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Biomedical subjects

B H Goldstein

Publications and source records attributed to B H Goldstein.

At least 19 recordsLinked to original sources
PubMed2002

Late cognitive and radiographic changes related to radiotherapy: initial prospective findings.

BACKGROUND: Assumptions about the damaging effects of radiotherapy (XRT) are based on studies in which total dose, dose fraction, treatment volume, degree of malignancy, chemotherapy, tumor recurrence, and neurologic comorbidity interact with XRT effects. This is a prospective, long-term study of XRT effects in adults, in which total dose and dose fraction were constrained and data related to tumor recurrence and neurologic comorbidity (e.g., hypertension) were excluded. METHODS: The effects of XRT on the cognitive and radiographic outcomes of 26 patients with low-grade, supratentorial, brain tumors yearly from baseline (6 weeks after surgery and immediately before XRT) and yearly to 6 years were examined. Radiographic findings were examined regionally. RESULTS: Selective cognitive declines (in visual memory) emerged only at 5 years, whereas ratings of clinical MRI (T2 images) showed mild accumulation of hyperintensities with post-treatment onset from 6 months to 3 years, with no further progression. White matter atrophy and total hyperintensities demonstrated this effect, with subcortical and deep white matter, corpus callosum, cerebellar structures, and pons accounting for these changes over time. About half of the patients demonstrated cognitive decline and treatment-related hyperintensities. CONCLUSIONS: There was no evidence of a general cognitive decline or progression of white matter changes after 3 years. Results argue for limited damage from XRT at this frequently used dose and volume in the absence of other clinical risk factors.

Adult↗
PubMed2001

Amalgam safety.

Explore the source record for details and available documents.

Dental Amalgam↗
PubMed2000

Unconventional dentistry: Part I. Introduction.

This is the first in a series of five articles providing a contemporary overview and introduction to unconventional (alternative) dentistry (UD) and correlation with unconventional (alternative) medicine (UM). UD is analogous to and conceptually inseparable from UM. Dentists should learn about UD and UM and be aware of evidence on the safety and effectiveness of treatments and procedures. While being skeptical of promotions, dentists should be able to accept and encompass science-based advances and reject unproven and disproven methods. Incorporating selected unconventional methods with conventional dentistry in selected patients for specific purposes may be useful to both patients and dentists. Improved education in critical thinking, research, science, medicine, behaviour, communication and patient management is needed.

Complementary Therapies↗
PubMed2000

Unconventional dentistry: Part III. Legal and regulatory issues.

This is the third in a series of 5 articles providing a contemporary overview and introduction to unconventional dentistry (UD) and its correlation to unconventional medicine (UM). UD presents issues of dental quackery, fraud and malpractice, and it also engenders professional concerns about public protection and professional risks. Case reports illustrate numerous issues. The reader is encouraged to evaluate the cases for problems related to malpractice, fraud, ethics, behaviours and professionalism. A discussion of ethical issues is beyond the scope of this paper.

Complementary Therapies↗
PubMed2000

Unconventional dentistry: Part V. Professional issues, concerns and uses.

This is the last in a series of 5 articles providing a contemporary overview and introduction to unconventional dentistry (UD) and its correlation to unconventional medicine (UM). UD and UM both present important concerns for health care professionals and for the general public. Professional concerns include risks to the practitioner and the patient. UD is of special concern because of the potential harm of invasive dental procedures. Nonetheless, because some UD practices may be of benefit to the patient, decision-making issues and guidelines for UD practice are suggested.

Complementary Therapies↗
PubMed2000

Unconventional dentistry: Part IV. Unconventional dental practices and products.

This is the fourth in a series of 5 articles providing a contemporary overview and introduction to unconventional dentistry (UD) and its correlation to unconventional medicine (UM). Several common UD and UM practices are described to familiarize practitioners with a variety of theories, practices, products and treatments that specifically apply to dentistry. This brief review is not intended as an in-depth resource.

Acupuncture Therapy↗
PubMed1999

Temporomandibular disorders: a review of current understanding.

OBJECTIVE: The purpose of this article is to conduct a narrative review of current evidence regarding the understanding, evaluation, management, and treatment of temporomandibular disorders to provide a broad perspective and updated introduction to an important and controversial subject with rapidly changing developments and limited well-designed research. DATA SOURCES: Studies were identified through a search of MEDLINE for 3 topics (temporomandibular disorder, temporomandibular joint, and chronic pain) over a 10-year period (January 1988 to August 1998) and of bibliographies of identified studies and review articles. STUDY SELECTION: More than 5000 articles were produced. In-depth review of all of this literature was beyond the scope of the present article, which is intended to provide an overview. The amount and diversity of the literature and the limitations of covering such a broad topic being recognized, the papers selected were those that reviewed limited topics or studied focused areas. This report is not a systematic (qualitative) or meta-analysis (quantitative) review. An acknowledged limitation of this narrative review method lies in the potential for bias in selection. The referenced works do not include all papers reviewed; only pertinent literature and reviews with comprehensive references were selectively included. CONCLUSIONS: Advances in basic and clinical science have resulted in important changes in the understanding and management of temporomandibular disorders. Many treatments are not supported by research, and the role of dentistry is changing to a more diagnostic and management-based model from the hands-on treatment procedures of the past. The present science-based understand-ing of a biopsychosocial disorder is important in properly and responsibly dealing with patients with temporomandibular disorders.

Humans↗
PubMed1999

Medical legal considerations in temporomandibular disorders.

Dentists commonly see patients with temporomandibular disorders who are involved in litigation, and dentists are occasionally accused of temporomandibular disorder-related negligence. Rapidly changing scientific knowledge must be reflected in dental practice and in the courtroom, where dentists act as experts. In this article, concepts pertaining to assessments of patients with temporomandibular disorders for impairment and disability and concepts pertaining to legal causation are discussed, especially in relation to motor vehicle accidents. Recommendations for avoiding malpractice suits are presented.

Dental Records↗
PubMed1981

Acute dissecting hematoma: a complication of oral and maxillofacial surgery.

The ADH is an uncommon but potentially life-threatening bleeding complication after oral maxillofacial surgery. Prevention via adequate preoperative laboratory evaluation and meticulous mechanical hemostasis during surgery is important. In spite of these measures, cases will infrequently occur, necessitating rapid accurate diagnosis and effective therapy. Close monitoring and continual airway assessment and control are paramount. Local measures are usually effective in hemorrhage control and the use of prophylactic antibiotics is suggested.

Adult↗
PubMed1980

Dysesthesia after mandibular third molar surgery: a retrospective study and analysis of 1,377 surgical procedures.

To statistically associate specific factors of surgical extraction of third molars with mandibular nerve dysesthesia, records of patients were reviewed for preoperative panoramic radiographs, complete operative and anesthetic records, preoperative and postoperative notes, and histories. Data were then tabulated and the cases of altered sensation were compared with cases of unaltered sensation.

Adolescent↗
PubMed1977

Cardiac dysrhythmias during outpatient general anesthesia--a comparison study.

Seventy-seven ASA Class I patients were studied to compare the cardiac dysrhythmias occurring during outpatient office general anesthesia for oral surgery to dysrhythmias occurring during outpatient medical and surgical office procedures without general anesthesia and to dysrhythmias occurring in inpatients having minor operating room procedures under general anesthesia. Eighty-eight percent of the operating room group, 81% of the oral surgery group, and 45% of the non-general-anesthetic group had some form of dysrhythmia. There was a statistically significant difference between the numbers of dysrhythmias that occurred in the general anesthetic groups and the non-general-anesthetic group. None of the dysrhythmias documented was of the potentially fatal or extremely serious category.

Adolescent↗