Integrating person-centered care into dental education: An oral medicine perspective.

Dental education is moving toward models of education and care that are person-centered. The purpose of this article is to explore and describe the teaching and patient care model (the attending-based model) used for the past 50 years in the oral medicine department at one dental education institution. This article briefly discusses how this teaching model promotes person-centered care and the biopsychosocial model, while highlighting some of the barriers, benefits, and opportunities to wider adoption in dental education.

PDL1 shapes the classical Hodgkin lymphoma microenvironment without inducing T-cell exhaustion.

Classical Hodgkin lymphoma (CHL) is unusually sensitive to PD1 inhibition and PDL1 is highly expressed on CHL cells and in the tumor microenvironment. This could be interpreted as evidence of exhaustion, but paradoxically, PD1+ lymphocyte infiltration does not predict response to PD1 inhibitors and no increase in cytotoxic markers is seen after PD1 therapy as might be expected with reversal of exhaustion. In contrast to PD1, elevated PDL1 does predict response to PD1 inhibitors and recent data associate both retained CHL MHC-II expression and increased T helper (TH) T-cell receptor diversity with response, suggesting a connection to the TH compartment.

A cross-sectional study of temporomandibular joint coronal plane disk position: imaging reliability and clinical utility.

Objectives: The aim of this study was to assess the reliability, frequency, and clinical significance of temporomandibular joint (TMJ) medial and lateral disk positions, observed in the coronal-oblique plane, to determine their importance in clinical diagnosis and for routine imaging.

Study Design: This cross-sectional study involved secondary data analysis (clinical and imaging) of 401 participants of the TMJ Impact Study. We used the χ statistic to evaluate the associations between coronal disk positions with (1) anterior disk displacements with reduction and without reduction; and (2) familiar TMJ pain resulting from excursive movements and palpation, range of motion, and joint sounds.

Prospective, Double-blind Evaluation of Perioperative Intravenous Acetaminophen and Ketorolac for Postoperative Pain and Opioid Consumption After Endoscopic Carpal Tunnel Release.

The current opioid epidemic highlights the need for pain management strategies to decrease or eliminate postoperative use of opioid medications. The purpose of this study was to determine if perioperative administration of intravenous (IV) acetaminophen and/or IV ketorolac decreases postoperative pain and opioid consumption after endoscopic carpal tunnel release. In all, 44 subjects were enrolled in this randomized, double-blind, placebo-controlled study from October 2015 to April 2017 and divided into 4 treatment arms: placebo, IV acetaminophen, IV ketorolac, or both IV acetaminophen and IV ketorolac.

Osteoarthritis of the temporomandibular joint and increase of the horizontal condylar angle: a longitudinal study.

Objective: Our previous study of patients with unilateral temporomandibular joint (TMJ) osteoarthritis (OA) showed that the affected joints had greater horizontal condylar angle (HCA) compared with the contralateral unaffected joints. However, it was unclear whether the HCA changes preceded or were the result of OA changes. The aim of this longitudinal study was to investigate the relationship between HCA and OA progression.

Adjuncts for the evaluation of potentially malignant disorders in the oral cavity: Diagnostic test accuracy systematic review and meta-analysis-a report of the American Dental Association.

Background: Oral squamous cell carcinoma is the most common manifestation of malignancy in the oral cavity. Adjuncts are available for clinicians to evaluate lesions that seem potentially malignant. In this systematic review, the authors summarized the available evidence on patient-important outcomes, diagnostic test accuracy (DTA), and patients' values and preferences (PVPs) when using adjuncts for the evaluation of clinically evident lesions in the oral cavity.

Evidence-based clinical practice guideline for the evaluation of potentially malignant disorders in the oral cavity: A report of the American Dental Association.

Background: An expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated clinical recommendations to inform primary care clinicians about the potential use of adjuncts as triage tools for the evaluation of lesions, including potentially malignant disorders (PMDs), in the oral cavity.

Types Of Studies Reviewed: This is an update of the ADA's 2010 recommendations on the early diagnosis of PMDs and oral squamous cell carcinoma. The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials and diagnostic test accuracy studies.

Palmar Soft Tissue Infection From Shewanella putrefaciens.

Shewanella putrefaciens, a gram-negative bacillus, ubiquitous in marine environments, is an opportunistic agent reported to cause rare human infection, most commonly in patients who are immunocompromised or who have a preexisting soft tissue defect. We present an immunocompetent, 40-year-old woman with a soft tissue infection of the left palm caused by S. putrefaciens.

The Radical Flank Effect and Cross-occupational Collaboration for Technology Development during a Power Shift.

This 12-month ethnographic study of an early entrant into the U.S. car-sharing industry demonstrates that when an organization shifts its focus from developing radical new technology to incrementally improving this technology, the shift may spark an internal power struggle between the dominant engineering group and a challenger occupational group such as the marketing group.

Longitudinal Stability of Common TMJ Structural Disorders.

The longitudinal course of temporomandibular joint (TMJ) disc displacement (DD) and degenerative joint disease (DJD) has never been conclusively described with magnetic resonance imaging and computed tomography, respectively. This 8-y observational study's objective was to assess the longitudinal stability of DD and DJD among 401 subjects. The Validation Project provided baseline measures; follow-up was performed in the TMJ Impact Project.

The American Dental Association Caries Classification System for clinical practice: a report of the American Dental Association Council on Scientific Affairs.

Background: The caries lesion, the most commonly observed sign of dental caries disease, is the cumulative result of an imbalance in the dynamic demineralization and remineralization process that causes a net mineral loss over time. A classification system to categorize the location, site of origin, extent, and when possible, activity level of caries lesions consistently over time is necessary to determine which clinical treatments and therapeutic interventions are appropriate to control and treat these lesions.

Methods: In 2008, the American Dental Association (ADA) convened a group of experts to develop an easy-to-implement caries classification system.

The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners--a report of the American Dental Association Council on Scientific Affairs.

Background: A panel of experts (the 2014 Panel) convened by the American Dental Association Council on Scientific Affairs developed an evidence-based clinical practice guideline (CPG) on the use of prophylactic antibiotics in patients with prosthetic joints who are undergoing dental procedures. This CPG is intended to clarify the "Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures: Evidence-based Guideline and Evidence Report," which was developed and published by the American Academy of Orthopaedic Surgeons and the American Dental Association (the 2012 Panel).

Types Of Studies Reviewed: The 2014 Panel based the current CPG on literature search results and direct evidence contained in the comprehensive systematic review published by the 2012 Panel, as well as the results from an updated literature search.

Carmustine, etoposide, cytarabine, and melphalan (BEAM)-campath allogeneic stem cell transplantation for aggressive non-hodgkin lymphoma: an analysis of outcomes from the British Society of Blood and Marrow Transplantation.

The role of allogeneic stem cell transplantation (SCT) in the management of aggressive non-Hodgkin lymphoma (NHL) remains to be defined, but the number of procedures performed continues to increase. We report here the outcomes of allogeneic SCT using carmustine, etoposide, cytarabine, and melphalan (BEAM)-Campath (Genzyme Corporation, Cambridge, MA) conditioning for aggressive NHL as reported to the British Society of Blood and Marrow Transplantation (BSBMT). This retrospective study identified 46 patients who reported to the BSBMT registry as having undergone BEAM-Campath conditioned allogeneic SCT for aggressive NHL between 1999 and 2010.

Collective genius.

How can leaders build an organization that is capable of innovating continually over time? By creating a community that is both willing and able to innovate. To be willing, the community must share a sense of purpose, values, and rules of engagement. When Luca de Meo was Volkswagen's head of marketing communication, he fostered a sense of purpose in his team by asking its members to reflect on what being part of VW meant to them; strengthened their shared values by encouraging them to use the brand's three components-innovation, responsibility, and value-to guide their work; and built significant responsibility and autonomy into their rules of engagement.

Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†.

Aims: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.

The coagulopathy and thrombotic risk associated with L-asparaginase treatment in adults with acute lymphoblastic leukaemia.

The dramatic improvements seen in the outcome of paediatric patients with acute lymphoblastic leukaemia (ALL) have led to increasing incorporation of L-asparaginase (L-Asp) in adult treatment protocols. However, its use is associated with a disruption in the physiological balance between haemostatic and anticoagulant pathways, with the predominant clinical manifestation being thrombosis. Although L-Asp therapy is known to be associated with an acquired deficiency of antithrombin (AT), the concurrent depletion of fibrinogen and other haemostatic proteins means that the precise mechanism of thrombosis remains to be defined.

Influence of temple headache frequency on physical functioning and emotional functioning in subjects with temporomandibular disorder pain.

Aims: To investigate the relationship of headache frequency with patient-reported physical functioning and emotional functioning in temporomandibular disorder (TMD) subjects with concurrent temple headache.

Methods: The Research Diagnostic Criteria for TMD (RDC/TMD) Validation Project identified, as a subset of 614 TMD cases and 91 controls (n = 705), 309 subjects with concurrent TMD pain diagnoses (RDC/TMD) and temple headache. The temple headaches were subdivided into infrequent, frequent, and chronic headache according to the International Classification of Headache Disorders, second edition (ICHD-II).

The power of collective ambition.

In the past few years, some companies have not just weathered the economic storm: They've emerged stronger than ever. How did such players as Four Seasons, Sephora, and Standard Chartered Bank defy conventional logic? Instead of pursuing a single ambition, such as profits, employees defined a collective ambition. As a result, those organizations deepened their engagement with employees and other stakeholders and became sustainably profitable.

Development of a brief and effective temporomandibular disorder pain screening questionnaire: reliability and validity.

Background: Available screening instruments for identifying temporomandibular disorders (TMDs) exhibit methodological or logistic limitations. The authors conducted a study to develop and assess the validity of a self-report instrument in screening patients for pain-related TMDs.

Methods: By using psychometric methods for item selection, the authors developed short (three-item) and long (six-item) versions of the questionnaire and evaluated them for validity among 504 participants.

Narrow band (light) imaging of oral mucosa in routine dental patients. Part I: Assessment of value in detection of mucosal changes.

The purpose of this investigation was to determine the value of adding narrow band (light) imaging (NBI) to the standard oral soft tissue examination process used to detect mucosal change. A total of 620 dental patients who came to the clinic for regular dental evaluation or for treatment of acute dental problems were given a standard oral soft tissue examination by dental students under faculty supervision. The results of the white light examination were recorded after the tissues were examined with NBI, at which point areas with a loss of fluorescence (LOF) were recorded.