Providing the Tools to Facilitate Quality Care for Children with Sickle Cell Disease.

Meeting best-practice guidelines can significantly enhance quality of life and longevity for those with sickle cell disease (SCD). However, many clinical settings lack the necessary resources for optimal care. We present an integrated suite of tools and collaborative actions designed to enhance SCD care.

Eliminating Health Care Access and Quality Inequities in Sickle Cell Disease: Policy Lessons from the End Sepsis Initiative.

Sickle cell disease is a prime example of the devastating impact of healthcare inequities. The End Sepsis Initiative developed after a tragic death due to sepsis, provides a powerful model for the sickle cell community. This model recognizes the importance of evidence-based protocols and policy recommendations/mandates to drive transformative systems change.

Early increase of von Willebrand factor predicts adverse outcome in unstable coronary artery disease: beneficial effects of enoxaparin. French Investigators of the ESSENCE Trial.

Background: The pathogenesis of unstable angina and non-Q-wave myocardial infarction is still poorly understood, and early evaluation of prognosis remains difficult. We therefore studied the predictive value of 5 biological indicators of inflammation, thrombogenesis, vasoconstriction, and myocardial necrosis, and we examined the effects of enoxaparin and unfractionated heparin on these markers after 48 hours of treatment.

Methods And Results: Sixty-eight patients with unstable angina or non-Q-wave myocardial infarction randomized in the international ESSENCE trial participated in this French substudy.

Dentinal permeability of the dog canine after exposure of a cervical cavity to the beam of a CO2 laser.

The dentinal permeability of the axial wall of a class V cavities in the canine of the dog was analyzed before and after its laser CO2 irradiation at two energy levels: 285 J per cm2 and 570 J per cm2. The sealing of the exposed dentin was verified by means of a pellet of cotton wool placed in contact with the axial wall and on which 20 microliters of a 50 mg per ml solution of noradrenaline was injected with a micrometric syringe. The transdentinal passage of noradrenaline induces a vasoconstriction of the pulp which is attested by a drop in its blood pressure.

[Effect of local anesthetics on the dental pulp. Study in rats].

According to the in vitro and in vivo procedures described by Rockert and Pracros, the effect of different local anesthetics (with and without vaso-constrictive solution) have been studied on rat incisor dental pulp. Histological analysis (optical microscopy) of samples (90 rat incisors) showed: A systematic pulp response with concentrations up to 2%. This response correspond with a toxic reaction on the respiratory activity of pulp cells; A highest response with solutions containing a vaso-constrictor additive; An increasing response according to the nature of the anesthetic solution.

[Experimental study of the effect of a photopolymerizable glass ionomer cavity liner on pulp pressure and temperature].

The biocompatibility of a light curing glass ionomer cement was studied for its pulpal effect when used as a capping agent in a dentin cavity. Pulpal pressure and temperature were recorded in 14 dog canines after placement of the glass ionomer cement. No increase was observed in 12 specimens on 14 samples.

[Diffusion of elements of glass ionomer cements placed in a dentin cavity: influence on pulp pressure].

The biocompatibility of glass ionomer cement with silver and titanium ions is studied in vivo on dog's canine. Class V cavities, side by side the pulp, are prepared and Ketak Silver cement is placed inside. Variation of pulp pressure are recorded before and after the cement's applying, after which the crowns are cut and broken at the filling level, the different components part diffusion through the dentin are placed in prominent position by means of a microanalysis and a cartography of the sample is obtained by colorimetric picture.

[[Doppler echocardiography in the diagnosis of tri-atrial heart in adults].

The authors report a case of isolated and well tolerated cor triatriatum in a 38-year old man without significant history admitted for aetiological diagnosis of atrial fibrillation. Echocardiography displayed the left intra-atrial septum and the openings of the 4 pulmonary veins in the proximal chamber, but there was no evidence of associated anomaly. Colour-coded doppler examination visualized a single systolo-diastolic trans-septal jet.

Repeat colonoscopy after endoscopic polypectomy.

The records of all patients undergoing endoscopic polypectomy between December 1979 and December 1982 were reviewed. One hundred seventy-two patients underwent colonoscopic polypectomy in the absence of carcinoma or inflammatory bowel disease. Of these, the polyp could not be retrieved in 4, and 19 were lost to follow-up.

Anorectal infiltration anesthesia in the prone position.

A safe technique of infiltration anesthesia for anorectal procedures is described. It eliminates patient discomfort and allows the surgeon to work with the patient in the prone position.

Preoperative tattooing of polypectomy site.

A simple method of marking polypectomy site is described. It involves submucosal injection of supravital dye via the colonoscope. It permits identification of site of pathology at the time of surgery.

[Asymptomatic coronaro-cardiac fistula. Apropos of a case].

The case of a 20 year old woman with a right coronary-right atrial fistula is reported. The diagnosis was made during investigation of a continuous murmur and the tolerance was excellent. Aortic root angiography demonstrated a fistula between the initial part of the right coronary artery and a right heart cavity.

[Vasomotor innervation of the maxillary canines of the dog].

Maxillary canine pulpar pressure was recorded on anesthetized dogs by means of a small bore cannula threaded into a hole drilled through the lateral surface of the tooth. Vasoconstriction was brought by the electrical stimulation of the cranial cervical ganglion. Vasodilation was induced by stilmulation of the pterygo-palatine ganglion.

[Methods of determination of fluoride in trace amounts. Application to the study of the diffusion of fluoride from an amalgam in dental tissues].

The study of fluoride diffusion in dental tissues has been performed by microprobe analysis. The fluoride supply is carried out in vivo by various fluorides added to conventional amalgams. This method differs then from previous work (topical applications, electrophoresis or fluoride solutions) by the study of fluoride penetration from amalgams either in dentine or in deep enamel, which are more susceptible to caries than superficial enamel.