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Biomedical subjects

A M Weintraub

Publications and source records attributed to A M Weintraub.

15 recordsLinked to original sources
PubMed1998

Potential for cross-contamination from use of a needleless injector.

BACKGROUND: Medical devices that are used on patients in fields containing potentially infectious body fluids can become contaminated and transmit infectious agents to other sites on the patient or to other patients if the devices are not properly cleaned and decontaminated after use on each patient treatment site. One such device is the needleless or jet injector, which is widely used in medicine and dentistry to deliver local anesthetic in procedures such as bone marrow aspirations, lumbar punctures, and cutaneous and intraoral injections. This study was conducted to determine whether cross-contamination can occur on in vitro reuse of a needleless injector and whether a manufacturer's recommended method of injector decontamination (ie, immersion sterilization) is effective in the prevention of cross-contamination. METHODS: The study was performed with new autoclaved injectors, fluorescein dye, and Streptococcus crista (the bacteria commonly found in saliva) in the field of use to determine whether these devices can become contaminated during use and carry over the contamination to other sites during immediate reuse. RESULTS: Fluorescein dye and bacteria tests with the needleless injectors showed that contamination or carryover does occur. It appeared to reduced to a minimum when a autoclaved, sterile rubber cap used over the head of the device during injection was replaced between each use, although replacement of the rubber cap alone did not prevent carryover. Immersion of the head of the injector in a 2% glutaraldehyde solution for 30 minutes followed by a sterile water rinse and the replacement of the rubber cap with a sterile cap between uses was shown to curtail bacterial growth and prevent cross-contamination on immediate reuse of the device. CONCLUSION: This study demonstrated that needleless injectors become contaminated during in vitro use and direct contact with contaminated surfaces and that needless injectors carry over the contamination to subsequent sites of release. The replacement of the injector's rubber cap with a new one after initial discharge or the removal of an exposed rubber cap and immersion of the head of the injector in 2% glutaraldehyde followed by a rinse of the head in sterile water, as recommended by one injector manufacturer, can minimize or eliminate the carryover.

Contrast Media↗
PubMed1997

The dental student as technician: an 18-year follow-up of preclinical laboratory programs.

In 1977, a survey of American and Canadian dental schools was conducted by Weintraub to determine the delegation of laboratory procedures in preclinical and clinical complete and removable partial denture programs. This was performed in light of challenges raised to the value of requiring dental students, rather than laboratory technicians, to perform the various laboratory procedures involved in the fabrication of complete and removable partial dentures. Since 1977, the rate of edentulism has declined in the United States, and fewer edentulous patients have sought regular dental care. In addition, approximately 20% fewer curriculum hours have been spent in dental schools in removable prosthodontic instruction; a declining number of graduating dental students have felt comfortable with their level of knowledge of removable prosthodontics, especially complete dentures, and have performed fewer removable prosthodontic procedures in practice because of a perceived lack of treatment cost-effectiveness. The present study, an 18-year follow-up to the 1977 survey, was designed to determine if such trends toward a deemphasis on removable prosthodontic treatment have affected the mechanisms of instruction in and the extent to which dental schools instruct students about removable prosthodontics laboratory procedures. The 1995 survey was mailed to 53 American dental schools. Forty-six schools returned the completed survey, for a response rate of 87%. Results showed that the proportion of schools with removable prosthodontic preclinical programs, especially those in removable partial dentures, increased, as did the relative amount of material presented to students in these programs. This was accomplished primarily through the enhancement of laboratory technician support, both in-house and commercial, of student preclinical removable prosthodontic laboratory procedures. The conflict between these outcomes and the call by the dental community, as well as that of the 1995 Institute of Medicine Study, for a reduced emphasis on teaching students about the technical details involved in removable prosthesis fabrication is recognized and explored.

Curriculum↗
PubMed1997

The dental student as technician: an 18-year follow-up of clinical laboratory programs.

In 1977, a survey of American and Canadian dental schools was conducted by Weintraub to determine the delegation of laboratory procedures in preclinical and clinical complete and removable partial denture programs. This was performed in light of challenges raised to the value of requiring dental students, rather than laboratory technicians, to perform the various laboratory procedures involved in the fabrication of complete and removable partial dentures. Since 1977, the rate of edentulism has declined in the United States, and fewer edentulous patients have sought regular dental care. In addition, approximately 20% fewer curriculum hours have been spent in dental schools in removable prosthodontic instruction; a declining number of graduating dental students have felt comfortable with their level of knowledge of removable prosthodontics, especially complete dentures, and have performed fewer removable prosthodontic procedures in practice because of a perceived lack of treatment cost-effectiveness. The present study, an 18-year follow-up to the 1977 survey, was designed to determine if such trends toward a de-emphasis on removable prosthodontic treatment have affected the mechanisms of instruction in and the extent to which dental schools instruct students about removable-prosthodontics laboratory procedures. The 1995 survey was mailed to 53 American dental schools. Forty-six schools returned the completed survey, for a response rate of 87%. Results showed that the relative amount of material presented to students in clinical removable prosthodontics programs increased, primarily through the enhancement of laboratory technician support, both in-house and commercial, of student clinical removable prosthodontic laboratory procedures. The increase was greater than in preclinical removable prosthodontic programs, which were described in a companion article. The conflict between these outcomes and the call by the dental community, as well as that of the 1995 Institute of Medicine Study, for a reduced emphasis on teaching students about the technical details involved in removable prosthesis fabrication is recognized and explored.

Canada↗
PubMed1996

Continuous quality improvement and dental practice: a marriage of necessity.

No business, regardless of its size, is ever problem-free. Continuous quality improvement is one way to keep businesses, including dental practices, functioning as near perfection as possible. The author discusses the value of CQI in the dental practice and outlines the principles of a CQI program.

Dental Staff↗
PubMed1995

The status of undergraduate implant education in dental schools outside the United States.

Over the past 20 years the incorporation of implant dentistry into academia has been documented in some detail for North American dental schools but has not been pursued on an international level. In June of 1993, we surveyed 51 dental schools outside of the United States affiliated with the University of Pennsylvania School of Dental Medicine's Office of International Relations concerning their teaching involvement with implant dentistry. Results from the 44 (86 percent) responding schools suggest that implant dentistry is being incorporated into predoctoral curriculums. Industrialized countries were more inclined to provide implant education. Insufficient time and the thought that the predoctoral level was not the place for implant dentistry were cited as some of the reasons for not incorporating implant dentistry into the curriculum. Oral surgery, prosthodontics, and periodontics departments developed and administered the implant curriculum. Formats varied among schools with respect to allotted time, curricular placement, laboratory experience, and clinical participation. Didactic material most frequently presented included a historical overview, diagnosis and treatment planning, classification of dental implants, and surgical and prosthetic concepts. Clinical involvement varied from actual implant placement to observation of prosthodontic procedures. Results were categorized based on the TOEFL (Test of English as a Foreign Language) classification of countries in six regions.

Africa↗
PubMed1995

Predoctoral implant dentistry programs in US dental schools.

Surveys of US dental schools over the last 20 years have reported a continual increase in the number and types of predoctoral and postdoctoral implant dentistry programs being taught. The purpose of the following article is to report on the results of a survey intended to update the status of predoctorl programs with respect to their curricular placement, departmental jurisdictions, and course contents. In June 1993, 54 US dental schools received the implant dentistry curriculum survey, and 50 of the schools (93%) returned responses. Results indicate that the trend toward implementation of more predoctoral implant dentistry programs has been sustained, with 86% of schools reporting the existence of implant curricula. This compares with 33% and 73% of US schools having such programs in 1974 and 1989, respectively. The major reasons that schools gave for not having implant dentistry courses for predoctoral students are a lack of curriculum time and scarce financial resources. The dental disciplines most frequently guiding such programs are oral surgery and periodontics. Schools offer varying degrees of lectures, laboratories, and clinical experiences in predoctoral implant dentistry, with the number of curriculum hours peaking in years three and four. General curricular topics most commonly include a historical overview of implant dentistry, diagnosis and treatment planning, classifications and types of dental implants, and surgical and prosthodontic procedures. Seventeen percent of schools require some form of undergraduate clinical implant dentistry exposure for all of their students.

Curriculum↗
PubMed1985

A luteinizing hormone-releasing hormone agonist for the prevention of chemotherapy-induced ovarian follicular loss in rats.

In an attempt to prevent chemotherapy-induced ovarian follicular loss, [D-Leu6, des-Gly10-NH2]-luteinizing hormone-releasing hormone ethylamide (LHRHa) was given subcutaneously to Sprague-Dawley cycling female rats in two daily doses of 2.5 micrograms starting 2 days prior to and concomitant with cyclophosphamide (CTX) (5 mg/kg/day for 21 days). Four groups of female cycling rats (10 in each) received either no treatment, CTX alone, CTX + LHRHa, or LHRHa alone. One ovary from each animal was serially sectioned, stained, and examined for the number and size of follicles. CTX produced a significant reduction in the total number of follicles. The pool of growing follicles (medium to large, greater than 30 microns in diameter) appeared to be vulnerable to the cytotoxic effect of CTX. LHRHa resulted in a significant reduction in the number of medium-to-large follicles and an increase in the number of small follicles. When given in combination with CTX, LHRHa significantly further reduced the number of medium-to-large follicles, significantly increased the number of small follicles, and resulted in an increase in the total number of follicles. Chronic LHRHa treatment resulted in functional deprivation of follicles from gonadotropins, thus halting the process of recruitment from the quiescent pool of primordial follicles into the CTX sensitive pool and thereby preserving the functional potential of the ovary.

Animals↗
PubMed1980

Hemochromatosis heart disease: an unemphasized cause of potentially reversible restrictive cardiomyopathy.

Cardiac involvement in hemochromatosis typically results in congestive cardiomyopathy; a restrictive cardiomyopathy due to hemochromatosis is distinctly rare. A restrictive cardiomyopathy, which developed in the patient described in this report, was due to hemochromatosis which mimicked constrictive pericarditis clinically, echocardiographically and hemodynamically, and resulted in a thoracotomy for attempted surgical therapy. The fact that hemochromatosis represents the only cause of a restrictive cardiomyopathy that is potentially reversible by medical therapy makes early recognition of hemochromatosis heart disease important.

Cardiomyopathies↗
PubMed1979

Cardiac findings in Charcot-Marie-Tooth disease. A prospective study of 68 patients.

Charcot-Marie-Tooth disease (peroneal muscular atrophy) has been reported to cause cardiac arrthymias and conduction disturbances in association with peripheral muscle atrophy. To establish more accurately the frequency of such cardiac disorders in this disease, 68 patients with Charcot-Marie-Tooth disease were evaluated prospectively for evidence of cardiac involvement. Cardiac findings were limited to five patients with conduction defects, two patients with supraventricular tachycardia, two patients with ischemic heart disease, and 20 with mitral valve prolapse. The frequency of each of the abnormal cardiac findings, with the possibly emalities in the population at large. The low incidence of cardiac involvement in patients with Charcot-Marie-Tooth disease may be helpful in distinguishing this disorder from Friedreich's ataxia, an entity that may mimic Charcot-Marie-Tooth disease but that is frequently associated with heart disease.

Adult↗
PubMed1977

Severe aortic regurgitation secondary to idiopathic aortitis.

Clinical and morphologic features are described in two relatively young adults with aortic regurgitation secondary to chronic aortitis. The regurgitation in each was severe enough to require aortic valve replacement. Both patients had normochromic, normocytic anemia, considerable weight loss despite congestive cardiac failure, and negative serologic tests for syphilis. These systemic manifestations in association with the aortitis suggest that both had Takayasu's arteritis. In addition, one patient had total occlusion at the origin of one subclavian artery (classic pulseless disease). Takayasu's arteritis must be added to the list of causes of severe aortic regurgitation.

Adult↗
PubMed1976

Varicose veins.

Varicosities may be due to congenital weakness of the vein walls or valves, or may be secondary to deep thrombophlebitis. The latter leads to loss of valve competency in the communicating veins and transmission of relatively high pressures to the superficial system. Edema, thrombophlebitis and stasis dermatitis are common side effects. Adequate surgical therapy is successful in 90% of cases. Sclerosing agents are of limited use.

Dermatitis↗
PubMed1975

Observations on the electrocardiographic changes associated with subarachnoid hemorrhage with special reference to their genesis.

A 36 year old man presented with bizarre behavior and had abnormal electrocardiograms on two occasions. Because of ST-T wave changes, he was treated both times for a possible subendocardial infarction. A more complete evaluation during the second admission revealed a basilar artery aneurysm with subarachnoid hemorrhage as the cause of the central nervous system symptoms. While the aneurysm was successfully clipped, the patient's electrocardiogram was recorded. Several electrocardiographic changes characteristic of intracranial disease were observed during the procedure. These changes developed with distortion of the circle of Willis and reverted when such distortion stopped. We review the spectrum of the electrocardiographic changes associated with intracranial disease. This list of abnormalities was compiled from observations obtained by the impatient tracings of persons with various central nervous system pathology. The mechanisms used to explain the changes are based solely on work performed on laboratory animals. The results of our findings in our patient link electrocardiographic abnormalities directly with a central nervous system lesion.

Adult↗