to be efficient, easy to perform, and comfortable for the patient.

  2. UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent

    Science.gov (United States)

    Horst, Jeremy A; Ellenikiotis, Hellene; Milgrom, Peter M

    2016-01-01

    The Food and Drug Administration recently cleared silver diamine fluoride for reducing tooth sensitivity. Clinical trials document arrest and prevention of dental caries by silver diamine fluoride; this off-label use is now permissible and appropriate under U.S. law. A CDT code was approved for caries arresting medicaments for 2016 to facilitate documentation and billing. We present a systematic review, clinical indications, clinical protocol, and consent procedure to guide application for caries arrest treatment. PMID:26897901

  3. Ozone and caries: a review of the literature.

    Science.gov (United States)

    Burke, F J Trevor

    2012-05-01

    Ozone, either in gaseous form or as ozonated water, has been available for use as a treatment for dental caries for a decade. This paper reviews the literature on the subject by examining the findings of publications in the peer review literature. Eighteen papers were identified by a literature search. From the review of these, it was concluded that, while some laboratory studies and some short duration clinical studies have suggested that ozone may be effective in the treatment of root caries or killing of oral micro-organisms, the clinical evidence for the use of ozone in treatment of caries is not compelling.

  4. An in vitro comparison between two methods of electrical resistance measurement for occlusal caries detection

    NARCIS (Netherlands)

    Kuhnisch, J; Heinrich-Weltzien, R; Tabatabaie, M; Stosser, L; Huysmans, MCDNJM

    2006-01-01

    Because of different measurement techniques and the easier design of the CRM prototype, this in vitro study aimed to compare the diagnostic performance and reproducibility of two electrical methods (Electronic Caries Monitor III, ECM and Cariometer 800, CRM) for occlusal caries detection, and to eva

  5. The Caries Management System: an evidence-based preventive strategy for dental practitioners. Application for adults.

    Science.gov (United States)

    Evans, R W; Pakdaman, A; Dennison, P J; Howe, E L C

    2008-03-01

    In the absence of effective caries preventive methods, operative care became established as the means for caries control in general practice. Water fluoridation resulted in a declining caries incidence which decreased further following the advent of fluoridated toothpaste. The challenge today is to develop a non-invasive model of practice that will sustain a low level of primary caries experience in the younger generation and reduce risk of caries experience in the older generations. The Caries Management System is a ten step non-invasive strategy to arrest and remineralize early lesions. The governing principle of this system is that caries management must include consideration of the patient at risk, the status of each lesion, patient management, clinical management and monitoring. Both dental caries risk and treatment are managed according to a set of protocols that are applied at various steps throughout patient consultation and treatment. The anticipated outcome of implementing the Caries Management System in general dental practice is reduction in caries incidence and increased patient satisfaction. Since the attainment and maintenance of oral health is determined mainly by controlling both caries and periodontal disease, the implementation of the Caries Management System in general practice will promote both outcomes.

  6. Fluorides in caries prevention and control: empiricism or science.

    Science.gov (United States)

    Ten Cate, J M

    2004-01-01

    The caries-preventive effects of fluoride are beyond any reasonable doubt! Inclusion of fluoride use in caries prevention protocols has resulted in significant reduction in caries prevalence in the majority of the population. Nevertheless, even in low-caries prevalence populations up to 20% of individuals may suffer to an unacceptable degree from caries. In the history of caries research various phases can be discerned. Starting with the initial - laboratory - studies to reveal the mode of action of fluoride, attention later shifted to intra-oral studies and in situ product testing. Currently much emphasis is given to evidence-based dentistry and guidelines for clinical practice, which trend has also focussed the research on fluoride and caries. While on some topics, such as the efficacy of fluoride toothpastes, evidence is convincing, additional research is indicated to resolve remaining questions. One such question is that of high-prevalence individuals for which a comprehensive research programme focussing both on caries aetiological and behavioural aspects should be further developed. Efforts should continue to be directed at improving our understanding of fluoride, in particular on topics where success so far has failed.

  7. Feasibility of streamlining an interactive Bayesian-based diagnostic support tool designed for clinical practice

    Science.gov (United States)

    Chen, Po-Hao; Botzolakis, Emmanuel; Mohan, Suyash; Bryan, R. N.; Cook, Tessa

    2016-03-01

    In radiology, diagnostic errors occur either through the failure of detection or incorrect interpretation. Errors are estimated to occur in 30-35% of all exams and contribute to 40-54% of medical malpractice litigations. In this work, we focus on reducing incorrect interpretation of known imaging features. Existing literature categorizes cognitive bias leading a radiologist to an incorrect diagnosis despite having correctly recognized the abnormal imaging features: anchoring bias, framing effect, availability bias, and premature closure. Computational methods make a unique contribution, as they do not exhibit the same cognitive biases as a human. Bayesian networks formalize the diagnostic process. They modify pre-test diagnostic probabilities using clinical and imaging features, arriving at a post-test probability for each possible diagnosis. To translate Bayesian networks to clinical practice, we implemented an entirely web-based open-source software tool. In this tool, the radiologist first selects a network of choice (e.g. basal ganglia). Then, large, clearly labeled buttons displaying salient imaging features are displayed on the screen serving both as a checklist and for input. As the radiologist inputs the value of an extracted imaging feature, the conditional probabilities of each possible diagnosis are updated. The software presents its level of diagnostic discrimination using a Pareto distribution chart, updated with each additional imaging feature. Active collaboration with the clinical radiologist is a feasible approach to software design and leads to design decisions closely coupling the complex mathematics of conditional probability in Bayesian networks with practice.

  8. Influência de variáveis socioeconômicas, clínicas e demográfica na experiência de cárie dentária em pré-escolares de Piracicaba, SP Influence of socioeconomic, clinical and demographic variables on caries experience of preschool children in Piracicaba, SP

    Directory of Open Access Journals (Sweden)

    Karine Laura Cortellazzi

    2009-09-01

    prevenção e intervenção direcionadas a este público seria essencial para o controle da doença.AIM: To evaluate the influence of socioeconomic, clinical and demographic variables on caries experience in 5-year-old preschool children from Piracicaba. METHODS: The sample consisted of 728 children attending 22 public (n=428 and 18 private (n=300 preschools. Dental caries were measured using the dmft/dmfs indexes and by detecting initial caries lesion (IL. Gingivitis, crowding, spacing, fluorosis, and mouth breathing were also recorded. Socioeconomic variables (monthly family income, number of people living in the household, parents' schooling, home ownership, and car ownership were collected by means of a parental semi structured questionnaire. RESULTS: The mean (standard deviation values for dmft and dmfs indexes were 1.30 (2.47 and 3.08 (7.55 respectively; and 62.2% of the children were caries-free. The mean (standard deviation values for dmft+LI and dmfs+LI were 1.72 (3.36 and 3.45 (7.94, respectively and 59.7% were caries-free. By means of multiple logistic regression analyses, children with fluorosis (OR=0.40 or family income > 4 minimum wages (OR=0.49 were less likely to experience caries. Those with gingivitis (OR=1.87 were more prone to have the disease. Considering the diagnostic threshold including IL, the multiple logistic regression analyses showed that children with fluorosis (OR=0.39 or family income > 4 minimum wages (OR=0.52 were less likely to have caries. Those with gingivitis (OR=1.80, crowding (OR=2.63 e OR=1.01 or mouth breathing (OR=1.37 were more likely to have the disease. CONCLUSION: The preschool children who presented gingivitis, crowding, mouth breathing or monthly family income < 4 minimum wages were more likely to experience caries. In this way, planning preventive and operative actions targeted at these children would be essential for caries control.

  9. [Abdominal masses in pediatric age; clinical aspects and diagnostic approach in 52 cases (author's transl)].

    Science.gov (United States)

    Perrelli, L; Calisti, A; Molle, P

    1981-01-01

    A large series of malignant and benign conditions are generally collected under the term of abdominal masses. Their common aspect is the lack, in most of the cases, of peculiar clinical features which may help early differential diagnosis. In many cases the mass is detected late after a long period of vague, aspecific symptoms. 40% of these space occupying lesions of the abdomen are of malignant origin and delayed detection and investigation affect clinical course. Preoperative study of abdominal masses is a problem of primary importance in pediatric surgical practice. A changing attitude is registered towards many diagnostic procedures and the role of largely diffused techniques like angiography is controversial. The introduction of ultrasonography makes in many cases intensive radiologic investigation unwarranted and academic. The Authors discuss the real role and targets of preoperative investigations of abdominal masses and refer on their experience based on 52 cases, to underline some clinical aspects and analyse their diagnostic approach to this pathology.

  10. Clinical and diagnostic challenges in a rare case of motor weakness with endocrinopathy: A case report

    Directory of Open Access Journals (Sweden)

    Ravinder Garg

    2016-01-01

    Full Text Available Electrolyte imbalance always poses challenging situations to the attending intensivists, particularly if it is associated with endocrinopathies and other comorbidities. One such rare clinical scenario is hypokalemic periodic paralysis (HPP due to hyperthyroidism. The epidemiology of such a condition is slightly higher among males of Asian origin as compared to its universal occurrence. The diagnostic challenges in this clinical situation can lead to higher morbidity if timeliness is compromised from the presentation to active management. Moreover, atypical presentation of this pathologic condition further compounds the problem if it is associated with overt hyperthyroidism. Here, we report a unique case that presented to the emergency medicine department of our institute with weakness of all the four limbs and in which we faced all the diagnostic and management challenges as the clinical condition of hypokalemia was somehow dominated by overt hyperthyroidism.

  11. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy.

    Science.gov (United States)

    Bjørndal, Lars; Reit, Claes; Bruun, Gitte; Markvart, Merete; Kjaeldgaard, Marianne; Näsman, Peggy; Thordrup, Marianne; Dige, Irene; Nyvad, Bente; Fransson, Helena; Lager, Anders; Ericson, Dan; Petersson, Kerstin; Olsson, Jadranka; Santimano, Eva M; Wennström, Anette; Winkel, Per; Gluud, Christian

    2010-06-01

    Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had caries lesions involving 75% or more of the dentin and were centrally randomized to stepwise or direct complete excavation. Stepwise excavation resulted in fewer pulp exposures compared with direct complete excavation [difference: 11.4%, 95% confidence interval (CI) (1.2; 21.3)]. At 1 yr of follow-up, there was a statistically significantly higher success rate with stepwise excavation, with success being defined as an unexposed pulp with sustained pulp vitality without apical radiolucency [difference: 11.7%, 95% CI (0.5; 22.5)]. In a subsequent nested trial, 58 patients with exposed pulps were randomized to direct capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1 yr [31.8% and 34.5%; difference: 2.7%, 95% CI (-22.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared with direct complete excavation. In view of the poor prognosis of vital pulp treatment, a stepwise excavation approach for managing deep caries lesions is recommended.

  12. 龋病早期诊断的现代理念与方法%New concept and moden high-teehes for early diagnosis of dental caries

    Institute of Scientific and Technical Information of China (English)

    姚晖; 张林朴; 李燕妮; 徐延勇; 王冠华

    2009-01-01

    介绍龋病成因及其早期诊断的现代理念和诊断标准,客观叙述了光学相干断层成像(OCT)、定量光激发荧光法(QIF)、激光荧光技术(IF)、红外热成像(IHT)、超声成像(UIT)等新兴龋齿早期检测技术的研究进展、存在问题和临床应用前景.指出经不断探索完善后的快速、无创、量化的现代龋齿早期检测技术将会使未来的牙科医生能够高效精确地在亚临床水平早期诊断龋病并采取有效的干预措施及时遏制甚至逆转龋病进程,降低龋齿发病率,提高人体健康水平.%Introduce etiopathogenisis of odontosphacelism,ideal early diagnostic standard for detecting caries,as well as new concept and hish-teches for early diagnosis of dental caries.Recount objectively the great achivments obtained nowadays for early caries dictating with optical coherence tomography(OCT),quantitative light induced fluorescence(QLF),laser fluorescence methods(LF),ultrasonic imaging technique (UZT) and infrared heat imaging technique(IHT),also the remaining inadequacy and clinical perspective of all.Finally pointed that the improved moden high-teches for quantitively dictating early dental caries will provide dentist with new effective,precise and un-traumatic diagnostic methods to arrest decayed process preclinically and adopt early intervention to dental caries as soon as possible,so as to reduce the incidence of caries and keep the health of human body.

  13. The Hampstead Clinic at work. Discussions in the Diagnostic Profile Research Group.

    Science.gov (United States)

    Koch, Ehud

    2012-01-01

    Minutes of the Hampstead Clinic's Diagnostic Profile Research Group during a fifteen-month period (1964-1965) are reviewed and discussed. A wide range of topics were considered and discussed, with a special focus on the affective life, object relations, and ego function of atypical children in comparison to the early ego functions and differentiation of normal and neurotic children. These lively clinical and theoretical discussions and their implications for therapeutic work with a wide range of children, demonstrate the multifaceted leadership and contributions of Anna Freud as teacher, clinician, and thinker, and of the Hampstead Clinic as a major center for psychoanalytic studies.

  14. Synthetic–schematic representation of the model of clinical diagnostic-therapeutic method

    Directory of Open Access Journals (Sweden)

    Luis Alberto Corona Martínez

    2007-04-01

    Full Text Available The use of a systemic approach in the theoretical analysis of the clinical method has allowed the elaboration of an schematic and synthetic representation of the new model of clinical diagnostic- therapeutic method developed from the conception of the medical assistance as a taking decisions process. The identification of the main components of the clinical method system, as well as of the interrelations established among these, facilitate the understanding of the medical attention process, and also allows the establishment of some of the regularities whose knowledge by the student is of great importance for the learning and application of the method by our Medicine students.

  15. Caries prevalence in older persons with and without dementia

    DEFF Research Database (Denmark)

    Ellefsen, Birita; Holm-Pedersen, Poul; Morse, Douglas E;

    2008-01-01

    To examine the prevalence of coronal and root caries in a memory clinic-based population of elderly patients with and without a diagnosis of dementia and to examine the influence of age, sex, social relations, social position, and functional ability.......To examine the prevalence of coronal and root caries in a memory clinic-based population of elderly patients with and without a diagnosis of dementia and to examine the influence of age, sex, social relations, social position, and functional ability....

  16. Clinical research on abutment gingivitis and secondary caries after partial centure fixing%固定义齿修复后基牙牙龈炎、继发龋的临床观察

    Institute of Scientific and Technical Information of China (English)

    徐频频; 林燕; 麻广丽; 周国锋

    2014-01-01

    目的:观察固定义齿修复后基牙牙龈炎与继发龋的临床表现,对比两种疾病的牙周指标。方法选取本院口腔科接受固定义齿修复的患者共50例:25例患者接受治疗后发生基牙牙龈炎,设定为A组;25例患者接受治疗后发生继发龋,设定为B组,对比两组患者的菌斑指数、社区牙周治疗需要指数、探诊深度以及菌斑细菌分布。结果 A组与B组患者的菌斑指数、社区牙周治疗需要指数、探诊深度差异无统计学意义,A组与B组的菌斑细菌分布差异有统计学意义(P<0.05)。结论固定义齿修复后基牙牙龈炎与继发龋的发生率较高,基牙牙龈炎与继发龋患者的牙周指标无显著差异,因此医生应注重患者固定义齿修复后的健康宣教,以降低牙周疾病的发生率。%Objective To observe the clinical manifestation of abutment gingivitis and secondary caries after partial denture fixing,and to have a comparison of periodontal index between abutment gingivitis and secondary caries. Meth-ods Fifty patients who received partial denture fixing were divided randomly into two groups.Twenty-five patients had abutment gingivitis,and twenty-five patients had secondary caries. The PLI,CPITN,PD and the classification of bacte-rial of two groups were compared. Results The PLI,CPITN,PD of both groups had no difference,but the classification of bacterial in both groups were significantly different (P<0.05). Conclusion The incidence of abutment gingivitis and secondary caries after partial denture fixing is massive. Although the periodontal index between patients who had abut-ment gingivitis or secondary caries after partial denture fixing have no difference. Doctors should strengthen the health education after treatment to reduce the rate of periodontal disease.

  17. DIAGNOSTIC ACCURACY OF CLINICAL AND MAGNETIC RESONANCE IN KNEE MENISCI AND LIGAMENTOUS INJURIES

    Directory of Open Access Journals (Sweden)

    Nilesh

    2016-03-01

    Full Text Available OBJECTIVE The purpose of this study was to evaluate the reliability of clinical diagnosis compared to MRI findings in ligamentous and meniscal injuries with respect to arthroscopic confirmation as a gold standard. METHODS 485 patients with knee injuries were prospectively assessed by clinical evaluation and magnetic resonance imaging and correlated after therapeutic arthroscopy. The overall accuracy, clinically productive values of sensitivity and specificity was derived. The actual value of the test with respect to positive predictive and negative predictive value was also derived, taking arthroscopic findings as confirmatory. The overall partial and total agreement among the clinical, MRI and arthroscopy was documented. RESULTS The overall accuracy for clinical examination was 85, 92, 100 and 100 and accuracy for MRI was 90, 97, 97 and 97 for detecting medial meniscus, lateral meniscus, ACL and PCL tears respectively. Clinically lateral meniscus tears are difficult to diagnose clinically with negative predictive value (90 whereas ACL injuries do not need MRI for diagnosis as evident by a high negative predictive value (100 of clinical examination. Total agreement with the clinical findings confirmed by arthroscopy was 64.40% which was relatively high as compared to total agreement of MRI findings which was only 31.50%. We found similar total agreement versus total disagreement of both clinical and MRI to be only 2.74% indicating very high accuracy in clinical diagnosis of meniscal and ligamentous injuries combined. CONCLUSION The clinical evaluation alone is sufficient to diagnose meniscal and ACL/PCL pathologies and MRI should be considered only as a powerful negative diagnostic tool. The arthroscopy decision should not be heavily dependent on MRI for ligamentous injuries but reverse is true for meniscal lesions. MR evaluation functions as a powerful negative diagnostic tool to rule out doubtful and complex knee injuries.

  18. Prevalence of neuropathic features of back pain in clinical populations: implications for the diagnostic triage paradigm.

    Science.gov (United States)

    Hush, Julia M; Marcuzzi, Anna

    2012-07-01

    SUMMARY Contemporary clinical assessment of back pain is based on the diagnostic triage paradigm. The most common diagnostic classification is nonspecific back pain, considered to be of nociceptive etiology. A small proportion are diagnosed with radicular pain, of neuropathic origin. In this study we review the body of literature on the prevalence of neuropathic features of back pain, revealing that the point prevalence is 17% in primary care, 34% in mixed clinical settings and 53% in tertiary care. There is evidence that neuropathic features of back pain are not restricted to typical clinical radicular pain phenotypes and may be under-recognized, particularly in primary care. The consequence of this is that in the clinic, diagnostic triage may erroneously classify patients with nonspecific back pain or radicular pain. A promising alternative is the development of mechanism-based pain phenotyping in patients with back pain. Timely identification of contributory pain mechanisms may enable greater opportunity to select appropriate therapeutic targets and improve patient outcomes.

  19. Diagnostic outcome following routine genetics clinic referral for the assessment of global developmental delay.

    LENUS (Irish Health Repository)

    Shahdadpuri, R

    2012-02-01

    The aim of this study was to ascertain the diagnostic yield following a routine genetics clinic referral for the assessment of global developmental delay. Detailed retrospective review of 119 complete consecutive case notes of patients referred to one single clinical geneticist over a 14 month time period was undertaken (n = 119; 54 males, 65 females). The age at initial review ranged from 2 months to 37 years 3 months (mean 8 y 3 mo [SD 7 y 10 mo]). We made a diagnosis in 36\\/119 (30%); 21\\/36 were new diagnoses and 15\\/36 were confirmations of diagnoses. We removed a wrong diagnostic label in 8\\/119 (7%). In 3\\/8 we were able to achieve a diagnosis but in 5\\/8 no alternative diagnosis was reached. We had a better diagnostic rate where the patients were dysmorphic (odds ratio [OR] 1.825; 95% confidence interval [CI] 1.065 to 3.128, p = 0.044). In the majority, the diagnosis was made by clinical examination only. Molecular diagnosis was reached in seven cases. Five cases were confirmed by cytogenetic analysis. Brain magnetic resonance imaging (MRI) revealed a diagnosis in three cases. This study confirms the importance of a clinical genetics assessment in the investigation of global developmental delay.

  20. Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders

    Directory of Open Access Journals (Sweden)

    Tivani P. Mashamba-Thompson

    2017-01-01

    Full Text Available Introduction: Key stakeholders’ involvement is crucial to the sustainability of quality point-of-care (POC diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC clinics in South Africa. Method: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it criteria for POC diagnostic services in resource-limited settings. Results: 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients’ needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Conclusions: Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics.

  1. Implementation of Point-of-Care Diagnostics in Rural Primary Healthcare Clinics in South Africa: Perspectives of Key Stakeholders

    Science.gov (United States)

    Mashamba-Thompson, Tivani P.; Jama, Ngcwalisa A.; Sartorius, Benn; Drain, Paul K.; Thompson, Rowan M.

    2017-01-01

    Introduction: Key stakeholders’ involvement is crucial to the sustainability of quality point-of-care (POC) diagnostics services in low-and-middle income countries. The aim of this study was to explore key stakeholder perceptions on the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa. Method: We conducted a qualitative study encompassing in-depth interviews with multiple key stakeholders of POC diagnostic services for rural and resource-limited PHC clinics. Interviews were digitally recorded and transcribed verbatim prior to thematic content analysis. Thematic content analysis was conducted using themes guided by the World Health Organisation (WHO) quality-ASSURED (Affordable, Sensitive, Specific, User friendly, Rapid and to enable treatment at first visit and Robust, Equipment free and Delivered to those who need it) criteria for POC diagnostic services in resource-limited settings. Results: 11 key stakeholders participated in the study. All stakeholders perceived the main advantage of POC diagnostics as enabling access to healthcare for rural patients. Stakeholders perceived the current POC diagnostic services to have an ability to meet patients’ needs, but recommended further improvement of the following areas: research on cost-effectiveness; improved quality management systems; development of affordable POC diagnostic and clinic-based monitoring and evaluation. Conclusions: Key stakeholders of POC diagnostics in rural PHC clinics in South Africa highlighted the need to assess affordability and ensure quality assurance of current services before adopting new POC diagnostics and scaling up current POC diagnostics. PMID:28075337

  2. Caries risk assessment

    DEFF Research Database (Denmark)

    Mejàre, I; Axelsson, S; Dahlén, G

    2014-01-01

    OBJECTIVE: To assess the ability of multivariate models and single factors to correctly identify future caries development in pre-school children and schoolchildren/adolescents. STUDY DESIGN: A systematic literature search for relevant papers was conducted with pre-determined inclusion criteria....... Seven studies had high quality, 35 moderate and the rest poor quality. The accuracy of multivariate models was higher for pre-school children than for schoolchildren/adolescents. However, the models had seldom been validated in independent populations, making their accuracy uncertain. Of the single...... predictors, baseline caries experience had moderate/good accuracy in pre-school children and limited accuracy in schoolchildren/adolescents. The period of highest risk for caries incidence in permanent teeth was the first few years after tooth eruption. In general, the quality of evidence was limited...

  3. [The clinical manifestations and diagnostics of otitis media caused by tuberculosis].

    Science.gov (United States)

    Kriukov, A I; Garov, E V; Ivoĭlov, A Y U; Shadrin, G B; Sidorina, N G; Lavrova, A S

    2015-01-01

    The objective of the present study was to clarify the characteristic pathognomonic features of middle ear lesions associated with tuberculosis and the approaches to their diagnostics under the present-day conditions. The study included 11 cases (18 ears) of tuberculosis otitis media and the related lesions of the mastoid process diagnosed with the use of clinical, roentgenological, cytological, bacteriological, pathomorphological, and molecular-genetic methods (including PCR diagnostics). The primary localization of tuberculosis in the middle ear was documented in 6 patients; in 5 patients, it was associated with pulmonary involvement. Five patients presented with smoldering exudative otitis media and the remaining six ones with suppurative perforating otitis media. The tuberculous process was diagnosed with the use of various methods including clinical examination, bacteriological (9%), cytological (27.3%), pathomorphological (18%) studies, and PCR diagnostics (55%). Diagnosis was made within a period from 1 month to 1.5 years after the application of the patients for medical assistance which suggests the difficulty of verification of tuberculous etiology of the disease of the middle ear. It is concluded that the high index of suspicion in the case of smoldering middle ear pathology facilitates its early diagnostics and successful treatment.

  4. SALIVA AS A DIAGNOSTIC FLUID

    Directory of Open Access Journals (Sweden)

    Pezelj-Ribarić Sonja

    2015-12-01

    Full Text Available Saliva is a readily available oral fluid with many functions, from digestion, maintenance of oral tissues' integrity, to caries prevention. Changes regarding its secretion may be divided into qualitative and quantitative: both of them are a consequence of certain conditions/diseases (e.g. internal factors or nutrients/drugs ingested (e.g. external factors. During the last 15 years, technological advances gave a significant momentum to utilization of saliva as a diagnostic tool. Analysis of saliva, just like the blood analysis, has two main objectives: to identify the subjects suffering from a certain disorder, and to follow the development and progress of therapy. This paper provides an overview of possibilities for the use of saliva for diagnostic purposes and gives specific examples of some clinical investigations, with the final aim to stimulate the use of this noninvasive means for the health care promotion.

  5. Association of parental stress and early childhood caries

    Directory of Open Access Journals (Sweden)

    Seyed Ebrahim Jabbarifar

    2009-01-01

    Full Text Available Background:Little research has been carried out on whether the parental stress affects children′s oral health in general and dental caries in particular. This study aimed to investigate the association be-tween parental stress and early childhood caries (ECC. Methods: A cross-sectional study was designed that included 250 children of 4-6 year-old; 127 ones attended the pediatric department of Isfahan School of Dentistry who had early childhood caries and a comparison group of 123 caries free children attended five kindergartens and pre-schools in Isfahan city. Clinical examinations were conducted to evaluate the caries status. The parents of the two study groups completed the self-administrated long form of the Parenting Stress Index questionnaire. De-tails of their socio-demographic status were gathered too. The collected data were analyzed by SPSS version 11.5. The nonparametric Mantel-Haenszel test for correlation statistics was used to determine bivariate associations between total parenting stress and their domains scores in the two groups; i.e., those with early childhood caries and the caries free group. Results: Mean score of PSI in the early childhood caries and caries free group were 286.66 ± 66.26 and 273.87 ± 31.03, respectively. There was not any significant relationship between total parental stress and ECC. The scores of the following domains of PSI demonstrated significant differences between ECC and CF groups: child reinforcement, child distractibility, child deficit attention, life stress and relationship with spouse (P = 0.01, 0.01, 0.001, 0.005 respectively. Conclusion: Findings of this study did not show any significant association between total parenting stress score and prevalence of early childhood caries.

  6. Caries-preventive Effect of Supervised Toothbrushing and Sealants.

    Science.gov (United States)

    Hilgert, L A; Leal, S C; Mulder, J; Creugers, N H J; Frencken, J E

    2015-09-01

    To investigate the effectiveness of 3 caries-preventive measures on high- and low-caries risk occlusal surfaces of first permanent molars over 3 y. This cluster-randomized controlled clinical trial covered 242 schoolchildren, 6 to 7 y old, from low socioeconomic areas. At baseline, caries risk was assessed at the tooth surface level, through a combination of ICDAS II (International Caries Detection and Assessment System) and fissure depth codes. High-caries risk occlusal surfaces were treated according to daily supervised toothbrushing (STB) at school and 2 sealants: composite resin (CR) and atraumatic restorative treatment-high-viscosity glass-ionomer cement (ART-GIC). Low-caries risk occlusal surfaces received STB or no intervention. Evaluations were performed after 0.5, 1, 2, and 3 y. A cavitated dentine carious lesion was considered a failure. Data were analyzed according to the proportional hazard rate regression model with frailty correction, Wald test, analysis of variance, and t test, according to the jackknife procedure for calculating standard errors. The cumulative survival rates of cavitated dentine carious lesion-free, high-caries risk occlusal surfaces were 95.6%, 91.4%, and 90.2% for STB, CR, and ART-GIC, respectively, over 3 y, which were not statistically significantly different. For low-caries risk occlusal surfaces, no statistically significant difference was observed between the cumulative survival rate of the STB group (94.8%) and the no-intervention group (92.1%) over 3 y. There was neither a difference among STB, CR, and ART-GIC on school premises in preventing cavitated dentine carious lesions in high-caries risk occlusal surfaces of first permanent molars nor a difference between STB and no intervention for low-caries risk occlusal surfaces of first permanent molars over 3 y.

  7. Adolescent rampant caries

    Directory of Open Access Journals (Sweden)

    Namita

    2012-01-01

    Full Text Available Adolescent rampant caries is a new and growing challenge in Conservative Dentistry. It has the same etiology and pattern as that of nursing bottle syndrome. Herein, a case is presented in which the main cause of rampant caries is the patient′s habit of keeping cariogenic food in her mouth and going to sleep. Educating this etiology and introduction of preventive strategies not only assists in meeting the special oral needs of the adolescent population, but also helps to establish lifelong healthful habits.

  8. Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management.

    Science.gov (United States)

    Poddighe, Dimitri; Gelardi, Matteo; Licari, Amelia; Del Giudice, Michele Miraglia; Marseglia, Gian Luigi

    2016-12-26

    Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. Allergic rhinitis has been considered to be the most frequent form of chronic rhinitis, as non-allergic rhinitis has been estimated to account for 25%. However, several evidences suggested that non-allergic rhinitis have been underrated, especially in children. In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management.

  9. Need for new caries detection methods

    Science.gov (United States)

    Young, Douglas A.; Featherstone, John D. B.

    1999-05-01

    Dental caries (tooth decay) continues to be a major problems for adults as well as children, even though great advances have been made in preventive methods in the last 20 years. New methods for the management of caries will work best if lesions can be detected at an early stage and chemical rather than physical intervention can take place, thereby preserving the natural tooth structure and helping the saliva to heal, or remineralize, the areas of early decay. Clinical detection of caries in the US relies on visual examination, tactile with hand held explorer, and conventional radiographs, all of which are inadequate for the occlusal (biting) surfaces of the teeth where most of the decay now occurs. The dentist often has to explore by drilling with a dental bur to confirm early decay in these areas. New method that can determine the extent and degree of subsurface lesions in these surfaces non-destructively are essential for further advances in the clinical management of dental caries. Optical methods, which exploit the differences between sound and carious enamel and dentin, show great promise for the accurate detection of these lesions. Two or three- dimensional images, which include a measure of severity will be needed.

  10. BRIEF REVIEW ON DIAGNOSTIC TECHNIQUE AND NOVEL MOLECULES IN CLINICAL TRIALS FOR TREATMENT OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    VISHAL KUMAR S. MODI

    2015-01-01

    Full Text Available Breast cancer is the most common cancer in women in both developed and undeveloped countries, and the second most frequent cause of cancer deaths after lung cancer. Although there have been many chemotherapeutic agents like 5-fluorouracil, taxol, tamoxifen, doxorubicin, cisplatin, and camptothecin and hormones are used to treat breast cancer. This review focuses on the causes of breast cancer, latest diagnostic techniques and various molecules under clinical trials for the treatment of breast cancer.

  11. Validation of secondary data sources to identify Parkinson disease against clinical diagnostic criteria.

    Science.gov (United States)

    Jain, Samay; Himali, Jayandra; Beiser, Alexa; Ton, Thanh G N; Kelly-Hayes, Margaret; Biggs, Mary Lou; Delaney, Joseph A C; Rosano, Caterina; Seshadri, Sudha; Frank, Samuel A

    2015-02-01

    Parkinson disease (PD) is the second most common neurodegenerative disorder. Its diagnosis relies solely on a clinical examination and is not straightforward because no diagnostic test exists. Large, population-based, prospective cohort studies designed to examine other outcomes that are more common than PD might provide cost-efficient alternatives for studying the disease. However, most cohort studies have not implemented rigorous systematic screening for PD. A majority of epidemiologic studies that utilize population-based prospective designs rely on secondary data sources to identify PD cases. Direct validation of these secondary sources against clinical diagnostic criteria is lacking. The Framingham Heart Study has prospectively screened and evaluated participants for PD based on clinical diagnostic criteria. We assessed the predictive value of secondary sources for PD identification relative to clinical diagnostic criteria in the Framingham Heart Study (2001-2012). We found positive predictive values of 1.0 (95% confidence interval: 0.868, 1.0), 1.0 (95% confidence interval: 0.839, 1.0), and 0.50 (95% confidence interval: 0.307, 0.694) for PD identified from self-report, use of antiparkinsonian medications, and Medicare claims, respectively. The negative predictive values were all higher than 0.99. Our results highlight the limitations of using only Medicare claims data and suggest that population-based cohorts may be utilized for the study of PD determined via self-report or medication inventories while preserving a high degree of confidence in the validity of PD case identification.

  12. Effect of clinical specialist physiotherapists in orthopaedic diagnostic setting - A systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Mikkelsen, Lone Ramer; Juhl, Carsten

    with musculoskeletal complaint performed by Clinical Specialist Physiotherapists (CSP) compared to Orthopaedic Surgeons (OS) on diagnostic agreement, economic cost and patient satisfaction. Methods: A systematic review was performed by searching in MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL......), EMBASE, CINAHL, PEDro and reference lists of included studies and previously published systematic reviews. Studies evaluating 1) adults (18+) with a musculoskeletal complaint referred to orthopaedic outpatient assessment and 2) patient assessment performed by CSP were included. Studies conducted...

  13. In vivo evaluation of DIAGNOdent for the quantification of occlusal dental caries.

    Science.gov (United States)

    Khalife, Moufida A; Boynton, James R; Dennison, Joseph B; Yaman, Peter; Hamilton, James C

    2009-01-01

    The accurate diagnosis of non-cavitated occlusal caries is generally considered problematic. Induced fluorescence quantified by the DIAGNOdent device (KaVo) gives a reading from 0-99, which may help in the caries diagnostic process. There is some controversy around the implication of increased severity of decay with increased DIAGNOdent readings. This in vivo study assessed the correlation of depth and volume of decay as it was removed by traditional rotary handpieces with DIAGNOdent readings and determined sensitivities/specificities of the device at different cut-off points. Included in the current study were 31 patients providing 60 permanent molar and premolar occlusal surfaces suspected of dentinal decay. DIAGNOdent readings were recorded, along with lesion depth (as measured by periodontal probe) and volume measurements (as calculated from measuring the mass of a polyvinyl siloxane impression of the cavity, divided by the material's calculated density). Clinical detection of decay at the DEJ was used as the gold-standard to calculate an appropriate cut-off. Pearson correlation coefficients indicated that DIAGNOdent readings were weakly correlated with lesion depth (r = 0.47) and lesion volume (also r = 0.47). An appropriate cut-off point for the sample in the current study was calculated between 35 and 40; a more specific cut-off point could not be determined due to the sample size distribution. It was concluded that the DIAGNOdent device should be used as an adjunct in the caries diagnosis and treatment planning process.

  14. Assessing the Performance of the Laser Fluorescence Technique in Detecting Proximal Caries Cavities

    Directory of Open Access Journals (Sweden)

    Majid Akbari

    Full Text Available Introduction: Diagnosing the necessity of cavity preparation and restoration in demineralized proximal areas is always considered as a challenge in restorative treatment planning. The purpose of this study was to assess the performance of the laser fluorescence (LF technique in detection of proximal cavities.Materials & Methods: In this clinical trial, 44 proximal surfaces in 38 dental students were evaluated. The selected patients had radiolucent proximal lesions restricted to inner half of enamel or outer third of dentine in bitewing radiographs (BW. DIAGNOdent pen (LF pen device was used to determine the presence or absence of caries cavities in suspected proximal surfaces. Orthodontic elastic separators were then placed in the contact areas to provide enough space for direct visual and tactile examination. The sensitivity, specificity and accuracy of the laser fluorescence technique were calculated versus the reference standard. The ROC curve was drawn and the best cut-off to determine the presence or absence of proximal cavities was determined.Results: Using DIAGNOdent pen, the optimal cut-off for detecting proximal cavities was 18. The sensitivity, specificity and accuracy of DIAGNOdent pen for diagnosing proximal caries cavities were 100 per cent, 97.3 per cent and 97.7 per cent, respectively. Conclusion: Due to the high diagnostic accuracy of DIAGNOdent pen in detecting proximal caries cavities, it can be used as a valuable supplement in restorative treatment planning.

  15. Effect of Dental Caries on Children Growth

    Directory of Open Access Journals (Sweden)

    T Malek Mohammadi

    2005-10-01

    Full Text Available Objectives: The study examined the hypothesis that severe dental caries may affect growth and development in preschool children. Methods: The study examined 218 children with severe caries using standard diagnostic criteria. All children were weighed and measured and a food frequency questionnaire was completed for each. Six months subsequent to tooth extraction, 131 of the children were followed up and underwent repeat measurement of height, weight, dental health and food intake. For each child, body mass index (BMI was calculated, and all measurements were converted into standard deviation scores and compared to the UK 1990 growth reference. Results: In the six months period after having their decayed teeth extracted the children’s BMIs had increased by 0.654. Two-sided t-tests for paired data showed this difference to be significant (P< 0.01. Conclusion: Treatment of gross dental disease appears to promote "catch-up" growth and normalisation of body mass index.

  16. Mutans streptococci and lactobacilli on healthy and carious teeth in the same mouth of children with and without dental caries

    OpenAIRE

    Toi, C. S.; Mogodiri, R.; Cleaton-Jones, P. E.

    2011-01-01

    Interactions between mutans streptococci and lactobacilli contribute towards the microbial challenge of dental caries. A comparison was made between numbers of mutans streptococci and lactobacilli in plaque from primary teeth in healthy children and between caries-free teeth and carious lesions in the same mouth of children with caries. The study group comprised 107 nursery-school children with a clinically healthy dentition and 117 children with caries. After a dental examination with mirror...

  17. Vertigo in childhood: proposal for a diagnostic algorithm based upon clinical experience.

    Science.gov (United States)

    Casani, A P; Dallan, I; Navari, E; Sellari Franceschini, S; Cerchiai, N

    2015-06-01

    The aim of this paper is to analyse, after clinical experience with a series of patients with established diagnoses and review of the literature, all relevant anamnestic features in order to build a simple diagnostic algorithm for vertigo in childhood. This study is a retrospective chart review. A series of 37 children underwent complete clinical and instrumental vestibular examination. Only neurological disorders or genetic diseases represented exclusion criteria. All diagnoses were reviewed after applying the most recent diagnostic guidelines. In our experience, the most common aetiology for dizziness is vestibular migraine (38%), followed by acute labyrinthitis/neuritis (16%) and somatoform vertigo (16%). Benign paroxysmal vertigo was diagnosed in 4 patients (11%) and paroxysmal torticollis was diagnosed in a 1-year-old child. In 8% (3 patients) of cases, the dizziness had a post-traumatic origin: 1 canalolithiasis of the posterior semicircular canal and 2 labyrinthine concussions, respectively. Menière's disease was diagnosed in 2 cases. A bilateral vestibular failure of unknown origin caused chronic dizziness in 1 patient. In conclusion, this algorithm could represent a good tool for guiding clinical suspicion to correct diagnostic assessment in dizzy children where no neurological findings are detectable. The algorithm has just a few simple steps, based mainly on two aspects to be investigated early: temporal features of vertigo and presence of hearing impairment. A different algorithm has been proposed for cases in which a traumatic origin is suspected.

  18. Official American Thoracic Society Clinical Practice Guidelines: Diagnostic Evaluation of Infants with Recurrent or Persistent Wheezing.

    Science.gov (United States)

    Ren, Clement L; Esther, Charles R; Debley, Jason S; Sockrider, Marianna; Yilmaz, Ozge; Amin, Nikhil; Bazzy-Asaad, Alia; Davis, Stephanie D; Durand, Manuel; Ewig, Jeffrey M; Yuksel, Hasan; Lombardi, Enrico; Noah, Terry L; Radford, Peggy; Ranganathan, Sarath; Teper, Alejandro; Weinberger, Miles; Brozek, Jan; Wilson, Kevin C

    2016-08-01

    Infantile wheezing is a common problem, but there are no guidelines for the evaluation of infants with recurrent or persistent wheezing that is not relieved or prevented by standard therapies. An American Thoracic Society-sanctioned guideline development committee selected clinical questions related to uncertainties or controversies in the diagnostic evaluation of wheezing infants. Members of the committee conducted pragmatic evidence syntheses, which followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The evidence syntheses were used to inform the formulation and grading of recommendations. The pragmatic evidence syntheses identified few studies that addressed the clinical questions. The studies that were identified constituted very low-quality evidence, consisting almost exclusively of case series with risk of selection bias, indirect patient populations, and imprecise estimates. The committee made conditional recommendations to perform bronchoscopic airway survey, bronchoalveolar lavage, esophageal pH monitoring, and a swallowing study. It also made conditional recommendations against empiric food avoidance, upper gastrointestinal radiography, and gastrointestinal scintigraphy. Finally, the committee recommended additional research about the roles of infant pulmonary function testing and food avoidance or dietary changes, based on allergy testing. Although infantile wheezing is common, there is a paucity of evidence to guide clinicians in selecting diagnostic tests for recurrent or persistent wheezing. Our committee made several conditional recommendations to guide clinicians; however, additional research that measures clinical outcomes is needed to improve our confidence in the effects of various diagnostic interventions and to allow advice to be provided with greater confidence.

  19. The Reproducibility of Changes in Diagnostic Figures of Merit Across Laboratory and Clinical Imaging Reader Studies.

    Science.gov (United States)

    Samuelson, Frank W; Abbey, Craig K

    2017-06-27

    In this paper we examine which comparisons of reading performance between diagnostic imaging systems made in controlled retrospective laboratory studies may be representative of what we observe in later clinical studies. The change in a meaningful diagnostic figure of merit between two diagnostic modalities should be qualitatively or quantitatively comparable across all kinds of studies. In this meta-study we examine the reproducibility of relative measures of sensitivity, false positive fraction (FPF), area under the receiver operating characteristic (ROC) curve, and expected utility across laboratory and observational clinical studies for several different breast imaging modalities, including screen film mammography, digital mammography, breast tomosynthesis, and ultrasound. Across studies of all types, the changes in the FPFs yielded very small probabilities of having a common mean value. The probabilities of relative sensitivity being the same across ultrasound and tomosynthesis studies were low. No evidence was found for different mean values of relative area under the ROC curve or relative expected utility within any of the study sets. The comparison demonstrates that the ratios of areas under the ROC curve and expected utilities are reproducible across laboratory and clinical studies, whereas sensitivity and FPF are not. Published by Elsevier Inc.

  20. Probability scores and diagnostic algorithms in pulmonary embolism: are they followed in clinical practice?

    Science.gov (United States)

    Sanjuán, Pilar; Rodríguez-Núñez, Nuria; Rábade, Carlos; Lama, Adriana; Ferreiro, Lucía; González-Barcala, Francisco Javier; Alvarez-Dobaño, José Manuel; Toubes, María Elena; Golpe, Antonio; Valdés, Luis

    2014-05-01

    Clinical probability scores (CPS) determine the pre-test probability of pulmonary embolism (PE) and assess the need for the tests required in these patients. Our objective is to investigate if PE is diagnosed according to clinical practice guidelines. Retrospective study of clinically suspected PE in the emergency department between January 2010 and December 2012. A D-dimer value ≥ 500 ng/ml was considered positive. PE was diagnosed on the basis of the multislice computed tomography angiography and, to a lesser extent, with other imaging techniques. The CPS used was the revised Geneva scoring system. There was 3,924 cases of suspected PE (56% female). Diagnosis was determined in 360 patients (9.2%) and the incidence was 30.6 cases per 100,000 inhabitants/year. Sensitivity and the negative predictive value of the D-dimer test were 98.7% and 99.2% respectively. CPS was calculated in only 24 cases (0.6%) and diagnostic algorithms were not followed in 2,125 patients (54.2%): in 682 (17.4%) because clinical probability could not be estimated and in 482 (37.6%), 852 (46.4%) and 109 (87.9%) with low, intermediate and high clinical probability, respectively, because the diagnostic algorithms for these probabilities were not applied. CPS are rarely calculated in the diagnosis of PE and the diagnostic algorithm is rarely used in clinical practice. This may result in procedures with potential significant side effects being unnecessarily performed or to a high risk of underdiagnosis. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  1. Clinical implications for biochemical diagnostic thresholds of adrenal sufficiency using a highly specific cortisol immunoassay.

    Science.gov (United States)

    Kline, G A; Buse, J; Krause, R D

    2017-06-01

    Recent guidelines recommend a diagnosis of adrenal insufficiency when a stimulated peak cortisol level falls below 500nmol/L. This may not be valid using a highly specific cortisol immunoassay or liquid chromatography-mass spectroscopy (LCMS/MS). We sought to determine the diagnostic threshold for adrenal insufficiency using a new and widely available, highly specific cortisol immunoassay. All patients having a dynamic test of adrenal reserve had results measured using the historical cortisol assay (Roche Cortisol) and the newer assay (Roche Cortisol II). Subjects were categorized according to the traditional assay (normal>500nmol/L) with clinical case adjudication where necessary. Results from Cortisol II assay were concomitantly measured along with cortisol levels measured by LCMS/MS. ROC curve analysis was performed to generate new diagnostic thresholds. The Roche Cortisol II compared favourably with measures by LCMS/MS, generating cortisol levels approximately 30% lower than the older immunoassay. Many normal subjects had peak cortisols as low as 300nmol/L with Cortisol II. The optimized diagnostic threshold for adrenal insufficiency was 350nmol/L with a sensitivity of 91% and specificity 97%. Use of the old diagnostic threshold with the Cortisol II assay would have inappropriately doubled the rate of patient-classification as adrenal insufficient. Transition to a more specific cortisol assay requires revision of diagnostic thresholds for dynamic tests of adrenal insufficiency. With the Roche Cortisol II assay, a cut-off of 350nmol/L should replace the traditional 500nmol/L although some healthy subjects may be very close to this level. Copyright © 2017 The Canadian Society of Clinical Chemists. All rights reserved.

  2. Clinical research and diagnostic efficacy studies in the oral and maxillofacial radiology literature: 1996–2005

    Science.gov (United States)

    Kim, IH; Patel, MJ; Hirt, SL; Kantor, ML

    2011-01-01

    Objectives The aim of this study was to determine the level of evidence that is published in the oral and maxillofacial radiology (OMR) literature. Methods OMR papers published in Dentomaxillofacial Radiology and Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology between 1996 and 2005 were classified using epidemiological study design and diagnostic efficacy hierarchies. The country of origin and number of authors were noted. Results Of the 725 articles, 384 could be classified with the epidemiological study design hierarchy: 155 (40%) case reports/series and 207 (54%) cross-sectional studies. The distribution of study designs was not statistically significant across time (Fisher's exact test, P = 0.06) or regions (P = 0.89). The diagnostic efficacy hierarchy was applicable to 246 articles: 71 (29%) technical efficacy and 166 (67%) diagnostic accuracy studies. The distribution of efficacy levels was not statistically significant across time (P = 0.22) but was significant across regions (P < 0.01). Authors from Japan produced 26% of the papers with a mean ± standard deviation of 5.78 ± 1.98 authors per paper (APP); American authors, 23% (3.78 ± 1.72 APP); and all others, 51% (3.76 ± 1.51 APP). Conclusion The OMR literature consisted mostly of case reports/series, cross-sectional, technical efficacy and diagnostic accuracy studies. Such studies do not provide strong evidence for clinical decision making nor do they address the impact of diagnostic imaging on patient care. More studies at the higher end of the study design and efficacy hierarchies are needed in order to make wise choices regarding clinical decisions and resource allocations. PMID:21697152

  3. Impact of clinical awareness and diagnostic tests on the underdiagnosis of Clostridium difficile infection.

    Science.gov (United States)

    Alcalá, L; Reigadas, E; Marín, M; Martín, A; Catalán, P; Bouza, E

    2015-08-01

    A multicenter study of Clostridium difficile infection (CDI) performed during 2008 in Spain revealed that two of every three episodes went undiagnosed or were misdiagnosed owing to nonsensitive diagnostic tests or lack of clinical suspicion and request. Since then, efforts have been made to improve the diagnostic tests used by laboratories and to increase the awareness of this disease among both clinicians and microbiologists. Our objective was to evaluate the impact of these efforts by assessing the current magnitude of underdiagnosis of CDI in Spain using two point-prevalence studies performed on one day each in January and July of 2013. A total of 111 Spanish laboratories selected all unformed stool specimens received for microbiological diagnosis on these days, and toxigenic culture was performed at a central reference laboratory. Toxigenic isolates were characterized both pheno- and genotypically. The reference laboratory detected 103 episodes of CDI in patients aged 2 years or more. Half (50.5 %) of the episodes were not diagnosed in the participating laboratories, owing to insensitive diagnostic tests (15.5 %) or the lack of clinical suspicion and request (35.0 %). The main ribotypes were 014, 078/126, 001/072, and 106. Ribotype 027 caused 2.9 % of all cases. Despite all the interventions undertaken, CDI remains a highly neglected disease because of the lack of sensitive diagnostic tests in some institutions and, especially, the absence of clinical suspicion, mainly in patients with community-associated CDI. Toxigenic C. difficile should be routinely sought in unformed stools sent for microbiological diagnosis, regardless of their origin.

  4. Detection activity assessment and diagnosis of dental caries lesions.

    Science.gov (United States)

    Braga, Mariana M; Mendes, Fausto M; Ekstrand, Kim R

    2010-07-01

    This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment and the method must be used for all patients. Use of indices, for example, the International Caries Detection and Assessment System (ICDAS), can improve the performance of this method. Using visual inspection, the clinician must decide about the presence, severity and activity of lesions. After this process, additional methods could aid the dentist in reaching a more appropriate treatment decision in some cases. The ICDAS, including the activity assessment system or the Nyvad system, seems to be the best option to reach final diagnoses for managing lesions. The radiographic method is the most recommended additional method available for daily clinical practice.

  5. Clinical utility of machine learning approaches in schizophrenia: Improving diagnostic confidence for translational neuroimaging

    Directory of Open Access Journals (Sweden)

    Sarina eIwabuchi

    2013-08-01

    Full Text Available Machine-learning approaches are becoming commonplace in the neuroimaging literature as potential diagnostic and prognostic tools for the study of clinical populations. However, very few studies provide clinically informative measures to aid in decision-making and resource allocation. Head-to-head comparison of neuroimaging-based multivariate classifiers is an essential first step to promote translation of these tools to clinical practice. We systematically evaluated the classifier performance using back-to-back structural MRI in two field strengths (3-Tesla and 7-Tesla to discriminate patients with schizophrenia (n=19 from healthy controls (n=20. Grey (GM and white matter (WM images were used as inputs into a support vector machine (SVM to classify patients and control subjects. 7T classifiers outperformed the 3T classifiers with accuracy reaching as high as 77% for the 7T GM classifier compared to 66.6% for the 3T GM classifier. Furthermore, diagnostic odds ratio (a measure that is not affected by variations in sample characteristics and number needed to predict (a measure based on Bayesian certainty of a test result indicated superior performance of the 7T classifiers, whereby for each correct diagnosis made, the number of patients that need to be examined using the 7T GM classifier was one less than the number that need to be examined if a different classifier was used. Using a hypothetical example, we highlight how these findings could have significant implications for clinical decision-making. We encourage the reporting of measures proposed here in future studies utilizing machine-learning approaches. This will not only promote the search for an optimum diagnostic tool but also aid in the translation of neuroimaging to clinical use.

  6. [Epidemiology of Minamata Disease--Focus on the Clinical Features Related to the 1977 Diagnostic Criteria].

    Science.gov (United States)

    Futatsuka, Makoto

    2015-01-01

    Large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s (Minamata Disease). Although the diagnostic criteria for the disease was controversial and difficult during that time, we, the Kumamoto University Study Group, carried out a large-scale study to assess the clinical features in 1972-1973. The author tried to reassess the results of that study to appraise the diagnostic criteria established in 1977 on the basis of those results. A substantial number of residents in the exposed area exhibited neurologic signs, especially paresthesia of only the extremities, namely, the male residents of Minamata City showed a positive predictive value of 0.73 and a negative predictive value of 0.23. The relative risks of paresthesia only were 2.6 (2.0-3.3) and 1.2 (0.9-1.5), in Minamata and Goshonoura related to Ariake (control), respectively. At least until 1977, the diagnostic criteria remained valid, although it was inadequate. Nevertheless, presently, a follow-up study of the certified patients may lead to the development of efficient new diagnostic criteria.

  7. Diagnostic discrepancies in clinical practice: An autopsy study in patients with heart failure.

    Science.gov (United States)

    Issa, Victor Sarli; Dinardi, Layara Fernanda Lipari; Pereira, Thiago Vicente; de Almeida, Lyna Kyria Rodrigues; Barbosa, Thaisa Silveira; Benvenutti, Luiz Alberto; Ayub-Ferreira, Silvia Moreira; Bocchi, Edimar Alcides

    2017-01-01

    Autopsies are the gold standard for diagnostic accuracy; however, no recent study has analyzed autopsies in heart failure (HF).We reviewed 1241 autopsies (January 2000-May 2005) and selected 232 patients with HF. Clinical and autopsy diagnoses were analyzed and discrepancies categorized according to their importance regarding therapy and prognosis.Mean age was 63.3 ± 15.9 years; 154 (66.4%) patients were male. The causes of death at autopsy were end-stage HF (40.9%), acute myocardial infarction (17.2%), infection (15.9), and pulmonary embolism 36 (15.5). Diagnostic discrepancies occurred in 191 (82.3%) cases; in 56 (24.1%), discrepancies were related to major diagnoses with potential influence on survival or treatment; pulmonary embolism was the cause of death for 24 (42.9%) of these patients. In 35 (15.1%), discrepancies were related to a major diagnosis with equivocal influence on survival or treatment; in 100 (43.1%), discrepancies did not influence survival or treatment. In multivariate analysis, age (OR: 1.03, 95% CI: 1.008-1.052, P = 0.007) and presence of diabetes mellitus (OR: 0.359, 95% CI: 0.168-0.767, P = 0.008) influenced the occurrence discrepancies.Diagnostic discrepancies with a potential impact on prognosis are frequent in HF. These findings warrant reconsideration in diagnostic and therapeutic practices with HF patients.

  8. Has dental caries prevalence some connection with caries index values in adults?

    Science.gov (United States)

    Larmas, M

    2010-01-01

    DMF index values have been used for 70 years and were originally meant to describe both dental status and treatment need in elementary school children. Since then its application to caries experience and severity determination has expanded. Today, WHO has standardized its use in oral health surveys in describing past and present caries experience in adults and the elderly as well. This expansion to all age cohorts creates some problems if the index is limited to dental caries, which can be easily avoided when individual values are not combined. This has been performed in some of the 7,187 DMF index publications included in PubMed. The high number of scientific articles using this index underlines its leading role in the present epidemiological caries research. On the other hand, WHO uses different determinations for clinical dental caries and missing teeth in ICD-10, the 10th revision of International Classification of Diseases, which does not include dental restorations. Combining the individual parameters of Oral Health Surveys and diseases of ICD-10, and analyzing the mean value of each parameter separately, will give a precise picture of dental health at different ages. Copyright 2010 S. Karger AG, Basel.

  9. Risk factors for dental caries in children with developmental disabilities.

    Science.gov (United States)

    Braúna, Ana Paula Vasques Sales; Abreu, Mauro Henrique Nogueira Guimarães de; Resende, Vera Lúcia Silva; Castilho, Lia Silva de

    2016-06-14

    The aim of the present study was to investigate risk factors for dental caries in children with developmental disabilities who were treated at a clinical reference service for patients with special needs in Belo Horizonte, MG, Brazil. This is a retrospective cohort study that evaluated 401 dental charts of individuals without dental caries or restorations in their first dental appointment. The dependent variable was the time of occurrence of new dental caries or restorations and was measured in months. Gender, age, International Code of Diseases (ICD), mother´s education, sugar consumption, use of fluoride toothpaste, oral hygiene, mouth breathing, reports of xerostomia, gingival status, use of psychotropic or asthma drugs, and history of asthma were covariates. The Cox proportional hazards regression model was used to estimate the raw and adjusted hazard ratios and their respective 95% confidence intervals. The average time that individuals remained free of dental caries/restoration was equal to 107.46 months (95%CI 95.41 to 119.51), with a median of caries-free children up to 94 months. For each point increase in the scale of sucrose consumption, the increase in caries risk was 1.07 (95%CI 1.01 to 1.15). Sucrose consumption was the only risk factor for dental caries found in this group of individuals with developmental disabilities.

  10. Low levels of caries in aggressive periodontitis: A literature review

    Directory of Open Access Journals (Sweden)

    Sulugodu Ramachandra Srinivas

    2014-04-01

    Full Text Available This article is a traditional literature review on caries levels in aggressive periodontitis. Aggressive periodontitis generally affects systemically healthy individuals aged <30 years (older individuals can also be affected and is characterized by a young age of onset, rapid rate of disease progression, and familial aggregation of cases. Dental caries is caused by the dissolution of enamel by acid-producing bacteria present in the plaque biofilm, especially when the biofilm reaches critical mass due to improper oral hygiene. The association between caries level and aggressive periodontitis has long been debated. Initial research indicated that caries levels were high in patients with aggressive periodontitis, but high-quality studies have consistently shown that caries and aggressive periodontitis are inversely related. A recent in vitro study showed that Streptococcus mutans was killed more readily in the saliva of patients with aggressive periodontitis and Aggregatibacter actinomycetemcomitans positivity than in patients with A. actinomycetemcomitans negativity. Other mechanisms possibly explaining the inverse relationship between caries and aggressive periodontitis in cases of Down’s syndrome are also discussed in this literature review. The usefulness of caries level in the diagnosis of aggressive periodontitis in developing countries such as India, where the disease is diagnosed primarily on the basis of clinical and radiographic features and familial history is also discussed.

  11. Doing diagnosis: whether and how clinicians use a diagnostic tool of uncertain clinical utility.

    Science.gov (United States)

    Armstrong, Natalie; Hilton, Paul

    2014-11-01

    Diagnosis is fundamental to the practice of medicine and mastery of it is central to the process of both becoming and practicing as a doctor. We focus on diagnosis as a process, in particular from the perspective of clinicians performing it. We explore how UK clinicians exercise discretion about whether and how to use a diagnostic tool (invasive urodynamic tests - IUT) for which there is, currently, no clear, high-quality evidence. Interviews were conducted with a purposive sample of 18 clinicians who had previously completed a survey on their use of IUT. Analysis was based on the constant comparative method. Participants tended to be polarised in their view of IUT. While many regarded it as a valuable diagnostic tool that they used frequently and thought was important, others reported using it only infrequently, and some were sceptical of its value in the diagnostic process even if they commonly used it. In addition to the anticipated clinical functions (e.g. adding to understanding of the condition, helping determine best treatment) there were additional, more social, functions that IUT could serve, including fitting in with local practice and helping to defend against possible future litigation. We discern two distinct approaches to the practice of diagnosis: one approach means 'leaving no stone unturned' and seeking all available evidence, proven or otherwise; while a second means using clinical judgement to say 'enough is enough' and thereby avoid exposing patients to possibly unnecessary tests and potentially wasting scarce healthcare resources.

  12. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

    OpenAIRE

    Nurgul Ceran; Recai Turkoglu; Ilknur Erdem; Asuman Inan; Derya Engin; Hulya Tireli; Pasa Goktas

    2011-01-01

    Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, s...

  13. Clinical Efficacy of Various Diagnostic Tests for Small Bowel Tumors and Clinical Features of Tumors Missed by Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Jung Wan Han

    2015-01-01

    Full Text Available Background. We aimed to evaluate the efficacy of various diagnostic tools such as computerized tomography (CT, small bowel follow-through (SBFT, and capsule endoscopy (CE in diagnosing small bowel tumors (SBTs. Additionally, we aimed to evaluate the clinical features of SBTs missed by CE. Methods. We retrospectively studied 79 patients with histologically proven SBT. Clinical data were analyzed with particular attention to the efficacy of CT, SBFT, and CE in detecting SBT preoperatively. We also analyzed the clinical features of SBTs missed by CE. Results. The most common symptoms of SBT were bleeding (43% and abdominal pain (13.9%. Diagnostic yields were as follows: CT detected 55.8% of proven SBTs; SBFT, 46.1%; and CE, 83.3%. The sensitivity for detecting SBTs was 40.4% for CT, 43.9% for SBFT, and 79.6% for CE. Two patients with nondiagnostic but suspicious findings on CE and seven patients with negative findings on CE were eventually found to have SBT. These nine patients were eventually diagnosed with gastrointestinal stromal tumor (4, small polyps (3, inflammatory fibroid polyp (1, and adenocarcinoma (1. These tumors were located in the proximal jejunum (5, middle jejunum (1, distal jejunum (1, and proximal ileum (1. Conclusion. CE is more efficacious than CT or SBFT for detecting SBTs. However, significant tumors may go undetected with CE, particularly when located in the proximal jejunum.

  14. Small-Fiber Neuropathy: A Diabetic Microvascular Complication of Special Clinical, Diagnostic, and Prognostic Importance.

    Science.gov (United States)

    Körei, A E; Istenes, I; Papanas, N; Kempler, P

    2016-01-01

    Damage of small nerve fibers may lead to a large variety of clinical symptoms. Small-fiber neuropathy underlies the symptoms of painful diabetic neuropathy, which may decrease quality of life. It also contributes to the poor prognosis of diabetic neuropathy because it plays a key role in the pathogenesis of foot ulceration and autonomic neuropathy. Impairment of small nerve fibers is considered the earliest alteration in the course of diabetic neuropathy. Therefore, assessment of functional and morphological abnormalities of small nerve fibers may enable timely diagnosis. The definition, symptoms, and clinical significance of small-fiber neuropathy are considered in the present review. An apparently more complex interaction between small-fiber impairment and microcirculation is extensively discussed. Diagnostic modalities include morphometric and functional methods. Corneal confocal microscopy and punch skin biopsy are considered gold standards, but noninvasive functional tests are also diagnostically useful. However, in routine clinical practice, small-fiber neuropathy is diagnosed by its typical clinical presentation. Finally, prompt treatment should be initiated following diagnosis.

  15. [The reactions of hypersensitivity: the mechanisms of development, clinical manifestations, principles of diagnostic (a lecture)].

    Science.gov (United States)

    Tukavkina, S Yu; Kharseyeva, G G

    2014-05-01

    The article considers the principles of modern classification of hypersensitivity, pathogenic mechanisms of formation of its various types resulting in development of typical clinical symptoms and syndromes. The knowledge and comprehension of these issues is important for physicians of different specializations since it permits to properly make out and formulate diagnosis and timely send patient for examination and treatment to such specialist as allergist-immunologist. The particular attention was paid to description of pathogenesis of diseases and syndromes underlaid by IgE-mediated type of hypersensitivity since their share is highest and clinical manifestations frequently require emergency medical care. The diagnostic of allergic diseases is to be implemented sequentially (step-by-step) and include common clinical and special (specific) methods. In case of choosing of extent of specialized allergological examination the diagnostic significance of techniques and their safety is to be taken into account concerning condition of patient. The diagnosis is objectively formulated only by complex of examination results. It is worth to remember about possibility of development of syndromes similar to IgE-mediated allergy by their clinical manifestations but belonging to non-allergic type of hypersensitivity. It is important to know main causes, mechanisms and ways of formation of such reactions previously named as anaphylactoid ones.

  16. [The issues and basic principles of training of physicians of clinical laboratory diagnostics].

    Science.gov (United States)

    Morozova, V T; Naumova, E V

    2012-07-01

    The article considers the main positions concerning the clinical laboratory diagnostics as an independent clinical specialty and the principles of professional training and improvement of specialists. The basic issues complicating the training and improvement of personnel to be kept in line with actual needs of laboratory service of public health system are discussed. Among them are the availability of laboratory academic sub disciplines demanding a profound special theoretical education and technical skills; the need to account in the process of professional training the variety of forms, sizes and types of laboratory structures in different medical institutions; the need of special training programs for numerous specialists with non-medical basic education. The combination of the present system of postgraduate training of specialists on chairs of state educational organizations with initiative involvement of specialists in various public forms of permanent professional improvement (professional scientific societies meetings, research conferences, internet seminars, etc.) is supported Along with a positive appraisal of the existing system of training in the state educational institutions and corresponding regulation documents, a critique is expressed regarding certain actual documents which improperly limit the administrative functions of physicians of clinical laboratory diagnostics and complicate training of bacteriologists for clinical laboratories.

  17. Brief communication: a pilot study: smooth surface early caries (caries incipiens) detection with KaVo DIAGNODent in historical material.

    Science.gov (United States)

    Tomczyk, Jacek; Komarnitki, Iulian; Olczak-Kowalczyk, Dorota

    2013-03-01

    In many odontological studies concerning archeological material, there is no analysis of early caries lesions (caries incipiens) that manifest as a carious spot. At this stage of caries, the enamel is still hard, and thus, it is impossible to diagnose caries by visual methods. We assessed the usefulness of the DIAGNODent pen (DD laser) in analyzing noncavity lesions on the smooth surface sites of crowns from historical populations. Twenty-seven individuals were examined: 18 from Radom (Poland), and nine from Tell Masaikh and Terqa (Syria). A total of 562 teeth were characterized. The series represented different climatic zones, but were dated from the similar period, 18th to 19th century AD. We used four diagnostic techniques: visual, DD laser, radiographic, and histological as the gold standard. DD laser showed that the mean values of healthy enamel in both series did not exceed 15 units. The mean values of smooth and rough spots in the Syrian population were significantly higher than those from Poland. This study showed that all the noncarious spots from the Radom series did not exceed 30 units. In the Syrian samples, this limit was higher at 44 units. These results were confirmed by histology and radiography. The DD laser provided good results in detecting dentine carious lesions in historical material, but its efficiency in diagnosing early caries (caries incipiens) remains uncertain based on the presented series.

  18. Efficacy of three-tone disclosing agent as an adjunct in caries risk assessment

    Directory of Open Access Journals (Sweden)

    Mungara Jayanthi

    2015-01-01

    Full Text Available Background: Today, most approaches to caries viewed that catastrophic change in normal plaque biofilm is responsible for the disease. The behavior and composition of the biofilm are a reflection of the oral environment; the caries is a reflection of adverse changes occurring in that environment. Thus, it is important to identify the pathogenicity of the plaque biofilm so as to predict the caries risk. The recently developed three-tone plaque disclosing agent was used to test its ability in identifying the pathogenicity of plaque. Aim: To assess the efficacy of three-tone plaque disclosing agent in identifying the plaque pathogenicity and correlate with the clinical caries status and microbiological findings. Materials and Methods: Sixty children of 6-13 years age group of both sexes were clinically examined for caries and plaque scores, and then disclosing agent was applied; the color stained plaque samples were collected and cultured for microbiological assessment, and the data were analyzed based on the caries status of the children. Results: There was a significant difference between the pathological plaque of caries active and caries free group (P < 0.05. The pathological plaque scores and the total colony counts, Streptococcus counts and mutans streptococci counts increased with the increase in caries. Conclusion: Three-tone plaque disclosing agent was effective in identifying pathological plaque and can be used as one of the chairside adjuvants in caries risk assessment.

  19. Cost-effectiveness of malaria diagnosis using rapid diagnostic tests compared to microscopy or clinical symptoms alone in Afghanistan

    DEFF Research Database (Denmark)

    Hansen, Kristian S; Grieve, Eleanor; Mikhail, Amy;

    2015-01-01

    BACKGROUND: Improving access to parasitological diagnosis of malaria is a central strategy for control and elimination of the disease. Malaria rapid diagnostic tests (RDTs) are relatively easy to perform and could be used in primary level clinics to increase coverage of diagnostics and improve tr...

  20. Next-generation sequencing-based genome diagnostics across clinical genetics centers : implementation choices and their effects

    NARCIS (Netherlands)

    Vrijenhoek, Terry; Kraaijeveld, Ken; Elferink, Martin; de Ligt, Joep; Kranendonk, Elcke; Santen, Gijs; Nijman, Isaac J.; Butler, Derek; Claes, Godelieve; Costessi, Adalberto; Dorlijn, Wim; van Eyndhoven, Winfried; Halley, Dicky J. J.; van den Hout, Mirjam C. G. N.; van Hove, Steven; Johansson, Lennart F.; Jongbloed, Jan D. H.; Kamps, Rick; Kockx, Christel E. M.; de Koning, Bart; Kriek, Marjolein; Deprez, Ronald Lekanne Dit; Lunstroo, Hans; Mannens, Marcel; Mook, Olaf R.; Nelen, Marcel; Ploem, Corrette; Rijnen, Marco; Saris, Jasper J.; Sinke, Richard; Sistermans, Erik; van Slegtenhorst, Marjon; Sleutels, Frank; van der Stoep, Nienke; van Tienhoven, Marianne; Vermaat, Martijn; Vogel, Maartje; Waisfisz, Quinten; Weiss, Janneke Marjan; van den Wijngaard, Arthur; van Workum, Wilbert; Ijntema, Helger; van der Zwaag, Bert; van IJcken, Wilfred F. J.; den Dunnen, Johan T.; Veltman, Joris A.; Hennekam, Raoul; Cuppen, Edwin

    2015-01-01

    Implementation of next-generation DNA sequencing (NGS) technology into routine diagnostic genome care requires strategic choices. Instead of theoretical discussions on the consequences of such choices, we compared NGS-based diagnostic practices in eight clinical genetic centers in the Netherlands, b

  1. Trends in dental caries rates over 45 years (1971-2016) among schoolchildren in Florianópolis, southern Brazil.

    Science.gov (United States)

    Paganelli, Ana Paula Debiasi; Mendes Constante, Helena; Sala, Felipe Sappino; Bainha, Carolina Cassol; Borges, Álvaro Luiz Socorro; Bastos, João Luiz; Peres, Marco Aurélio

    2017-09-07

    The present study aimed to estimate the prevalence and severity of dental caries in schoolchildren from Florianópolis, southern Brazil, in 2016, as well as to compare these findings with data obtained from six previous studies carried out in the same school since 1971. A cross-sectional study was conducted with 133 schoolchildren, 12 and 13 years of age. Clinical data were collected by three previously calibrated examiners, according to the 2013 World Health Organization diagnostic criteria, in order to estimate the mean count of decayed, missing and filled teeth/surfaces (DMFT/DMFS indexes) and the Significant Caries Index (SiC). The study response rate was 87.2% (n = 116), and the prevalence of dental caries decreased from 98.0% (95% CI: 96.0-100.0) in 1971 to 39.6% (95% CI 30.7-49.2) in 2016. The mean DMFT index fell from 9.2 in 1971 to 0.9 in 2016, while the DMFS index ranged from 2.0 (95% CI: 1.2-2.8) in 2009 to 1.5 (95% CI: 1.0-1.9) in 2016. The SiC index, which was 3.4 (95% CI: 3.0-3.8) in 2002, reached 2.5 (95% CI: 2.0-2.9) in 2016. Over the 45 years of monitoring, a significant decline in rates of dental caries has been observed. However, the SiC index suggests that dental caries lesions are unequally distributed in the study sample, with one-third of the schoolchildren showing a significantly higher mean DMFT score compared with the entire sample. © 2017 FDI World Dental Federation.

  2. Comparison of a Smartphone-Based Photographic Method with Face-to-Face Caries Assessment: A Mobile Teledentistry Model.

    Science.gov (United States)

    Estai, Mohamed; Kanagasingam, Yogesan; Huang, Boyen; Shiikha, Julia; Kruger, Estie; Bunt, Stuart; Tennant, Marc

    2017-05-01

    This study sought to evaluate the efficacy of a mobile teledentistry approach using a smartphone camera for remote screening of dental caries. An image acquisition Android App was created to facilitate the acquisition and transmission of dental images to a store-and-forward based telemedicine server. One hundred participants who were attending routine checkups at dental clinics were enrolled in 2014. Following a face-to-face oral screening by a screener (dentist), images of patients' teeth were obtained using a smartphone camera. These images, along with patient information, were then transmitted from the Android App to the server through the Internet for later independent assessment by two charters (off-site dentists). The assessments of these charters were then compared to the benchmark face-to-face caries assessment. Sensitivity values for the photographic method when compared to the benchmark face-to-face caries assessment were moderate, and ranged from 60% to 63%. Weighted kappa (K) as a measure of intragrader agreement for the photographic assessment was estimated as almost perfect (K = 0.84). The intergrader agreement for the photographic method compared to the face-to-face caries assessment ranged from moderate to substantial (K = 0.54-0.66). Despite some limitations, the mobile teledentistry approach has shown the potential to detect occlusal caries from photographs taken by a smartphone camera with an acceptable diagnostic performance compared to traditional face-to-face screening. This study suggests that telemedicine and cellular phone technology can be combined to create an inexpensive and reliable screening tool.

  3. A Diagnostic Model for Dementia in Clinical Practice-Case Methodology Assisting Dementia Diagnosis.

    Science.gov (United States)

    Londos, Elisabet

    2015-04-02

    Dementia diagnosis is important for many different reasons. Firstly, to separate dementia, or major neurocognitive disorder, from MCI (mild cognitive impairment), mild neurocognitive disorder. Secondly, to define the specific underlying brain disorder to aid treatment, prognosis and decisions regarding care needs and assistance. The diagnostic method of dementias is a puzzle of different data pieces to be fitted together in the best possible way to reach a clinical diagnosis. Using a modified case methodology concept, risk factors affecting cognitive reserve and symptoms constituting the basis of the brain damage hypothesis, can be visualized, balanced and reflected against test results as well as structural and biochemical markers. The model's origin is the case method initially described in Harvard business school, here modified to serve dementia diagnostics.

  4. Cushing Syndrome: Diagnostic Workup and Imaging Features, With Clinical and Pathologic Correlation.

    Science.gov (United States)

    Wagner-Bartak, Nicolaus A; Baiomy, Ali; Habra, Mouhammed Amir; Mukhi, Shalini V; Morani, Ajaykumar C; Korivi, Brinda R; Waguespack, Steven G; Elsayes, Khaled M

    2017-07-01

    Cushing syndrome (CS) is a constellation of clinical signs and symptoms resulting from chronic exposure to excess cortisol, either exogenous or endogenous. Exogenous CS is most commonly caused by administration of glucocorticoids. Endogenous CS is subdivided into two types: adrenocorticotropic hormone (ACTH) dependent and ACTH independent. Cushing disease, which is caused by a pituitary adenoma, is the most common cause of ACTH-dependent CS for which pituitary MRI can be diagnostic, with bilateral inferior petrosal sinus sampling useful in equivocal cases. In ectopic ACTH production, which is usually caused by a tumor in the thorax (e.g., small cell lung carcinoma, bronchial and thymic carcinoids, or medullary thyroid carcinoma) or abdomen (e.g., gastroenteropancreatic neuroendocrine tumors or pheochromocytoma), CT, MRI, and nuclear medicine tests are used for localizing the source of ACTH. In ACTH-independent CS, which is caused by various adrenal abnormalities, adrenal protocol CT or MRI is usually diagnostic.

  5. Infant Hip Joint Diagnostic Support System Based on Clinical Manifestations in X-ray Images

    Directory of Open Access Journals (Sweden)

    Honda,Mitsugi

    2010-06-01

    Full Text Available Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH. The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on the measurement of 4 items in X-ray images:the outward displacement rate, upward displacement rate, OE angle, and alpha angle. This system was then applied to the data from Group 2, and the results were compared between the 2 groups to verify the reliability of the system. We obtained good results that matched the confirmed diagnoses of orthopedists with an accuracy of 85.9%.

  6. Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

    Science.gov (United States)

    Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

    2017-09-01

    Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  7. Caries risk assessment in schoolchildren - a form based on Cariogram® software

    Directory of Open Access Journals (Sweden)

    Renata Nunes CABRAL

    2014-10-01

    Full Text Available Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram® software provides this analysis, and protocols simplifying the method were suggested. Objectives: The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA form based on the Cariogram® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form. Material and Methods: 150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS II. Information for filling in the form based on Cariogram® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk. Results: Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001, showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources. Conclusion: The use of the form based on the Cariogram® software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk.

  8. The colony number of Streptococcus mutans and Lactobacillus in saliva of dental caries and free caries children

    Directory of Open Access Journals (Sweden)

    Seno Pradopo

    2008-06-01

    Full Text Available Streptococcus mutans (S. mutans are regarded as the main initiator microorganism of caries, with Lactobacilli participating on caries progression, due to its carcinogenic capacity. The purpose of this study was to examine the number of S. mutans and Lactobacillus sp in children with in children’s saliva with dental caries and free caries. Twenty children attending the Paediatric Dental Clinic in Airlangga University participated in our study. Their age ranged from 1–14 years old. Subject was divided into two groups, which were study group consisting of 10 children with 3–5 dmft/DMFT and control group with 10 caries free children. Subjects were examined and their caries number was recorded using WHO index. Stimulated saliva was collected from each subject for bacterial assessment. Colony counting of S. mutans and Lactobacillus sp count in each saliva sample group were done. The study showed that subject with 3–5 dmft/DMFT had higher number of S. mutans and Lactobacillus sp than caries free.

  9. Opportunities and challenges associated with clinical diagnostic genome sequencing: a report of the Association for Molecular Pathology.

    Science.gov (United States)

    Schrijver, Iris; Aziz, Nazneen; Farkas, Daniel H; Furtado, Manohar; Gonzalez, Andrea Ferreira; Greiner, Timothy C; Grody, Wayne W; Hambuch, Tina; Kalman, Lisa; Kant, Jeffrey A; Klein, Roger D; Leonard, Debra G B; Lubin, Ira M; Mao, Rong; Nagan, Narasimhan; Pratt, Victoria M; Sobel, Mark E; Voelkerding, Karl V; Gibson, Jane S

    2012-11-01

    This report of the Whole Genome Analysis group of the Association for Molecular Pathology illuminates the opportunities and challenges associated with clinical diagnostic genome sequencing. With the reality of clinical application of next-generation sequencing, technical aspects of molecular testing can be accomplished at greater speed and with higher volume, while much information is obtained. Although this testing is a next logical step for molecular pathology laboratories, the potential impact on the diagnostic process and clinical correlations is extraordinary and clinical interpretation will be challenging. We review the rapidly evolving technologies; provide application examples; discuss aspects of clinical utility, ethics, and consent; and address the analytic, postanalytic, and professional implications.

  10. Diagnostic accuracy of behavioral, activity, ferritin, and clinical indicators of restless legs syndrome.

    Science.gov (United States)

    Richards, Kathy C; Bost, James E; Rogers, Valerie E; Hutchison, Lisa C; Beck, Cornelia K; Bliwise, Donald L; Kovach, Christine R; Cuellar, Norma; Allen, Richard P

    2015-03-01

    Lack of a valid diagnostic measure of restless legs syndrome (RLS) for persons with dementia, who do not have the cognitive ability to report complex symptoms, impedes RLS treatment and research in this population. The aim of this study was to determine the sensitivity and specificity of a combination of indicators for identifying RLS that could eventually be used to diagnose RLS in persons with dementia. 3-day, prospective instrument validation. Sleep laboratory. Cognitively intact, 107 with RLS, 105 without RLS. N/A. Serial 20-min observations with a new measure, the Behavioral Indicators Test-Restless Legs (BIT-RL); leg movements with 3 nights of the Periodic Activity Monitor-Restless Legs (PAM-RL); ferritin; sleep history; clinical data; polysomnography; Hopkins Telephone Diagnostic Interview of RLS Symptoms. The best-fitting diagnostic model for identifying RLS included previous history of iron deficiency (odds ratio [OR] 7.30), leg discomfort (OR 6.47), daytime fatigue (OR 6.15), difficulty falling asleep (OR 3.25), RLS family history (OR 2.60), BIT-RL (OR 1.49), and absence of diabetes (OR 0.27), with sensitivity 78%, specificity 79%, and 77% correctly classified. This model retained its predictive accuracy even with co-morbid sleep apnea. When compared to those without RLS, persons with RLS have observable behaviors, such as rubbing the legs, that differentiate them, but the behaviors have no circadian and activity-related variability. The final model of clinical and sleep historical data and observation for RLS behaviors using the BIT-RL had good diagnostic accuracy. © 2015 Associated Professional Sleep Societies, LLC.

  11. Plaque, caries level and oral hygiene habits in young patients receiving orthodontic treatment

    DEFF Research Database (Denmark)

    Martignon, S; Ekstrand, K R; Lemos, M I

    2010-01-01

    To assess plaque, caries, and oral hygiene habits amongst patients receiving fixed-orthodontic treatment at the Dental-Clinic, Universidad-El-Bosque, Bogotá, Colombia.......To assess plaque, caries, and oral hygiene habits amongst patients receiving fixed-orthodontic treatment at the Dental-Clinic, Universidad-El-Bosque, Bogotá, Colombia....

  12. Clinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews

    DEFF Research Database (Denmark)

    Petersen, Tom; Laslett, Mark; Juhl, Carsten Bogh

    2017-01-01

    -anatomical disorders in the lumbar spine; i.e. intervertebral discs, sacroiliac joints, facet joints, bone, muscles, nerve roots, muscles, peripheral nerve tissue, and central nervous system sensitization. Methods A sensitive electronic search strategy using MEDLINE, EMBASE and CINAHL databases was combined with hand...... searching and citation tracking to identify eligible studies. Criteria for inclusion were: persons with low back pain with or without related leg symptoms, history or physical examination findings suitable for use in primary care, comparison with acceptable reference standards, and statistical reporting...... involvement, and spinal stenosis. Single clinical test appear not to be as useful as clusters of tests that are more closely in line with clinical decision making. Conclusions This is the first comprehensive systematic review of diagnostic accuracy studies that evaluate clinical examination findings...

  13. The Diagnostic Accuracy of Clinical and External Pelvimetry in Prediction of Dystocia in Nulliparous Women

    Directory of Open Access Journals (Sweden)

    R Alijahan

    2011-08-01

    Full Text Available Introduction: Clinical pelvimetry is very uncomfortable for the patient and is associated with subjective error, while external pelvimetry is a simple and acceptable method for patients. The objective of this study was to compare the diagnostic accuracy of clinical and external pelvimetry in prediction of dystocia in nulliparous women. Methods: In this study between December 2008 and January 2009, 447 nulliparous women with a single pregnancy in vertex presentation and gestational age 38-42 weeks referring to the Ommolbanin hospital of Mashhad were included. External pelvic dimensions were assessed at the time of admission and clinical pelvimetry was performed by another examiner. These measurements were not available to the clinician in charge of the delivery. Dystocia was defined as caesarean section and vacuum or forceps delivery for abnormal progress of labor ( active uterine contractions, arrest of cervical dilatation or cervical dilatation less than 1 cm /h in the active phase for 2 hours, prolongation of second stage beyond 2 hours or fetal head descent less than 1cm/h. Statistical tests included Fisher exact test and Chi- square test. Results: The highest sensitivity obtained from clinical pelvimetry was 33.3% and related to diagonal conjugate less than 11.5 cm. The sensitivity of external pelvic dimensions was higher than clinical pelvimetry that was highest for the Michaelis transverse diameter(60.72%. Conclusion: External pelvimetry in comparison to clinical pelvimetry is a better method for identifying dystocia in nulliparous women and can replace clinical pelvimetry in antenatal care programs.

  14. General dentists', pediatric dentists', and endodontists' diagnostic assessment and treatment strategies for deep carious lesions: A comparative analysis.

    Science.gov (United States)

    Koopaeei, Mahshid Majlessi; Inglehart, Marita R; McDonald, Neville; Fontana, Margherita

    2017-02-01

    There is a large variation among clinicians when managing deep carious lesions (DCLs). The purpose of this study was to assess general dentists' (GDs), pediatric dentists' (PDs), and endodontists' (EDs) diagnostic methods, clinical decision-making considerations, treatment strategies, and knowledge, behavior, and attitudes related to the diagnosis and treatment of DCLs. A total of 175 GDs, 511 PDs, and 377 EDs responded to a nationwide Web-based survey. Most EDs (68%) and GDs (47%) practiced complete caries removal. PDs (31%) were more likely than GDs (12%) and EDs (4%) to remove carious tissues partially. Dentin hardness was the most important diagnostic criterion used during caries excavation (GDs, 90%; PDs, 72%; EDs, 88%). Only 30% of GDs, 17% of PDs, and 90% of EDs used diagnostic tests (for example, a cold test) when assessing pupal health. A substantial percentage of respondents considered endodontic treatment as a choice for treating DCLs in asymptomatic teeth in young patients (GDs, 40%; PDs, 30%; EDs, 40%). GDs rarely used a rubber dam when treating these lesions. Most respondents practiced complete caries removal until hard dentin was felt, using hardness as the primary excavation criterion, and did not use pulp diagnostic tests routinely before making decisions about treatment of teeth with DCLs. Efforts should be made to translate the growing body of evidence supporting the use of conservative caries removal criteria to preserve pulpal health and tooth structure integrity when managing DCLs. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  15. Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: Diagnostic study

    NARCIS (Netherlands)

    R.G. Nijman (Ruud); Y. Vergouwe (Yvonne); M.J. Thompson (Matthew); M.V. Veen (Mirjam Van); A.H.J. van Meurs (Alfred); J. van der Lei (Johan); E.W. Steyerberg (Ewout); H.A. Moll (Henriëtte); R. Oostenbrink (Rianne)

    2013-01-01

    textabstractObjective: To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Design: Prospective observational diagnostic study. Setting: Three paediatric em

  16. Methods used by Dental Practice-Based Research Network (DPBRN) dentists to diagnose dental caries

    Science.gov (United States)

    Gordan, Valeria V.; Riley, Joseph L; Carvalho, Ricardo M.; Snyder, John; Sanderson, James L; Anderson, Mary; Gilbert, Gregg H.

    2010-01-01

    Objectives To (1) identify the methods that dentists in The Dental Practice-Based Research Network (DPBRN) use to diagnose dental caries; (2) quantify their frequency of use; and (3) test the hypothesis that certain dentist and dental practice characteristics are significantly associated with their use. Methods A questionnaire about methods used for caries diagnosis was sent to DPBRN dentists who reported doing at least some restorative dentistry; 522 dentists participated. Questions included use of dental radiographs, dental explorer, laser fluorescence, air-drying, fiber optic devices, and magnification, as used when diagnosing primary, secondary/recurrent, or non-specific caries lesions. Variations on the frequency of their use were tested using multivariate analysis and Bonferroni tests. Results Overall, the dental explorer was the instrument most commonly used to detect primary occlusal caries as well as to detect caries at the margins of existing restorations. In contrast, laser fluorescence was rarely used to help diagnose occlusal primary caries. For proximal caries, radiographs were used to help diagnose 75-100% of lesions by 96% of the DPBRN dentists. Dentists who use radiographs most often to assess proximal surfaces of posterior teeth, were significantly more likely to also report providing a higher percentage of patients with individualized caries prevention (p = .040) and seeing a higher percentage of pediatric patients (p = .001). Conclusion Use of specific diagnostic methods varied substantially. The dental explorer and radiographs are still the most commonly used diagnostic methods. PMID:21488724

  17. MODERN APPROACHES TO CLINICAL AND LABORATORY DIAGNOSTICS OF RHEUMATOID ARTHRITIS EARLY ONSET

    Directory of Open Access Journals (Sweden)

    D. G. Rekalov

    2013-10-01

    Full Text Available Rheumatoid arthritis (RA leads not only to a rapid development of disability, but can influence the life of these patients. One-third of patients with rheumatoid arthritis may have signs of disability during the first 3 years of the onset of the disease, while mortality in patients with RA almost two times higher in comparison with the general population. Analysis of recent prospective studies on the progression of the pathological process and predicting of the long-term outcomes in RA clearly indicate the need for clinical evaluation and a comprehensive laboratory and instrumental diagnosis of the disease in the initial manifestations of the most followed by early adequate pathogenetic therapy. The purpose of this survey was to determine modern clinical aspects of diagnosis, the possibility of standard and specialized instrumental examinations in patients with eRA, followed by predicting long-term results. We studied 52 specialized publications on clinical classification and a modern laboratory and diagnostic tests for eRA. This review presents the data of the importance of differentiation of several stages of RA in relation to the time factor. The data on the sensitivity and specificity of the diagnostic classification and clinical criteria of eRA and an algorithm for the identification of the disease were presented. It was shown prognostic value of the main serological markers of RA, and the predictive value for early detection of antibodies to the circulating peptide as a marker of the severity of bone-destructive changes in patients with certain clinical manifestations. Antibodies to the circulating peptide (ACPA can be detected many years before the onset of RA. Study of anti-citrulline mutated vimentin (anti-MCV in patients with eRA can be applied as a marker of activity of the process and the subsequent possibility of use for predicting long-term results. This review presents the major diagnostic errors using standard instrumental

  18. Nature vs. nurture in dental caries.

    Science.gov (United States)

    Mandel, I D

    1994-10-01

    Why are some people more resistant to dental caries than others? Certainly diet plays a part, but are there hereditary factors that affect caries development? This report explores genetic components that appear related to caries resistance and susceptibility.

  19. Drugs that promote dental caries.

    Science.gov (United States)

    2015-02-01

    Dental caries result from erosion of tooth enamel or cementum by acidic substances produced by bacteria found in dental plaque. Caries can lead to pulp necrosis and tooth loss. Risk factors include certain dietary habits, poor oral hygiene, and dry mouth. Diabetes and Sjogren's syndrome can also promote dental caries. Psychotropic substances such as cocaine, methamphetamine, heroin and cannabis can promote dental caries. Many medicinal drugs facilitate the formation of dental caries, through various mechanisms; they include formulations with a high sugar content; drugs that cause dry mouth (especially antimuscarinics); drugs that lower the buccal pH (inhaled powders, etc.); and drugs that cause demineralisation (tetracyclines, etc.). In practice, patients (and parents) should be informed that some drugs can increase the risk of dental caries. They should be encouraged to adapt and reinforce dental hygiene, and advised to visit a dentist regularly.

  20. Prediction of 6-yr symptom course trajectories of anxiety disorders by diagnostic, clinical and psychological variables.

    Science.gov (United States)

    Spinhoven, Philip; Batelaan, Neeltje; Rhebergen, Didi; van Balkom, Anton; Schoevers, Robert; Penninx, Brenda W

    2016-12-01

    This study aimed to identify course trajectories of anxiety disorder using a data-driven method and to determine the incremental predictive value of clinical and psychological variables over and above diagnostic categories. 703 patients with DSM-IV panic disorder with or without agoraphobia, agoraphobia, social phobia, or generalized anxiety disorder were selected from a prospective cohort study. Latent Growth Mixture Modeling was conducted, based on symptoms of anxiety and avoidance as assessed with the Life Chart Interview covering a 6-year time period. In 44% of the participants symptoms of anxiety and avoidance improved, in 24% remained stable, in 25% slightly increased, and in 7% severely increased. Identified course trajectories were predicted by baseline DSM-IV anxiety categories, clinical variables (i.e., severity and duration and level of disability) and psychological predictors (i.e., neuroticism, extraversion, anxiety sensitivity, worry, and rumination). Clinical variables better predicted unfavorable course trajectories than psychological predictors, over and above diagnostic categories. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Clinical Impact and Cost-Effectiveness of Whole Exome Sequencing as a Diagnostic Tool: A Pediatric Center’s Experience

    OpenAIRE

    C Alexander Valencia; Ammar eHusami; Jennifer eHolle; Johnson, Judith A; Yaping eQian; Abhinav eMathur; Chao eWei; Subba Rao Indugula; Fanggeng eZou; Haiying eMeng; Lijun eWang; Xia eLi; Rachel eFisher; Tony eTan; Amber eHogart Begtrup

    2015-01-01

    Background There are limited reports of the use of whole exome sequencing (WES) as a clinical diagnostic tool. Moreover, there are no reports addressing the cost burden associated with genetic tests performed prior to WES. Objective We demonstrate the performance characteristics of WES in a pediatric setting by describing our patient cohort, calculating the diagnostic yield, and detailing the patients for whom clinical management was altered. Moreover, we examined the potential cos...

  2. Gilbert’s syndrome: clinical features, diagnostics, differential diagnosis and treatment (part 2

    Directory of Open Access Journals (Sweden)

    T.V. Sorokman

    2017-03-01

    Full Text Available We searched for published and unpublished research using PubMed as the search engine by the keywords: “Gilbert’s syndrome”, “clinical manifestation”, “diagnosis”, “treatment”, taking into consideration studies conducted in the last 10 years, citation review of relevant primary and review articles, conference abstracts, personal files, and contact with expert informants. The criterion for the selection of articles for the study was based on their close relevance to the topic, thus, out of 75 analyzed articles, the findings of the researches covered in 28 articles were crucial. Clinical manifestations of Gilbert’s syndrome (GS are possible both in homozygous for UGT1A1, and in heterozygous status. A latent variant of the disease prevails in individuals with heterozygous status. Up to 30 % of homozygous for the defective gene of GS individuals have an asymptomatic course of the disease. Clinical types of GS: dyspeptic — 43.2 %, asthenovegetative — 15.9 %, icteric — 14.8 % and asymptomatic — 26.1 %. Dietary deviations, mental fatigue, stress, trauma, acute infections, including hepatitis, certain medications intake are the triggers for GS. In 86.4 % of children with GS, the pathology of the upper digestive tract was detected: duodenitis — in 58 % of cases, gastritis — in 56.8 %, esophagitis — in 12.5 %, duodenal ulcer — in 2.3 %, in 39.7 % of patients sphincter disorders were registered (duodenogastric and gastroesophageal bile reflux. The GS is characterized by reduced detoxification function of the liver, in particular in 2/3 of patients decreased hepatocyte metabolic activity was observed, the excretory function of liver cell suffers in another half of patients, the biliary tract disorders and increased risk of gallstones formation are described in 88 % of cases. Some patients with GS have certain psychological disorders, including anxiety. Diagnostic criteria for GS: 1. A peculiar pale yellowish

  3. Clinical and research diagnostic criteria for developmental coordination disorder: a review and discussion.

    Science.gov (United States)

    Gueze, R H; Jongmans, M J; Schoemaker, M M; Smits-Engelsman, B C

    2001-03-01

    The aim of this review was to investigate the selection criteria used in the past in studies of children with developmental motor problems (excluding those suffering from neurological dysfunctions such as cerebral palsy, muscular dystrophy, etc.). We therefore conducted an extensive analysis of 176 publications. First, an overview of the main characteristics of these studies (terminology, population, type and purpose) and the selection criteria that are reported in these publications are presented. Following this, the DSM-IV selection criteria for developmental coordination disorder (DCD) are contrasted with the selection criteria reported in 41 publications that have used this terminology to classify the children. The results of this comparison show that the inclusion criteria are largely followed, albeit with little consistency concerning selection instruments and quantitative cut-offs, while adherence to the exclusion criteria is not common practice. Strengths and weaknesses of the DSM-IV criteria, complementary to the previous discussion by Henderson and Barnett in the HMS special issue on DCD in 1998 on this same topic, are discussed. The results of the review also show that many studies have used additional selection criteria related to the specific research questions of the study concerned. In the broader context of clinical practice as well as basic research, the latter result suggests the usefulness of a distinction between Clinical Diagnostic Criteria and Research Diagnostic Criteria. This distinction helps to develop a unifying view on the use of diagnostic criteria for research and clinical practice. We conclude with a number of recommendations concerning the selection criteria for children with DCD.

  4. Probiotics for caries prevention and control

    DEFF Research Database (Denmark)

    Twetman, S; Keller, M K

    2012-01-01

    Modulation of the microbiota for restoring and maintaining health is a growing issue in medical science. A search for relevant clinical trials on the use of probiotic bacteria as a potential and clinically applicable anti-caries measure was performed. According to predetermined criteria, papers...... of heterogeneity among the included investigations hampered the analysis. Significant reductions of mutans streptococci in saliva or plaque following daily intake of probiotic lactobacilli or bifidobacteria were reported in 12 out of 19 papers, whereas 3 reported an increase of lactobacilli. Three caries trials...... in preschool children and the elderly demonstrated prevented fractions of between 21% and 75% following regular intakes of milk supplemented with L. rhamnosus. No adverse effects or potential risks were reported. The currently available literature does not exclude the possibility that probiotic bacteria can...

  5. EAPD interim seminar and workshop in Brussels May 9 2015 Non-invasive caries treatment

    OpenAIRE

    van Loveren, C.; van Palenstein Helderman, W.

    2016-01-01

    Aim This was to collect information for the 9th European Academy of Paediatric Dentistry Interim Seminar and Workshops to discuss the state of art on non-invasive caries therapy to be used if possible to formulate clinical guidelines by European experts in paediatric dentistry Methods Based on systematic reviews and additional papers were assessed for methods to prevent caries initiation and caries progression both in the state of pre-cavitation and cavitation without invasive technologies. R...

  6. Photoacoustic imaging of hidden dental caries by using a fiber-based probing system

    Science.gov (United States)

    Koyama, Takuya; Kakino, Satoko; Matsuura, Yuji

    2017-04-01

    Photoacoustic method to detect hidden dental caries is proposed. It was found that high frequency ultrasonic waves are generated from hidden carious part when radiating laser light to occlusal surface of model tooth. By making a map of intensity of these high frequency components, photoacoustic images of hidden caries were successfully obtained. A photoacoustic imaging system using a bundle of hollow optical fiber was fabricated for using clinical application, and clear photoacoustic image of hidden caries was also obtained by this system.

  7. A comparison of periapical radiographs and their digital images for the detection of dental caries

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Cheol [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonnam National University, Kwangju (Korea, Republic of)

    1994-02-15

    In summary, it has been demonstrated by this study that the detection rate of definite large proximal surface caries (C2) on the digital images was good and the detection rate of the first stage caries (C1) was somewhat inferior to film based images. It has been demonstrated by this study and others that the detection of proximal surface caries by present clinical methodologies is still poor. Every effort should be made to develop new means to improve digitizing process.

  8. Predicting Dental Caries Outcomes in Children

    Science.gov (United States)

    Divaris, K.

    2015-01-01

    In recent years, unprecedented gains in the understanding of the biology and mechanisms underlying human health and disease have been made. In the domain of oral health, although much remains to be learned, the complex interactions between different systems in play have begun to unravel: host genome, oral microbiome with its transcriptome, proteome and metabolome, and more distal influences, including relevant behaviors and environmental exposures. A reasonable expectation is that this emerging body of knowledge can help improve the oral health and optimize care for individuals and populations. These goals are articulated by the National Institutes of Health as “precision medicine” and the elimination of health disparities. Key processes in these efforts are the discovery of causal factors or mechanistic pathways and the identification of individuals or population segments that are most likely to develop (any or severe forms of) oral disease. This article critically reviews the fundamental concepts of risk assessment and outcome prediction, as they relate to early childhood caries (ECC)—a common complex disease with significant negative impacts on children, their families, and the health system. The article highlights recent work and advances in methods available to estimate caries risk and derive person-level caries propensities. It further discusses the reasons for their limited utility in predicting individual ECC outcomes and informing clinical decision making. Critical issues identified include the misconception of defining dental caries as a tooth or surface-level condition versus a person-level disease; the fallacy of applying population-level parameters to individuals, termed privatization of risk; and the inadequacy of using frequentist versus Bayesian modeling approaches to derive individual disease propensity estimates. The article concludes with the notion that accurate caries risk assessment at the population level and “precision dentistry

  9. Transcriptomics in cancer diagnostics: developments in technology, clinical research and commercialization.

    Science.gov (United States)

    Sager, Monica; Yeat, Nai Chien; Pajaro-Van der Stadt, Stefan; Lin, Charlotte; Ren, Qiuyin; Lin, Jimmy

    2015-01-01

    Transcriptomic technologies are evolving to diagnose cancer earlier and more accurately to provide greater predictive and prognostic utility to oncologists and patients. Digital techniques such as RNA sequencing are replacing still-imaging techniques to provide more detailed analysis of the transcriptome and aberrant expression that causes oncogenesis, while companion diagnostics are developing to determine the likely effectiveness of targeted treatments. This article examines recent advancements in molecular profiling research and technology as applied to cancer diagnosis, clinical applications and predictions for the future of personalized medicine in oncology.

  10. [The challenges of standardization in clinical diagnostic laboratories of medical organizations].

    Science.gov (United States)

    Men'shikov, V V

    2013-04-01

    The generalized data concerning the conditions of application of regulations of national standards in clinical diagnostic laboratories of medical organizations is presented. The primary information was provided by 14 regions of 6 federal administrative okrugs of Russia. The causes of challenges of application of requirements of standards are presented. They are mostly related with insufficient financial support, lacking of manpower, difficulties with reagents supply, inadequate technical maintenance of devices and absence of support of administration of medical organizations. The recommendations are formulated concerning the necessity of publishing the document of Minzdrav of Russia to determine the need in application of standards in laboratory practice.

  11. Malignant otitis externa: Variability of clinical course and difficulties of diagnostics

    Directory of Open Access Journals (Sweden)

    Janićijević Miloš

    2014-01-01

    Full Text Available This paper shows the case of a 70-year-old diabetic patient who was admitted to the ORL and MFS clinic as an emergency case with the right ear otalgia, in the right mastoid extension, facialis paralysis and the right ear suppuration all of which lasted for a month before the hospitalization. On admission, the initial diagnostics stated canal skin edema of the external hearing canal which made the eardrum impossible to visualize. Granulations at the bottom of the canal were visible. During the admission, the patient was submitted to conservative and surgical treatments which confirmed that it was the case of malignant otitis externa.

  12. DIAGNOdent: an optical method for caries detection.

    Science.gov (United States)

    Lussi, A; Hibst, R; Paulus, R

    2004-01-01

    The onset of caries is characterized by demineralization of dental hard tissues. Optimal fluoridation with respective oral hygiene habits and diet may stop the progression of a lesion and even allow for its remineralization. The aim of modern dentistry must be a preventive approach rather than invasive repair of the disease. This is possible only with early detection and respective preventive measures. Some of today's diagnostic tools are not sensitive enough to detect this early onset of destruction. Tools based on fluorescence could have the possibility to overcome this problem. This overview will focus on today's knowledge of one possible tool, the DIAGNOdent.

  13. The clinical inadequacy of the DSM-5 classification of somatic symptom and related disorders: an alternative trans-diagnostic model.

    Science.gov (United States)

    Cosci, Fiammetta; Fava, Giovanni A

    2016-08-01

    The Diagnostic and Statistical of Mental Disorders, Fifth Edition (DSM-5) somatic symptom and related disorders chapter has a limited clinical utility. In addition to the problems that the single diagnostic rubrics and the deletion of the diagnosis of hypochondriasis entail, there are 2 major ambiguities: (1) the use of the term "somatic symptoms" reflects an ill-defined concept of somatization and (2) abnormal illness behavior is included in all diagnostic rubrics, but it is never conceptually defined. In the present review of the literature, we will attempt to approach the clinical issue from a different angle, by introducing the trans-diagnostic viewpoint of illness behavior and propose an alternative clinimetric classification system, based on the Diagnostic Criteria for Psychosomatic Research.

  14. Detection activity assessment and diagnosis of dental caries lesions

    DEFF Research Database (Denmark)

    Braga, Mariana M; Mendes, Fausto M; Ekstrand, Kim R

    2010-01-01

    This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment...... and the method must be used for all patients. Use of indices, for example, the International Caries Detection and Assessment System (ICDAS), can improve the performance of this method. Using visual inspection, the clinician must decide about the presence, severity and activity of lesions. After this process......, additional methods could aid the dentist in reaching a more appropriate treatment decision in some cases. The ICDAS, including the activity assessment system or the Nyvad system, seems to be the best option to reach final diagnoses for managing lesions. The radiographic method is the most recommended...

  15. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

    Directory of Open Access Journals (Sweden)

    Nurgul Ceran

    2011-02-01

    Full Text Available Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83% and fever (44%. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

  16. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region

    Directory of Open Access Journals (Sweden)

    Nurgul Ceran

    Full Text Available Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83% and fever (44%. All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

  17. Neurobrucellosis: clinical, diagnostic, therapeutic features and outcome. Unusual clinical presentations in an endemic region.

    Science.gov (United States)

    Ceran, Nurgul; Turkoglu, Recai; Erdem, Ilknur; Inan, Asuman; Engin, Derya; Tireli, Hulya; Goktas, Pasa

    2011-01-01

    Brucellosis is a zoonotic infection and has endemic characteristics. Neurobrucellosis is an uncommon complication of this infection. The aim of this study was to present unusual clinical manifestations and to discuss the management and outcome of a series of 18 neurobrucellosis cases. Initial clinical manifestations consist of pseudotumor cerebri in one case, white matter lesions and demyelinating syndrome in three cases, intracranial granuloma in one case, transverse myelitis in two cases, sagittal sinus thrombosis in one case, spinal arachnoiditis in one case, intracranial vasculitis in one case, in addition to meningitis in all cases. Eleven patients were male and seven were female. The most prevalent symptoms were headache (83%) and fever (44%). All patients were treated with rifampicin, doxycycline plus trimethoprim-sulfamethoxazole or ceftriaxone. Duration of treatment (varied 3-12 months) was determined on basis of the CSF response. In four patients presented with left mild sequelae including aphasia, hearing loss, hemiparesis. In conclusion, although mortality is rare in neurobrucellosis, its sequelae are significant. In neurobrucellosis various clinical and neuroradiologic signs and symptoms can be confused with other neurologic diseases. In inhabitants or visitors of endemic areas, neurobrucellosis should be kept in mind in cases that have unusual neurological manifestations.

  18. Principles of dispensary observation of patients with Parkinson's disease in a specialized clinical diagnostic room

    Directory of Open Access Journals (Sweden)

    Krivonos О.V.

    2013-12-01

    Full Text Available Aim: to develop and implement of the order of the dispensary observation of Parkinson's disease patients. Material and methods, the dispensary observation of Parkinson's disease patients had been performed by neurologist and diagnostic room (CDR based on the outpatient department of health care institutions obeyed by FMBA of Russia in six Closed Administrative-Territorial Units: Seversk, Zarechniy, Ozersk, Lesnoy, Sarov and Zheleznogorsk. Neurologist examined of patients and put data to the Register's database. Register's database had 588 Parkinson's disease examined patients, 112 of them (19,1% had stage II of the disease by Hoehn and Yahr, 231 (39,3% patients — stage III by Hoehn and Yahr, 187 (31,8% patients — stage IV byHoehn and Yahr, 58 (9,9% patients — stage V by Hoehn and Yahr. The duration of the dispensary observation of Parkinson's disease patients was 4 years (2009-2012. Results. There are and implement the order of the observed and accounting of adult's group of Parkinson's disease patients were developed, who are registered in the clinical and diagnostic rooms, including the frequency of physician's visits, the list of diagnostic and treatment activities and efficiency endpoint of the dispensary observation. Conclusion. Implementation of the order of the dispensary observation according to the Register allowed to identify the main disabling PD's symptoms (depression, dementia, motor fluctuations and dyskinesia and timely correction of therapy.

  19. Caries diagnosis using laser fluorescence

    Science.gov (United States)

    Zanin, Fatima A. A.; Pinheiro, Antonio L. B.; Souza-Campos, Dilma H.; Brugnera, Aldo, Jr.; Pecora, Jesus D.

    2000-03-01

    Caries prevention is a goal to be achieved by dentist in order to promote health. There are several methods used to detect dental caries each one presenting advantages and disadvantages, especially regarding hidden occlusal caries. The improvement of laser technology has permitted the use of laser fluorescence for early diagnosis of hidden occlusal caries. The aim of this study was to assess the efficacy of the use of 655 nm laser light on the detection of hidden occlusal caries. Forty molar teeth from patients of both sexes which ages ranging from 10 - 18 years old were used on this study. Following manufacture's instructions regarding the use of the equipment, the teeth had their occlusal surface examined with the DIAGNOdent. Twenty six of 40 teeth had hidden occlusal caries detected by the DIAGNOdent. However only 17 of these 26 teeth showed radiographic signs of caries the other 9 teeth showed no radiological signs of the lesion. Radiographic examination was able to identify 34,61% of false negative cases. This means that many caries would be left untreated due to the lack of diagnosis using both visual and radiographic examination. The use of the DIAGNOdent was effective in successfully detecting hidden occlusal caries.

  20. Minimal intervention dentistry II: part 2. Management of caries and periodontal risks in general dental practice.

    Science.gov (United States)

    Lallam, C; Decup, F

    2014-02-01

    The long-term clinical management of caries and periodontal diseases requires a double approach, one that is concerned with both treatment and prevention. Dentists should recognise the risk factors and their likely triggers to be able to implement the right strategy as early as the diagnostic phase. This comprehensive assessment can easily be done in general practice. All it takes is to combine the patient's general information with the systemic and behavioural factors, and the clinical observations with the local factors. The resulting patient profile can thus effectively support treatment by providing the necessary explanations, advice or prescriptions in relation with the clinical procedures. The modifiable risk factors need to be monitored and the behaviours changed to stabilise or limit disease progression. The practitioner's active approach is meant to meet the patient's demand for preventive counselling.

  1. Factors Used for Caries Prediction in First Infancy

    Directory of Open Access Journals (Sweden)

    Lívia Azeredo Alves ANTUNES

    2006-08-01

    Full Text Available Objective: To evaluate the early presence of caries cavitation and active white spots (AWS in maxilary anterior teeth in the primary dentition associating them with other factors (diet, fluor exposure, precocious ocorrence of mutans streptococci, oral hygiene with the purpose of predict future caries lesion in posterior primary teeth. Method: The examination of the charts was done by the evaluation including anamnesis and clinical examination recorder in 250 files (young children with 18 - 36 months attended at the Pediatric Dentistry Clinic from a public University Dental School of Rio de Janeiro in 2000 - 2003. Results: After data analysis, the result agree with other studies: the early experience of caries in anterior primary teeth was the best predictor of caries cavitation in deciduos molares (74,49%, other risks factors also have been significance in the prediction. After carie, the second most important variable was anterior teeth with white spots (58,82%, followed by high consuption of sugar (54% and natural breastfeeding after 12 months of age (49,59%. Conclusion: This way this study could establish that dental caries is the best predictor, so preventive operatives shoud be done in early primary dentition.

  2. MO-C-BRB-06: Translating NIH / NIBIB funding to clinical reality in quantitative diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, E. [University of Wisconsin (United States)

    2015-06-15

    Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, and the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration

  3. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries.

    Science.gov (United States)

    Ismail, A I; Sohn, W; Tellez, M; Amaya, A; Sen, A; Hasson, H; Pitts, N B

    2007-06-01

    This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR-OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR-OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven-point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity.

  4. Non invasive radiofrequency diagnostics of cancer. The Bioscanner — Trimprob technology and clinical applications

    Science.gov (United States)

    Vedruccio, Clarbruno; Ricci Vedruccio, Carla

    2011-12-01

    A new paper by Pokorny, Vedruccio, Cifra, Kucera, titled Cancer physics: Diagnostics based on damped cellular elasto-electrical vibrations in microtubules, recently available on Eur. Biophys. J., discloses the mechanism of active grown cancer tissues interaction with a Non- Linear Resonance Interaction (NLRI) Bioscanner Trimprob diagnostic device that is certified and ready to be used to investigate suspected cases of disease and cancer. This technology spreads early capabilities of cancer detection by means of low level radiofrequency oscillations in UHF band. The system is based on an unique and extremely innovative non- linear radiofrequency oscillator working on 462-465 MHz plus the harmonics. The diseased tissues suspected of cancer, are irradiated by means of a handy probe near field emission, while a spectrum analyzer placed in the far field detects by means of a small antenna, the oscillator interaction within the tissues. The Bioscanner is characterized by a high dynamic range, in the order of 30 or more decibel, and is useful for detection of small cancer agglomerates, if used by a well trained operator. At the resonance, the free running oscillator locks-in on the specific interaction frequency, in a sharp frequency window centered on 462 MHz; the resulting effect is evidenced by a deep decrease of the 462 MHz spectral line propagation in the far field around the oscillator probe. The NLRI provides a selective characterization, like a sort of a electronic biopsy response of biologic tissues in support of modern imaging diagnostics. Further to existing literature describing methods for cancer detections by means of electromagnetic fields this paper shows this innovative in vivo medical diagnostic equipment and some clinical applications.

  5. Long-term survival and vitality outcomes of permanent teeth following deep caries treatment with step-wise and partial-caries-removal: A Systematic Review.

    Science.gov (United States)

    Hoefler, Vaughan; Nagaoka, Hiroko; Miller, Craig S

    2016-11-01

    A systematic review was performed to compare the long-term survival of deep dentine caries-affected permanent teeth treated with partial-caries-removal (PCR) versus similar teeth treated with stepwise-caries-removal techniques (SWT). Clinical studies investigating long-term PCR and SWT outcomes in unrestored permanent teeth with deep dentine caries were evaluated. Failures were defined as loss of pulp vitality or restorative failures following treatment. PubMed, Web of Science, Dentistry and Oral Sciences Source, and Central databases were systematically searched. From 136 potentially relevant articles, 9 publications utilizing data from 5 studies (2 RCTs, and 3 observational case-series) reporting outcomes for 426 permanent teeth over two to ten years were analyzed. Regarding restorative failures, >88% success at two years for both techniques was reported. For loss of pulp vitality, observational studies reported >96% vitality at two years for each technique, while one RCT reported significantly higher vitality (pdeep dentine caries. Partial-caries-removal may result in fewer pulpal complications over a three year period than SWT, although claims of a therapeutic advantage are based on very few, limited-quality studies. Partial-caries-removal and SWT are deep caries management techniques that reduce pulp exposure risk. Permanent teeth with deep dentine caries treated with either technique have a high likelihood for survival beyond two years. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Are CSF Biomarkers Useful as Prognostic Indicators in Diagnostically Unresolved Cognitively Impaired Patients in a Normal Clinical Setting

    DEFF Research Database (Denmark)

    Nielsen, Malene Schjønning; Simonsen, Anja Hviid; Siersma, Volkert

    2016-01-01

    in diagnostically unresolved patients. METHODS: Data on 348 patients were retrospectively evaluated. All participants had a standardized diagnostic workup and follow-up in a memory clinic. RESULTS: Aβ42 levels and Aβ42/p-tau ratios were reduced and levels of t-tau and p-tau as well as the t-tau × p-tau/Aβ42 ratio......BACKGROUND: Despite an extensive evaluation program, patients may remain diagnostically unresolved with regard to the etiology of their cognitive dysfunction. Cerebrospinal fluid neuroinflammation and Alzheimer disease (AD) biomarkers may act as indicators of neurodegenerative disorders...... were elevated in diagnostically unresolved patients who clinically progressed, compared to a stable group. No differences in neuroinflammatory parameters were found. CONCLUSION: AD biomarkers - in particular the Aβ42/p-tau ratio, but not neuroinflammatory parameters - predicted clinical progression...

  7. The Marketplace for New Caries Management Products: Dental Caries Detection and Caries Management by Risk Assessment

    OpenAIRE

    Berg Joel H

    2006-01-01

    Abstract The number of new technologies emerging each year in the realm of dental caries management is growing at an exponential rate. Examining the patent literature, one can see that this growth rate will likely continue, with the outcome that dentistry will see an expanded growth in managing dental caries by risk assessment with medicinal therapeutic interventions. Restorative dentistry solutions, treating the results of dental caries, will continue to grow, while technologies to identify ...

  8. Diagnostic accuracy of clinical symptoms and rapid diagnostic test in group A streptococcal perianal infections in children.

    Science.gov (United States)

    Cohen, Robert; Levy, Corinne; Bonacorsi, Stéphane; Wollner, Alain; Koskas, Marc; Jung, Camille; Béchet, Stéphane; Chalumeau, Martin; Cohen, Jérémie; Bidet, Philippe

    2015-01-15

    From 2009 to 2014, we prospectively enrolled 132 children with perianal infections. The presentation of painful defecation, anal fissures, and macroscopic blood in stools was highly suggestive of group A streptococcal perianal infection (probability 83.3%). We found a high sensitivity of a group A streptococcal rapid diagnostic testing (98%) but relatively low specificity (72.8%).

  9. Hereditary neuropathies: systematization and diagnostics (clinical case of hereditary motor and sensor neuropathy of the IA type

    Directory of Open Access Journals (Sweden)

    Kolokolova A.M.

    2016-09-01

    Full Text Available Aim: to study the value of routine methods (clinical symptoms, electrophysiological findings and results of DNA analysis in diagnostics of hereditary motor sensory neuropathy type IA in outpatient clinics. Material and Methods. The review of foreign literature is represented. The phenotypic polymorphism, genetic heterogeneity and the difficulties of diagnostics are identified. A family with hereditary motor sensory neuropathy of lAtype is presented, which was diagnosed on the base of available methods in outpatient practice (clinical symptoms, genealogical method, electro-physiological findings and DNA analysis results. Results. Routine algorithm (consistent valuation of clinical symptoms, neurophysiologic findings and the results of DNA analysis helped to verify the diagnosis of hereditary motor sensory neuropathy of lAtype in outpatient practice after more than 20 years of the onset of the disease. Conclusion. The neurologists of outpatient clinics and other specialists must be informed about the availability of diagnostics of hereditary diseases of nervous system.

  10. Clinical experience with a circumferential clip-based vascular closure device in diagnostic catheterization.

    Science.gov (United States)

    Hermiller, James; Simonton, Charles; Hinohara, Tom; Lee, Daniel; Cannon, Louis; Mooney, Michael; O'Shaughnessy, Charles; Carlson, Harold; Fortuna, Richard; Yarbrough, Carol Anne; Zapien, Michael; Chou, Tony

    2005-10-01

    The StarClose Vascular Closure System (Abbott Vascular Devices, Redwood City, California) utilizes a small, flexible nitinol clip to complete a circumferential, extravascular closure of the femoral arteriotomy site. The StarClose is an investigational device in the United States, limited by Federal law to investigational use. The StarClose is CE Mark approved. The CLIP study was a prospective, randomized, multicenter trial utilizing a noninferiority design to compare the rate of major vascular complications and time-to-hemostasis using the StarClose system versus manual compression. A total of 596 subjects were enrolled, 208 of whom underwent diagnostic angiography. This diagnostic subset is the focus of this report. The primary safety endpoint was major vascular complications and the primary efficacy endpoint was time-to-hemostasis. All patients were followed at 30 days with a clinical exam. Subjects were randomized 2:1 to the StarClose (n = 136) or manual compression (n = 72). There were no major vascular complications in either group. Minor vascular complications occurred in 3 StarClose patients (2.2%), and 1 manual compression patient (1.4%) (p = 1.00). Use of the StarClose device reduced mean time-to-hemostasis from 15.47 +/- 11.4 to 1.46 +/- 4.5 minutes (p manual compression, and reduced the average time-to-ambulation from 269 +/- 135 to 163 +/- 105 minutes (p < or = 0.001). Device success was 94.1% (127/135), and procedural success was 100% (136/136). The clinical results of this study concluded that the StarClose Vascular Closure System is noninferior to standard compression with respect to the the primary safety endpoint of closing arteriotomies in patients who undergo percutaneous diagnostic procedures.

  11. Adult Attention Deficit Hyperactivity Disorder: Neurobiology, Diagnostic Problems and Clinical Features

    Directory of Open Access Journals (Sweden)

    Cengiz Tuglu

    2010-04-01

    Full Text Available Attention-deficit/hyperactivity disorder (ADHD is a chronic, lifelong neurobeha-vioral disorder with childhood-onset, which seriously impairs the affected adults in a variety of daily living functions like academic, social and occupational functioning. Prevalence of ADHD declines with age in the general population. The approximate prevalence rates of ADHD is 8% in childhood, 6% in adolescence and 4% in adulthood. The unclear validity of DSM-IV diagnostic criteria for this condition can lead to reduced prevalence rates by underestimation of the prevalence of adult ADHD. The disorder is characterized by behavioral symptoms of inattention, hyperactivity, and impulsivity across the life cycle and is associated with considerable morbidity and disability. Although its etiology remains unclear, considerable evidence documents its strong neurobiological and genetic underpinnings. ADHD is associated with a high percentage of comorbid psychiatric disorders in every lifespan. In adulthood between 65-89% of all patients with ADHD suffer from one or more additional psychiatric disorders, above all mood and anxiety disorders, substance use disorders and personality disorders, which complicate the clinical picture in terms of diagnostics, treatment and outcome issues. The high comorbidity with other psychiatric disorders, the resulting deficits in social competences and risky health behavior that often go along with a diminished life quality must be stressed in these patients. Preventive and therapeutic interventions should be taken at an early stage to counteract the possible negative influences of ADHD on functioning and relationships. In this paper, we reviewed the historical aspects, epidemiology, neurobiology, comorbidity, diagnostic difficulties and clinical features of adult ADHD.

  12. Low back pain in school-age children: risk factors, clinical features and diagnostic managment.

    Science.gov (United States)

    Boćkowski, L; Sobaniec, W; Kułak, W; Smigielska-Kuzia, J; Sendrowski, K; Roszkowska, M

    2007-01-01

    Low back pain (LBP) is common in adult population, and it is becoming a serious health concern in adolescents. On surveys, about every fifth child in the school-age reports LBP. The study objective was to analysis the natural history, risk factors, clinical symptoms, causes and diagnostic management in school-age children hospitalized with LBP. The study group consisted of 36 patients at the age between 10 and 18 years, 22 girls and 14 boys suffering from LBP hospitalized in our Department of Pediatric Neurology and Rehabilitation in years 2000-2004. The mean age of clinical onset of LBP in our group was 14.7 years, earlier in girls, later in boys. We find the family history of LBP in 50% children. Most frequent factors associated with LBP were: spina bifida (16.7%) and incorrect posture (13.9%). Half of patients pointed the factor initialising LBP: rapid, incoordinated move (39%) or heavy load rise (11%). 58% of patients present the symptoms of ischialgia. Diagnostic imaging showed disc protrusion in 11 children (31%) 6 in computed tomography, 4 in magnetic resonance imaging and 1 in X-Ray examination only. Other causes of LBP included: spondylolysis in 2 patients, Scheuermann disease in one case and juvenile reumatoid arthritis in one case. Some school-age children suffering on low back pain, particulary with sciatic neuralgia symptoms seek medical care in hospital. Althought the main causes are mechanical, associated with lack of physical activity or strenous exercise, serious diagnostic managment is strongly recommended.

  13. Uptake and Diagnostic Yield of Chromosomal Microarray in an Australian Child Development Clinic

    Directory of Open Access Journals (Sweden)

    Dylan Mordaunt

    2014-05-01

    Full Text Available Autism is an etiologically heterogeneous developmental disorder for which the range of genetic investigations has expanded considerably over the past decade. Introduction of chromosomal microarray (CMA to clinical practice has expanded the range of conditions which pediatricians are able to detect. This study reviewed the utilization, yield and cost of genetic investigations in a sample of children with pervasive developmental disorders (PDD in an Australian metropolitan child development service. Six hundred and ninety eight patients with PDD were identified from the clinic population. One hundred and ten (15.7% of the clinic population had undergone investigation with chromosomal microarray, 140 (20.0% with karyotype (KT, and 167 (23.9% with Fragile X testing (FRGX. Twelve (10.9% CMA findings were reported, of which seven (6.3% were felt to be the likely cause of the child’s clinical features. Five (3.5% KT findings were reported, of which four (2.9% were felt to be the likely cause of the child’s clinical features. Two patients (1.2% were identified with Fragile X expansions. One fifth of the clinic’s recent PDD population had undergone testing with CMA. CMA appears to have increased the diagnostic yield of the genetic investigation of autism, in line with internationally reported levels. Number needed to test (NNT and cost per incremental diagnosis, were also in line with internationally reported levels.

  14. Diagnostic efficacy and therapeutic impact of computed tomography in the evaluation of clinically suspected otosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Dudau, Cristina [King' s College Hospital NHS Foundation Trust, Department of Neuroradiology, London (United Kingdom); Salim, Fakhruddin; Jiang, Dan [Department of Otolaryngology, Head and Neck Surgery, Auditory Implantation Centre, London (United Kingdom); Connor, Steve E.J. [Department of Radiology, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom)

    2017-03-15

    To assess the diagnostic efficacy and therapeutic impact of CT in evaluating patients with clinically suspected otosclerosis. CT scans performed over a 5-year period for clinically suspected otosclerosis were retrospectively reviewed. CT diagnoses were correlated with subsequent surgical management. For otosclerosis positive cases, clinically significant extensions of otosclerosis were correlated with audiometry and the diagnosis was correlated with surgical findings. Of 259 CT studies, 46 % of patients were positive, 49 % negative and 5 % equivocal for otosclerosis. A relevant alternative CT diagnosis was evident in 33 % of the negative studies. One targeted surgery was performed for every four CT studies. CT outcome influenced the decision to perform stapedectomy in 41 % CT-positive versus 4 % CT-negative patients. CT-positive ears for otosclerosis could not be predicted from baseline clinical or audiometric criteria. Those with endosteal extension demonstrated lower bone conduction thresholds presurgically. The positive predictive value of CT diagnosis of otosclerosis was 100 %. CT demonstrated a high rate of clinically relevant diagnoses in both CT-positive and -negative for otosclerosis patients, and this frequently influenced surgical management. CT also added value by demonstrating relevant extensions of the otosclerotic foci, some of which were predictive of audiometric parameters. (orig.)

  15. Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia

    Directory of Open Access Journals (Sweden)

    Nusbaumer Charly

    2007-03-01

    Full Text Available Abstract Background Community-acquired pneumonia (CAP is the most frequent infection-related cause of death. The reference standard to diagnose CAP is a new infiltrate on chest radiograph in the presence of recently acquired respiratory signs and symptoms. This study aims to evaluate the diagnostic and prognostic accuracy of clinical signs and symptoms and laboratory biomarkers for CAP. Methods 545 patients with suspected lower respiratory tract infection, admitted to the emergency department of a university hospital were included in a pre-planned post-hoc analysis of two controlled intervention trials. Baseline assessment included history, clinical examination, radiography and measurements of procalcitonin (PCT, highly sensitive C-reactive protein (hsCRP and leukocyte count. Results Of the 545 patients, 373 had CAP, 132 other respiratory tract infections, and 40 other final diagnoses. The AUC of a clinical model including standard clinical signs and symptoms (i.e. fever, cough, sputum production, abnormal chest auscultation and dyspnea to diagnose CAP was 0.79 [95% CI, 0.75–0.83]. This AUC was significantly improved by including PCT and hsCRP (0.92 [0.89–0.94]; p Conclusion PCT, and to a lesser degree hsCRP, improve the accuracy of currently recommended approaches for the diagnosis of CAP, thereby complementing clinical signs and symptoms. PCT is useful in the severity assessment of CAP.

  16. Evidence That a Psychopathology Interactome Has Diagnostic Value, Predicting Clinical Needs: An Experience Sampling Study

    Science.gov (United States)

    van Os, Jim; Lataster, Tineke; Delespaul, Philippe; Wichers, Marieke; Myin-Germeys, Inez

    2014-01-01

    Background For the purpose of diagnosis, psychopathology can be represented as categories of mental disorder, symptom dimensions or symptom networks. Also, psychopathology can be assessed at different levels of temporal resolution (monthly episodes, daily fluctuating symptoms, momentary fluctuating mental states). We tested the diagnostic value, in terms of prediction of treatment needs, of the combination of symptom networks and momentary assessment level. Method Fifty-seven patients with a psychotic disorder participated in an ESM study, capturing psychotic experiences, emotions and circumstances at 10 semi-random moments in the flow of daily life over a period of 6 days. Symptoms were assessed by interview with the Positive and Negative Syndrome Scale (PANSS); treatment needs were assessed using the Camberwell Assessment of Need (CAN). Results Psychotic symptoms assessed with the PANSS (Clinical Psychotic Symptoms) were strongly associated with psychotic experiences assessed with ESM (Momentary Psychotic Experiences). However, the degree to which Momentary Psychotic Experiences manifested as Clinical Psychotic Symptoms was determined by level of momentary negative affect (higher levels increasing probability of Momentary Psychotic Experiences manifesting as Clinical Psychotic Symptoms), momentary positive affect (higher levels decreasing probability of Clinical Psychotic Symptoms), greater persistence of Momentary Psychotic Experiences (persistence predicting increased probability of Clinical Psychotic Symptoms) and momentary environmental stress associated with events and activities (higher levels increasing probability of Clinical Psychotic Symptoms). Similarly, the degree to which momentary visual or auditory hallucinations manifested as Clinical Psychotic Symptoms was strongly contingent on the level of accompanying momentary paranoid delusional ideation. Momentary Psychotic Experiences were associated with CAN unmet treatment needs, over and above PANSS

  17. Clinical neurophysiology of prolonged disorders of consciousness: From diagnostic stimulation to therapeutic neuromodulation.

    Science.gov (United States)

    Ragazzoni, Aldo; Cincotta, Massimo; Giovannelli, Fabio; Cruse, Damian; Young, G Bryan; Miniussi, Carlo; Rossi, Simone

    2017-09-01

    The identification of signs of awareness in patients with prolonged disorders of consciousness (DoC) after severe brain injury is a challenging task for clinicians. Differentiating on behavioural examination the vegetative state (VS) from the minimally conscious state (MCS) can lead to a high misdiagnosis rate. Advanced neuroimaging and neurophysiological techniques can supplement clinical evaluation by providing physiological evidence of brain activity. However, an open issue remains whether these empirical results are directly or indirectly associated with covert consciousness and limitations emerge for their diagnostic application at the single-patient level. On the therapeutic side, the efficacy of both non-invasive and invasive brain stimulation/modulation trials is matter of debate. The present review provides an updated analysis of the diagnostic and prognostic impact that the different neurophysiological techniques of stimulation [including short-latency evoked potentials, long-latency event related potentials (ERPs), transcranial magnetic stimulation (TMS), TMS-EEG co-registration] offer in prolonged DoC. The results of the therapeutic stimulation techniques are also evaluated. It is concluded that TMS-EEG emerges as the most promising tool for differentiating VS from MCS whereas ERPs allow neurophysiologists to probe covert cognitive capacities of each patient. Significant behavioural improvements in prolonged DoC with brain stimulation techniques are still anecdotical and further treatment options are awaited. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  18. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches.

    Science.gov (United States)

    Noya, Belkisyolé Alarcón de; Díaz-Bello, Zoraida; Colmenares, Cecilia; Ruiz-Guevara, Raiza; Mauriello, Luciano; Muñoz-Calderón, Arturo; Noya, Oscar

    2015-05-01

    Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred i