Stability of epinephrine in dental anesthetic solutions: implications for autoclave sterilization and elevated temperature storage.
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Biomedical subjects
Publications and source records attributed to J R Kelly.
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Injectable foreign matter may originate in part from: anesthetic cartridge diaphragm surfaces, diaphragm polymer materials, and debris in the lumen of sterile, manufacturer-sealed needles. Particles ranging from 30 to 305 microns were collected from four brands of dental anesthetic cartridges (320 cartridges/brand). Results of this study suggest that rubber and aluminum debris may commonly be injected with anesthetic solutions. Debris on the outer surface of the needle may also be drawn into injection sites. Possible health implications of injectable matter are discussed and remain conjectural.
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The physical properties of nonprecious alloys can differ significantly from those of alloys containing a high percent of gold. Relationships among constituents, physical properties, and handling characteristics of base metal alloys were surveyed. Toxicity of nickel, beryllium, and their compounds was discussed with attention given to the dental environment. Allergic contact dermatitis appears to be a health risk to certain patients from nickel-containing prostheses. Beryllium dust is apparently not a hazard in properly ventilated and exhausted grinding and polishing areas. Lack of data on nickel-related health problems in dental laboratory workers should be interpreted with caution. This article also reviewed research on porcelain bonding and corrosion of nonprecious alloys. Although this research cannot yet predict an alloy's porcelain bonding behavior in mouths, little or no porcelain bond problems have been reported. A few controlled clinical studies report little corrosion in up to 4 years.
The Phadebact Gonococcus Test (Pharmacia Diagnostics, Piscataway, N.J.) is used for the identification of Neisseria gonorrhoeae. In this test, boiled organisms are examined by using a 3-min coagglutination technique. A total of 313 isolates of Neisseria confirmed by the fluorescent-antibody technique or identified to the species level by the cysteine-tryptose agar utilization technique, were tested by the coagglutination technique. Of 229 isolates of N. gonorrhoeae, 13 (5.7%) were negative by the coagglutination technique on the first testing, 4 (1.7%) of which remained negative on subsequent testing after subculture. Of the 84 isolates of Neisseria other than N. gonorrhoeae, none showed a positive coagglutination reading. The Phadebact Gonococcus Test provides rapid, accurate identification for most isolates of N. gonorrhoeae. As with any new technique, standard procedures (fluorescent-antibody or cysteine-tryptose agar analysis or both) should be performed along with the new technique until laboratory workers are comfortable with the performance and interpretation of the test. We must, however, emphasize that it is very important to follow carefully the procedures outlined on the package insert.
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A brief review of the Pierre Robin syndrome and the various methods of treatment employed for children with the condition have been outlined. A suggested treatment approach utilizing an acrylic resin obturator with an adjustable wire tongue restraint has been discussed.
We believe, then, that our patient represents an infrequently reported form of tetracycline toxicity. She developed a picture consistent with multisystem involvement, with a positive ANA test. All of the toxic manifestations were reversed upon withdrawal of the drug.
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After a definite diagnosis, rational management begins with the construction of a grid flow sheet on which can be recorded vital signs, urine sugar and acetone, blood glucose and electrolytes, arterial blood gases and treatment (fluids, insulin, potassium). Fluids correct the hyperosmolar state, sodium deficit and hypovolemia. Hypokalemia is aggravated by insulin therapy and potassium levels must be monitored chemically and with the electrocardiogram. High-dose and low-dose insulin regimens have been used. Sudden hypoglycemia must be avoided.
There are exciting new developments in the serology of hepatitis A. These new studies will lead to the development of diagnostic tests comparable to the Australia antigen (HBsAg) for hepatitis B. Although active immunization is not likely to be available in the near future, passive immunization is effective. Most patients with clinical disease will recover uneventfully with good diet and ad lib activity. Severe restrictions and hospitalization are rarely indicated.
A 55-year-old man presented with the acute onset of seizures occurring during the post orgasmic phase of sexual intercourse. Evaluation for brain neoplasm was negative. During the hospital stay, the patient developed status epilepticus during which electrocardiogram documented complete heart block. The seizure disorder was corrected with the insertion of a permanent epicardial pacemaker.
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The elfin facies syndrome is characterized by idiopathic infantile hypercalcemia; mental retardation; cardiovascular anomalies, usually supravalvular aortic stenosis and peripheral pulmonary artery stenosis; a peculiar elfin facies and oral anomalies, primarily enamel hypoplasia and oligodontia. The dental features found in the three cases reported include enamel hypoplasia, severe dental decay, oligodontia, pulp stones, microdontia, and abnormally small roots. Some consistent cephalometric abnormalities were thought to contribute to the unusual facial appearance of these patients.
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