Evaluation In Clinical Practice Research Articles

Diagnosis and management of bruxism: Evaluation of clinical practices in France

ABSTRACT Objective: The Evaluation of Clinical Practice (ECP) conducted with a sample of French general dental practitioners aimed to measure the methods used to diagnose and manage bruxism. Methods: The ECP was performed using a declarative online questionnaire-based anonymous survey (SurveyMonkey) of 1388 practitioners. Twenty-two questions were grouped in 5 categories: (1) Sociodemographic characteristics (Q1-6); (2) Knowledge of the prevalence and definition of bruxism (Q7-9); (3) Diagnostic approach (Q10-11) and management (Q12-Q13); (4) The use of occlusal splints (Q14-21); (5) Oral rehabilitation (Q22). Results: The answers obtained (233; 16.8%) revealed a wide disparity and insufficient diagnosis (e.g. only 41% looked for sleep disorders, 22.3% for consumption of stimulants, 3% for upper airway obstruction) and management of bruxism (e.g. only 21.9% of participants proposed cognitive-behavioral therapy). Discussion: The discrepancies detected, such as the use of inappropriate splints (30 to 70%), emphasize the need for more prompt research-to-practice transfer of new knowledge.

Analyse des circonstances de survenue des extravasations de produits de contraste en imagerie

To prevent extravasations in medical imaging, analyses of organizational and professional circumstances of the occurrence of extravasations have been conducted in the Bordeaux University Hospital (BUH). Two parallel studies were conducted: (i)clinical practice evaluation (CPE) including practice analysis groups and development of indicator of extravasation occurrence; (ii)Case-control study analyzing the factors associated with the occurrence of extravasations. Cases were constituted with consecutive series ofpatients with extravasation occurred in the BUH; controls were constituted of series of patients managed in medical imaging in the BUH without any extravasation. Statistical analysis included univariate and multivariate regression logistic models. CPE identified the following circumstances: patient' characteristics (female gender, low blood vessels) and professional situations (lack of check of: peripheral veinous access, contrast media temperature, injection process and lack of matching between injection amount and veinous access diameter). In the case-control analysis, patients' gender and catheter placement in medical imaging were significantly associated with the occurrence of extravasations. Guidelines have been drafted allowing the decrease of extravasation incidence. Adherence to guidelines of contrast media preparation and injection process is very important to prevent extravasation and improve patient safety.

Relative length of human kidney as more precise measuring of normal kidney

Malformations in kidney development and kidney diseases are accompanied with changes in their size. For kidney evaluation in clinical practice, the kidney length is the most widely used measurement, since it provides the most precise results and it is easy to perform. Recently, the measurement of relative renal length has become more preferable as it takes into account the body height. The aim of this study was to measure both the absolute and relative length of normal cadaveric kidneys according to the body height, sex and age. In this study, we examined 95 adult cadaveric kidneys, without renal and vascular impairment, their age ranging from 23-87 years. To determine the period of the most abundant changes in kidney length, we separated them into a 10-year range. The relative renal length was calculated using the kidney length and body height ratio (kidney/body ratio). The absolute and relative length of left kidney in males was longer than the right one, with a statistically significant correlation. In females, the left kidney length was also longer than the right one, however, without a statistical significance. In contrast to the absolute length, the relative length of both kidneys did not show a significant difference between sexes, and did not manifest a significant decrease with age. There was a significant correlation between the kidney length and the subject's height. The relative renal length represents kidney size better than the absolute renal length because it eliminates sex and height differences until the age of 59 year. From the seventh decade of life, there is a significant decrease in both the absolute and relative renal length.