The correlation between bowel complications and cardiac surgery

Although advances in knowledge and technology have improved outcomes in surgical cardiac patients over the last decade, complications following cardiac operations still remain to be potentially fatal. Gastrointestinal complications, in particular, tend to have high rates of reintervention and mortality following cardiac surgery, with ischemia and hemorrhage being two of the commonest underlying causes. The intention of this review is to identify which risk factors play important roles in predisposing patients to such complications and to gain better insight into the pathogenesis of the sequelae. Furthermore, strategies for prevention have been discussed to educate and increase awareness of how adverse cardiac surgical outcomes can be minimized.

GDP referrals for orthodontic treatment

OBJECTIVE

To assess the accuracy of the information provided by General Dental Practitioners (GDPs) in referral letters for orthodontic treatment.

DESIGN

An audit.

SETTING

Orthodontic Department, Royal Aberdeen Children's Hospital, Aberdeen. METHOD (SUBJECTS): Prospective assessment of GDP referrals over a two month period. Information provided by referrals compared with British Orthodontic Society guidelines.

RESULTS

A total of 103 new referrals were assessed. Only 25 (24%) patients knew why they were referred. Nineteen (18%) patients were keen on treatment before being explained what treatment was indicated. Nine (8%) patients declined treatment after being explained the risk/benefit of the treatment. Approximately one third of the patients examined had inadequate oral hygiene. Five (4%) patients had more than two active carious lesions. Forty two (41%) referrals provided no information or missed important malocclusion features. None of the letters provided details of patient's general medical practitioner.

CONCLUSIONS

The present audit has highlighted a number of recurring problems with GDP referrals to a hospital orthodontic department. It has indicated a need to inform referring GDPs about the minimum information required in their referral letters. It is suggested that referring dentists should follow the recommendations of the British Orthodontic Society.

Creation of a chimaeric periodontium in the rat by isotopic tooth germ transplantation

The purpose of this work was to develop and test a chimaeric periodontium in which it would be possible to distinguish between connective tissue cells of odontogenic and oral mucosal origin. The recombinant periodontium was created by transplanting first maxillary molar tooth germs with their follicles from 1-3-day-old hooded Lister rats into the corresponding evacuated crypts of 6-9-day-old histocompatible recipients of the same strain. Of 71 transplants, 22 had formed erupted teeth 3 weeks later, with dentogingival junctions and periodontal ligaments histologically similar to those of control teeth. The recombinant nature of the graft periodontium was confirmed by incubating tooth germs in vitro with tritiated thymidine before grafting them, and then demonstrating radiolabelled nuclei in the dentogingival junctions formed by the transplants. Labelled cells were randomly distributed within the periodontal ligament and predominantly near to the basement membrane of junctional epithelium.

A clinical trial of a light activated bonding material over an 18 month period

Heliosit-orthodontic, a visible light cured adhesive, has been compared with Right-on, a chemically activated adhesive, on 122 patients for a mean period of 12 months with a range 3-18 months. The overall bond failure rate was 20 per cent. Heliosit-orthodontic had a 23 per cent failure rate compared with a 16 per cent failure rate for Right-on. Heliosit-orthodontic performed less well on the posterior teeth particularly lower second premolars (P less than 0.01). Both materials performed equally well in the labial segment.