RESUMEN
Nosocomial infections represent a major health problem and can have a significant impact on the cost of treating a patient. Hospital-acquired pneumonia (HAP) is the second most common nosocomial infection in the United States and the leading cause of death due to a nosocomial infection. The high prevalence of HAP and its significant impact on increased length of stay and incremental treatment costs identify nosocomial pneumonia (NP) as a key component in managing the total cost of care. The study's objective was to develop a predictive tool for identifying those adult patients in critical care (CC) who are at greatest risk of developing NP to better manage the costs of care. The authors also expected to determine the expected probability of a patient developing NP in CC. A prospective study of longer stay critical care unit (CCU) patients was performed in nine U.S. CCUs. There were no interventions in the study. Development was based on variables common to CC and specific patient profile risk factors. Twelve statistically significant and clinically meaningful risk factors were identified and placed in a sequential cascade fashion. The positive predictive value of the sequential decision process and corresponding tool was 87.03 percent.
Asunto(s)
Cuidados Críticos , Infección Hospitalaria/economía , Costos de la Atención en Salud , Neumonía/economía , Medición de Riesgo , Adulto , Control de Costos , Infección Hospitalaria/epidemiología , Humanos , Neumonía/epidemiología , Estudios Prospectivos , Estados Unidos/epidemiologíaRESUMEN
A new direct gold material that is considerably different from other direct golds has been available since 1989. The advantages of this material are that the final restoration exhibits greater density than other forms of granular gold and has a 50% increase in shear strength when compared to gold foil. Clinical experience with the use of this new restorative material has been encouraging. Further clinical and laboratory research comparing this material with the other types of direct gold is anticipated.
Asunto(s)
Restauración Dental Permanente/métodos , Oro , Estudios de Evaluación como Asunto , Aleaciones de Oro , HumanosRESUMEN
The application of die-spacer to crown preparation dies prior to the fabrication of the cast crown is an acceptable procedure to improve the fit of the restoration. Previous studies have shown that the retention of the restoration will be improved, unchanged, or reduced when an appropriate thickness of die-spacer is used. No studies have determined the effect on retention if excessive die-spacer is used. This study evaluated the effect of increasing die-spacer thickness on the retention of cast full crowns. Cast copings were fabricated on dies coated with either 0, 4, 8, 12, or 16 coats of die-spacer, cemented on the respective teeth, and removed using an Instron Universal Testing Machine. There were no statistically significant differences (P < or = 0.05) between the mean force required to remove the cemented copings. It appears that increasing the application of die-spacer up to 16 coats (151 micrometers) does not adversely affect the retention of cemented cast copings.
Asunto(s)
Coronas , Técnica de Colado Dental/instrumentación , Retención de Prótesis Dentales/métodos , Análisis de Varianza , Diente MolarAsunto(s)
Recubrimiento Dental Adhesivo , Dentina , Cementos Dentales , Dentina/ultraestructura , HumanosRESUMEN
This evaluation consisted of a photographic evaluation of eight brands of commercially available #330 burs; comparisons were made to the standard as set by Dr Miles Markley. They were also evaluated as to their meeting ADA Specification No 23 for dental burs. In a second portion of the study, the burs were used to prepare channels in extracted teeth, and the pattern produced was evaluated. The results indicate that there is a great difference in the shape of the burs produced by the various manufacturers, as there was in the pattern they produced in preparing tooth structure.
Asunto(s)
Instrumentos Dentales , Diseño de EquipoRESUMEN
A variation in design of a cantilever fixed prosthesis is suggested using a wrap-around configuration of the mesial surface of the lateral incisor pontic. The preparation on the canine is modified with one or more shallow grooves to provide additional resistance to rotational forces. All occlusal contacts on the lateral incisor pontic are avoided.
Asunto(s)
Diseño de Dentadura , Dentadura Parcial Fija , Incisivo , Retención de Dentadura , Humanos , MaxilarRESUMEN
The principles of cavity preparation, retention, pin placement, and finishing of the pin amalgam restoration differ in several respects when applied to the pin amalgam when it is intended to serve as a foundation for a cast restoration. A more conservative extension and removal of undermined enamel is indicated because the amalgam will be covered with a cast restoration. The axial reduction required during crown preparation frequently reduces retention of the pin amalgam foundation; therefore, it is necessary to plan for those alterations during the cavity preparation. The degree of finishing and polishing required is determined by the length of time the pin amalgam foundation is expected to function as an interim restoration.