Laboratory Quality Assurance in the Department of Restorative Dentistry at the University of Illinois at Chicago,College of Dentistry

Purpose: The purpose of this study was to evaluate data collected in University of Illinois at Chicago College of Dentistry (UIC COD) laboratory quality assurance (QA) forms, analyze the collected data, and create a report of the findings. The goals of the study were to (1) identify the most common mistakes occurring during laboratory and clinical procedures when performing prosthodontic treatment, (2) note the incidence and trends of mistakes made by D3, D4, and IDDP2 students, and (3) observe any differences in the types of mistakes made by D3, D4, and IDDP2. Materials and Methods: QA data from June 1, 2007 to May 31, 2009 were evaluated based on forms gathered from the QA dental laboratory from all D3, D4, and IDDP2 students’ submissions. All students had graduated from the UIC COD at the time of collection. Data were recorded for type of errors made in submission of laboratory work (Indirect Restorations [IR], Removable Partial Dentures [RPD], Complete Dentures [CD]), year of student in dental school (D3, D4, IDDP2), and frequency of rejection for each respective student. The frequency of common mistakes were pooled, evaluated, and reported by respective class year. Results: The five most common laboratory submission errors for D3, D4, and IDDP2 students were nearly the same among student years for IR, RPD, and CD. D4 students had disproportionately higher numbers of work rejections compared to D3 and IDDP2 students. Conclusions: D4 students had a higher percentage of laboratory submission errors compared to D3 students for all laboratory procedures. There were similar types of errors noted between foreign‐trained students (IDDP2) and domestically trained students (D3, D4).     

Noncurative Gastrectomy for Gastric Adenocarcinoma Should only be Performed in Highly Selected Patients

Background

The benefit of surgical resection in patients with incurable gastric adenocarcinoma is controversial.

Methods

A total of 289 patients who presented with advanced or metastatic gastric cancer from 1995 to 2010 were retrospectively reviewed.

Results

Ten patients (3.5 %) required emergent surgery at presentation and were excluded from further analyses. Patients who underwent nonemergent surgery at presentation (n = 110, 38.1 %) received either gastric resection (group A, n = 46, 42 %) or surgery without resection (group B, n = 64, 58 %). Procedures in group A included distal gastrectomy (n = 25, 54 %), total gastrectomy (n = 17, 37 %), and proximal/esophagogastrectomy (n = 4, 9 %). Procedures in group B included laparoscopy (n = 17, 27 %), open exploration (n = 25, 39 %), gastrostomy and/or jejunostomy tube (n = 12, 19 %), and gastrojejunostomy (n = 10, 16 %). Group A required a stay in the intensive care unit or additional invasive procedure significantly more often than group B (15 vs. 2 %, p = 0.009). Four patients in group A (8.7 %) and three patients in group B (4.7 %) died within 30 days of surgery (p = 0.45). When the 110 patients who underwent nonemergent surgery (groups A and B) were compared to nonoperatively managed patients (group C, n = 169, 58 %), median overall survival did not significantly differ (8.6 vs. 9.2 vs. 7.7 months; p > 0.05). Three patients in group B (4.7 %) and three in group C (1.8 %) ultimately required an operation for their primary tumor.

Conclusions

Patients with gastric adenocarcinoma who present with advanced or metastatic disease not amenable to curative resection infrequently require emergent surgery. Noncurative resection is associated with significant perioperative morbidity and mortality as well as limited overall survival, and should therefore be performed judiciously.     

Macronutrient and Energy Database for the 1995 Exchange Lists for Meal Planning: A Rationale for Clinical Practice Decisions

For more than 50 years the exchange lists have been one method of meal planning for persons with diabetes as well as for those on weight–loss regimens. Little research has been conducted, however, concerning the methodologic basis of the system or its clinical effectiveness. Justification for specific food inclusions and general food groupings for the 1995 revision of the Exchange Lists for Meal Planning is provided by a database of foods and associated energy and macronutrient values. The mean energy and macronutrient values for each of the lists and sublists (starch, fruit, milk, and vegetables from the carbohydrate group; the meat and meat substitutes group, and the fat group) closely match the mean exchange values; however, the standard deviation and range are large. Interpretation of the database provides a rationale and guidance for decision making in clinical practice when using exchanges for meal planning, recipe, and food label calculations. J Am Diet Assoc. 1996; 96:1167–1171.     

A Multicenter Study of Complementary and Alternative Medicine Usage among ED Patients

Objectives: To estimate the prevalence of complementary and alternative medicine (CAM) usage among emergency department (ED) patients. Methods: This study was a cross-sectional study in four Boston-area EDs. For two 24-hour periods, the authors interviewed consecutive patients age 18 and older about whether they had ever used or had recently (within the past year) used CAM "remedies" (e.g., herbal treatments) or "therapies" (e.g., chiropractic). The authors also asked about the patient's disclosure of CAM usage to allopathic health care providers. Results: Of 978 patients, 752 patients were eligible. Among these, 539 (72%) were interviewed. Of these patients, ever having used CAM was reported by 57% (95% CI = 52% to 61%), and 37% (95% CI = 33% to 41%) reported use in the past year. In a multivariate model of recent CAM usage, independent predictors were younger age, higher education level, and chronic pain. Patients who spoke Spanish as their primary language were less likely to report CAM usage. Disclosure of CAM usage to allopathic providers was low, yet >80% reported that they would be comfortable discussing their CAM usage with allopathic providers. Conclusions: CAM usage was common among ED patients enrolled in our study, despite underreporting to ED staff. Given the growing evidence of benefits and hazards from popular CAM remedies and therapies, ED staff should consider raising this health issue with their patients.     

Women in Prosthodontics: A Brief Look at Pioneers,Leaders, and Inspirers

There are several women pioneers in prosthodontics, and each deserves recognition and admiration for all she has achieved in helping bridge the gender gap in dentistry. Women have come a long way from being first depicted as a thieving woman assistant in early 1523 to becoming award‐winning, Board‐certified clinicians, program directors, department chairs, and deans of dental schools. However, current female resident membership in the American College of Prosthodontists is less than 40%. Women in leadership roles are still scarce, and advancement is still needed. This article provides a brief summary of the history of prosthodontics, highlighting prominent women prosthodontists and their stories, while providing inspiration for future prosthodontists, men as well as women.