bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of Resuscitation Care and Survival After In-Hospital Cardiac Arrest in Patients With Advanced Cancer
Authors: Bruckel Jeffrey T. , Wong Sandra L. , Chan Paul S. , Bradley Steven M. , Nallamothu Brahmajee K. 
Published: August 2017

Purpose: Little is known regarding patterns of resuscitation care in patients with advanced cancer who suffer in-hospital cardiac arrest (IHCA). Methods: In the Get With The Guidelines – Resuscitation registry, 47,157 adults with IHCA with and without advanced cancer (defined as the presence of metastatic or hematologic malignancy) were identified at 369 hospitals from April 2006 through June 2010. We compared rates of return of spontaneous circulation (ROSC) and survival to discharge between groups using multivariable models. We also compared duration of resuscitation effort and resuscitation quality measures. Results: Overall, 6,585 patients with IHCA (14.0%) had advanced cancer. Patients with advanced cancer had lower multivariable-adjusted rates of ROSC (52.3% [95% CI, 49.5% to 55.3%] v 56.6% [95% CI, 53.8% to 59.5%]; P < .001) and survival to discharge (7.4% [95% CI, 6.6% to 8.4%] v 13.4% [95% CI, 12.1% to 14.8%]; P < .001). Among nonsurvivors who died during resuscitation, patients with advanced cancer had better performance on most resuscitation quality measures. Among patients with ROSC, patients with advanced cancer were made Do Not Attempt Resuscitation (DNAR) more frequently within 48 hours (adjusted relative risk, 1.30 [95% CI, 1.24 to 1.37]; P < .001). Adjustment for DNAR status explained some of the immediate effect of advanced cancer on survival; however, survival remained significantly lower in patients with cancer. Conclusion: Patients with advanced cancer can expect lower survival rates after IHCA compared with those without advanced cancer, and they are more frequently made DNAR within 48 hours of ROSC. These findings have important implications for discussions of resuscitation care wishes with patients and can better inform end-of-life discussions.
Effects of Esmolol on the Esophagogastric Junction: A Double-Blind, Randomized, Crossover Study on 14 Healthy Volunteers
Authors: Ander Fredrik , Magnuson Anders , Berggren Lars , Ahlstrand Rebecca , de Leon Alex 
Published: August 2017

BACKGROUND:
Passive regurgitation may occur throughout the perioperative period, increasing the risk for pulmonary aspiration and postoperative pulmonary complications. Hypnotics and opioids, especially remifentanil, that are used during anesthesia have been shown to decrease the pressure in the esophagogastric junction (EGJ), that otherwise acts as a barrier against passive regurgitation of gastric contents. Esmolol, usually used to counteract tachycardia and hypertension, has been shown to possess properties useful during general anesthesia. Like remifentanil, the β-1-adrenoreceptor antagonist may be used to attenuate the stress reaction to tracheal intubation and to modify perioperative anesthetic requirements. It may also reduce the need for opioids in the postoperative period. Its action on the EGJ is however unknown.
The aim of this trial was to compare the effects of esmolol and remifentanil on EGJ pressures in healthy volunteers, when administrated as single drugs.

METHODS:
Measurements of EGJ pressures were made in 14 healthy volunteers using high-resolution solid-state manometry. Interventions were administered in a randomized sequence and consisted of esmolol that was given IV as a bolus dose of 1 mg/kg followed by an infusion of 10 μg·kg−
1·minute−1 over 15 minutes, and remifentanil with target-controlled infusion of 4 ng/mL over 15 minutes. Interventions were separated by a 20-minute washout period. Analyses of EGJ pressures were performed at baseline, and during drug administration at 2 (T2) and 15 minutes (T15). The primary outcome was the inspiratory EGJ augmentation, while the inspiratory and expiratory EGJ pressures were secondary outcomes.

RESULTS:
There was no effect on inspiratory EGJ augmentation when comparing remifentanil and esmolol (mean difference −4.0 mm Hg [−9.7 to 1.7]; P= .15). In contrast, remifentanil significantly decreased both inspiratory and expiratory pressures compared to esmolol (−12.2 [−18.6 to −5.7]; P= .003 and −8.0 [−13.3 to −2.8]; P= .006).

CONCLUSIONS:
Esmolol, compared with remifentanil, does not affect EGJ function. This may be an advantage regarding passive regurgitation and esmolol may thus have a role to play in anesthesia where maintenance of EGJ barrier function is of outmost importance.
LA RESOLUCIÓN DE PROBLEMAS ARITMÉTICO - ALGEBRAICOS Y LAS ESTRATEGIAS DE APRENDIZAJE EN MATEMÁTICAS. UN ESTUDIO EN EDUCACIÓN SECUNDARIA OBLIGATORIA (ESO)
Authors: Gasco- Txabarri Javier 
Published: August 2017

Uno de los bloques esenciales de la enseñanza - aprendizaje de las matemáticas está formado por los problemas verbales y su resolución; las estrategias de aprendizaje fomentan la autonomía y pueden ayudar a tomar decisiones en esta tarea matemática. Este estudio pretende relacionar la forma de resolver problemas con el empleo de dichas estrategias. La investigación se realiza con alumnado de Educación Secundaria Obligatoria (ESO) de 2º, 3º y 4º curso. El alumnado se categoriza en tres grupos: el grupo de resolución algebraica, el de resolución mixta y el grupo sin perfil definido. Las estrategias de aprendizaje se miden mediante un cuestionario. El grupo algebraico obtiene mejores resultados que el mixto en diversas estrategias, especialmente en las metacognitivas. El grupo sin perfil definido emplea en menor medida todas las estrategias excepto la de repetición.
LA ELABORACIÓN DE PREGUNTAS EN LA ENSEÑANZA DE LA COMPRENSIÓN DE PROBLEMAS MATEMÁTICOS
Authors: Pérez Ariza Karel , Hernández Sánchez José Emilio 
Published: August 2017

El artículo que se presenta tiene como objetivo ofrecer una metodología para la elaboración de preguntas que desarrollen la comprensión de problemas matemáticos en la Enseñanza Primaria. El principal aporte de la investigación a la Didáctica de la Matemática reside en la metodología que se ofrece, la cual se sustenta en la reconceptualización de los problemas matemáticos como textos y la asunción de la resolución de problemas como proceso de comprensión textual. La efectividad de la metodología fue valorada mediante su implementación en la práctica educativa de la Escuela Vocacional de Arte “Luis Casas Romero” durante el curso 2010 – 2011.
Good Night, Squashbite: A ‘How to’ Paper on Better Wax Occlusal Records
Authors: Shargill Inderjit , Ashley Martin 
Published: August 2017

During the technical stages of dental treatment, a dental technician may only be able to unite a set of dental casts in a ‘best-guess’ relationship, unless they are either able to examine the patient themselves, or are given further information about the occlusal position chosen during the clinical procedure. The most common method for this is to use some form of occlusal record, which can be created from a variety of techniques and materials, such as either one of the dental waxes or one of the more recently introduced syringable materials. This paper describes a better technique for using dental wax to make occlusal records. The ‘squashbite’ technique has no place in clinical dentistry for those attempting to obtain accurate results.
Tobacco Usage and Control: Information and Advice for Primary Dental Care Practitioners
Authors: Olley Ryan C , Gallagher Jennifer E 
Published: August 2017

Ten years on from the white paper Smoking Kills, the UK is a leader on tackling tobacco within Europe. However, over 100,000 people die each year in the UK as a result of the effects of smoking; the most common form of tobacco use. Tobacco cessation is, moreover, a global issue with wide variation in tobacco usage, multiple determinants and numerous approaches to prevention. This article provides an overview of the trends in tobacco usage and control in the UK compared with other nations, to bring the process into context for primary dental practitioners. Guidance is also provided on appropriate smoking interventions in dental practice that support national health targets and population health.
A current update on osteonecrosis of the jaw and bisphosphonates
Authors: Arrain Yazdana , Masud Tahir 
Published: August 2017

Bisphosphonates are effective drugs used to treat important medical conditions affecting the skeleton, such as malignancy and osteoporosis. Bisphosphonate-associated osteonecrosis of the jaw (BONJ) is a rare but painful condition that can affect quality of life. Healthcare professionals need to be aware of this potential side-effect of bisphosphonates, as well as ways to minimize its occurrence. Clinical Relevance: This review addresses the definitions of BONJ, differential diagnosis and staging, prevention and also discusses a recently recognized non-exposed variant of BONJ. The possibility that a recently introduced anti-resorptive agent, denosumab, which is not a bisphosphonate, may cause jaw osteonecrosis is also discussed.
Defective dental restorations: to repair or not to repair? part 1: direct composite restorations
Authors: Blum Igor R , Jagger Daryll C , Wilson Nairn H F 
Published: August 2017

The presentation of patients with failing dental restorations that exhibit minor defects is a common clinical situation in everyday dental practice. The repair of such restorations, rather than replacement, is increasingly considered to be a viable alternative to the replacement of the defective restoration. This first of two papers considers indications and techniques for the repair of defective direct composite restorations. It is possible that some dental practitioners are unaware of the option of repair rather than replacement of composite restorations. This article provides an overview of contemporary knowledge and understanding of restoration repair in the clinical management of defective composite restorations. Clinical Relevance: A sound understanding of the indications, benefits and techniques of direct composite restoration repair could allow the longevity of the existing restoration to be extended without unnecessarily sacrificing healthy tooth structure.
Periodontal disease in the older patient
Authors: Irwin Chris R 
Published: August 2017

Population projections predict an increasing number of dentate older people who will require assessment and treatment of periodontal disease. Studies show that healthy, older patients show no increased risk of periodontal disease progression compared to younger individuals, while periodontal treatment can be equally successful in the older age group. However, co-morbidity can impact negatively on both the periodontal tissues and the dentition. These effects range from a reduced ability to maintain adequate plaque control, to the use of drug and other therapies directly affecting the periodontal tissues and salivary flow. Clinical Relevance: An individualized treatment plan is required for older patients, taking account of all factors impacting on the periodontal tissues.
Domiciliary oral healthcare
Authors: Lewis Debbie , Fiske Janice 
Published: August 2017

There is increasing demand for Domiciliary Oral Healthcare (DOHC) and the skills and equipment required to provide a quality, patient-centred service with careful assessment and management in a sometimes compromised situation. Commissioning of DOHC needs to be set in the context and current agenda of equality, diversity and human rights in both health and social care. Effective marketing and community engagement are required to promote awareness of how to access services amongst people confined to home and their families and carers. Training for the whole dental team should be available in order to address the concerns and problems encountered regarding the provision of DOHC. Clinical Relevance: Members of the dental team should be aware of the skills required for DOHC and be familiar with using effective care pathways in relation to the provision of DOHC.
Unexpected temporary mental nerve deficit after extraction of mandibular first molar: case report
Authors: Amailuk Paul , Badcock Mark , Chandu Arun 
Published: August 2017

Temporary neurologic deficit affecting the distribution of the left mental nerve was reported in a warfarinized, diabetic patient who had a history of previous CVA with right-sided body weakness. The neurologic deficit was reported following routine extraction of a left mandibular first molar. Recovery of sensation began six weeks after the procedure. Possible mechanisms and preventive measures are discussed. Clinical Relevance: The reader should understand that mental paraesthesia can be an unexpected outcome in the most routine of mandibular extractions.
Bleaching and bonding for the older patient
Authors: Kelleher Martin GD , Djemal Serpil , Al-Khayatt Ahmed S , Ray-Chaudhuri Arijit J , Briggs Peter FA , Porter Richard WJ 
Published: August 2017

Older people who remain reasonably well may wish to maintain or enhance their dental and oral appearance, preferably at minimal biologic and financial costs. Bleaching and bonding represents a very good treatment option and a sensible strategy for this group. Bleaching addresses the discoloration, while direct composite bonding can improve the shape of worn, or otherwise unaesthetic, teeth without damaging the structure or health of the residual tooth tissue. This pragmatic treatment is well tolerated by older patients. The visual and functional improvements are greatly appreciated by this group, partly because of the non-destructive and affordable nature of the benefits. Clinical Relevance: Bleaching and bonding represents a proven, sensible, pragmatic, affordable and practical approach to managing the aesthetic problems of older patients, and the benefits are achievable without destroying their residual sound tooth tissue.
Schwannoma presenting in the soft palate of a nine-year-old boy
Authors: Chawla Ourvinder , North Sarah , Yates Julian M 
Published: August 2017

Swellings and tumours within the oral cavity are a common finding, however, benign intra-oral schwannoma or neurolemma is relatively uncommon, especially in younger patients. Involvement of the palate is a rare presentation although there have been a few reported cases relating to the lingual and other tissues. Clinical Relevance: This paper reviews intra-oral schwannomas and presents a case of such a tumour of the soft palate in a paediatric patient and discusses the presenting features, differential diagnoses, along with the management of the condition.
Suturing: an update for the general dental practitioner
Authors: Sharif Mohammad Owaise , Coulthard Paul 
Published: August 2017

Sutures are routinely used to achieve haemostasis and to approximate soft tissues after extractions, periodontal procedures, implant surgery and soft tissue biopsies. This paper provides the general dental practitioner with the knowledge and understanding of sutures to select the most appropriate for use. Common suturing techniques are also discussed. Clinical Relevance: Suturing is an important aspect of dental practice, the selection of an appropriate suture and technique is integral to obtaining an optimal outcome.
Differential diagnosis for orofacial pain, including sinusitis, tmd, trigeminal neuralgia
Authors: Hegarty Anne M , Zakrzewska Joanna M 
Published: August 2017

Correct diagnosis is the key to managing facial pain of non-dental origin. Acute and chronic facial pain must be differentiated and it is widely accepted that chronic pain refers to pain of 3 months or greater duration. Differentiating the many causes of facial pain can be difficult for busy practitioners, but a logical approach can be beneficial and lead to more rapid diagnoses with effective management. Confirming a diagnosis involves a process of history-taking, clinical examination, appropriate investigations and, at times, response to various therapies. Clinical Relevance: Although primary care clinicians would not be expected to diagnose rare pain conditions, such as trigeminal autonomic cephalalgias, they should be able to assess the presenting pain complaint to such an extent that, if required, an appropriate referral to secondary or tertiary care can be expedited. The underlying causes of pain of non-dental origin can be complex and management of pain often requires a multidisciplinary approach.
Prosthodontic care for elderly patients
Authors: Allen P Finbarr , McKenna Gerald , Creugers Nico 
Published: August 2017

For older patients, clinicians should consider maintaining teeth and using functionally-orientated treatment strategies as an alternative to removable prostheses. When the remaining dentition has a poor prognosis, key teeth should be preserved as overdenture abutments and a gradual transition to edentulousness planned. Where complete dentures are provided, these can be retained using dental implants to overcome many of the problems associated with conventional replacement dentures. Clinical Relevance: The elderly population of today is better informed and more demanding of oral healthcare providers than previous generations. Clinicians should be aware of all the prosthodontic treatment options available for older patients.
Primary cutaneous cd8-positive t-cell lymphoma: a case report of a rare and aggressive disease with oral presentation
Authors: Geddes A , Savin J , White SJ , Gibson J 
Published: August 2017

A case of a 66-year-old man, who was referred to the Oral Medicine service with persistent oral ulceration and widespread cutaneous rash is presented. Laboratory investigations confirmed a diagnosis of epitheliotropic, CD8-positive, cytotoxic, T-cell lymphoma. Clinical Relevance: Oral ulceration represents a heterogeneous group of aetiologies: the patient with this more concerning pathology presented both to his general medical and dental practitioners.
Sickle cell disease, dentistry and conscious sedation
Authors: Bryant Catherine , Boyle Carole 
Published: August 2017

The features of sickle cell disease (SCD) are described. Two case reports of patients treated in a Dental Institute are presented and the dental management of patients with SCD discussed. Since infection is one of the major risk factors for sickle cell crisis, the prevention of oral disease and infection is vital for this group of patients and there is no contra-indication to the delivery of dental treatment under local anaesthetic with inhalational sedation if required in the primary care setting. Since patients with sickle cell disease are particularly vulnerable to the effects of periods of hypoxia, which may produce significant morbidity, and because of the additional practical challenges in sedating this group of patients, intravenous sedation should be undertaken in a specialist unit. Clinical Relevance: The increasing prevalence of sickle cell disease highlights the importance of dentists practising in multi-cultural communities having an understanding of this condition and its implications on their clinical practice. This will facilitate the safe management of patients with sickle cell disease.
Frequently asked questions in composite restorative dentistry
Authors: McConnell Robert J , Sabbagh Joseph , de la Macorra Jose C , Lund Arne , Cassidy Mike 
Published: August 2017

With an increasing number of dental practitioners using composite resins as the restorative material of choice, knowledge of terminology, handling properties and restorative techniques are important. Clinical Relevance: This paper addresses many of the questions raised by participants at lectures and courses given by the authors across Europe.
An interesting potential reaction to warfarin
Authors: Avinchey Grainne Mc , Swinson Brian 
Published: August 2017

Warfarin is an oral anticoagulant, used routinely for patients with atrial fibrillation, deep vein thrombosis, pulmonary embolism and those with a mechanical prosthetic valve. There are several noted adverse reactions associated with its use, in particular the risk of haemorrhage. Other adverse reactions include: hypersensitivity, rash, alopecia, diarrhoea, unexplained drop in haematocrit, purple toes, skin necrosis, jaundice, hepatic dysfunction, nausea, vomiting and pancreatitis. In this case report, an interesting potential adverse reaction to warfarin is discussed. The reaction described affected the patient's tongue, without affecting any other aspect of the oral cavity or body. Clinical Relevance: This case report highlights the potential problems that can be encountered by patients on warfarin therapy, specifically, the possibility for hypersensitivity type reactions.
Spontaneous fracture of the genial tubercles: a case report
Authors: Burnett Peter J , Nixon Paul P , Rogers Simon N 
Published: August 2017

Spontaneous fracture of the genial tubercles is rare and, of the 13 reported cases in the literature, all involve the older edentulous patient. A case of genial tubercle fracture in a 62-year-old edentulous female is presented. The symptoms are pain and swelling of the floor of the mouth and restricted tongue movement. Surgical intervention was not required and a complete recovery without loss of function was made. Clinical Relevance: This case aims to make practitioners aware of genial tubercle fracture as a possible diagnosis when the older edentulous patient presents with pain and swelling in the floor of the mouth.
Mouthwatering but erosive? a preliminary assessment of the acidity of a basic sauce used in many indian dishes
Authors: Ghai Nandini , Burke FJ Trevor 
Published: August 2017

The aim of this study was to assess whether some types of Indian cuisine may contain erosive components. Indian dishes were prepared by a previously published method and their pH measured using a pH probe. The results indicated: (i) that some components of Indian cooking, such as tomatoes and red chilli powder, had the potential to erode enamel; (ii) that the pH of some foods was reduced with increasing temperature; and (iii) that all the basic masalas made and tested had a pH of less than 4.5. Within the limitations of the study, it may be concluded that the basic sauce/masala used in north Indian dishes may have erosive potential. Clinical Relevance: This information could be considered useful when advising patients who eat Indian curries about causes of acid erosion of their teeth.
Full-arch implant-retained prosthetics in general dental practice
Authors: Rosenbaum Nigel 
Published: August 2017

The loss of all teeth from one or both dental arches is a significant disability affecting self-confidence, communication, masticatory function and aesthetics. Whilst missing teeth cannot be restored to the natural state, the development of a prosthetic dentition has been a goal of dental science throughout the centuries. Contemporary techniques allow for the replacement of missing dentition with fixed or removable solutions, solving many of the problems. Implant dentistry has transformed this area of medicine. This article provides dental practitioners with an overview of this important area of patient care. Clinical Relevance: Dental practitioners in clinical practice will frequently see edentulism; a good understanding of the available options for rehabilitation is essential.
Successful removable partial dentures
Authors: Lynch Christopher D 
Published: August 2017

Removable partial dentures (RPDs) remain a mainstay of prosthodontic care for partially dentate patients. Appropriately designed, they can restore masticatory efficiency, improve aesthetics and speech, and help secure overall oral health. However, challenges remain in providing such treatments, including maintaining adequate plaque control, achieving adequate retention, and facilitating patient tolerance. The aim of this paper is to review the successful provision of RPDs. Clinical Relevance: Removable partial dentures are a successful form of treatment for replacing missing teeth, and can be successfully provided with appropriate design and fabrication concepts in mind.