Increasing Your Vitality
Before any restorative treatment, pulpal health must be assessed, usually by measuring the response to percussion and thermal or electrical stimulation. A diagnosis of nonvitality can be confirmed by preparing a test cavity without the administration of local anesthetic. Vitality tests, however, assess only the afferent nerve supply. Misdiagnosis can occur if the nerve supply is damaged but the blood supply is intact. Careful inspection of radiographs is
A first device with 39 parallel electrodes which can generate from 0 to 19 cylinder-shaped DEP cages 29 has been applied to separate white blood cells from red blood cells Fig. 6.4(d) . The same system was recently employed to demonstrate that these cells are suitable for genomic studies. This is one of the several studies available in literature that show that DEP manipulation can be performed without damaging the vitality of the cells.
Tooth may, on occasion, display idiopathic pulpal recession. Such teeth remain vital, but usually display a yellow to brown darkening. The appearance is often one of a non-vital tooth, but the tooth's actual condition can be differentiated on the basis of vitality testing. Treatment The treatment is the same as for the dental alloy material staining. If the tooth has vitality standard vital tooth whitening is usually effective. The difficulty most commonly found with this category of staining is that it can be extremely localized. Thus, the procedure selected should be dictated by the same factors as in staining from idiopathic pulpal recession. If the tooth is non-vital, standard non-vital bleaching should be utilized. Sometimes the stains are so dark and resistant to whitening that supplemental bonding is indicated. Treatment No treatment should be instituted until it is felt that the tooth has fully recovered from the trauma. Sometimes the natural color will return without...
Considering this matter of paramount importance for the evolution of our discipline, Wallerstein (1988) made it the subject of his presidential address to the Montreal Congress of the International Psychoanalytic Association (IPA) in his seminal presentation One Psychoanalysis or Many Reflecting on that talk, Wallerstein (1990) noted that no paper of his had ever provoked such intense reaction, both positive and negative. That dramatic response attested to the significance, passion, acrimony, and vitality associated with this debate.
Such comparisons show that patients with chronic sinusitis have SF-36 scores in domains such as general health and vitality similar to scores of patients with other chronic illnesses, such as chronic obstructive pulmonary disease. Using generic health measures in this way gives us a better understanding of the relative public health impact of one illness versus another.
If you have progressed to end-stage renal disease (ESRD), a kidney transplant may be the preferred treatment for you. Transplantation has even been recommended to infants, elderly patients, diabetic patients, and those with other significant health problems who would not have been candidates in the past. A kidney transplant offers improved quality of life over both kinds of dialysis. Patients who do well after transplantation generally report improvement in vitality and freedom to return to the style of life that they experienced before their progression to ESRD.
At the recall appointment, the patient may describe one or more episodes of pain during the previous months. This could indicate the loss of vitality of an abutment tooth and should be investigated. Appropriate corrective measures can then be taken. One advantage of partial-coverage restorations is that pulp health can be monitored with an electric pulp tester (Fig. 32-15), although the vitality of any tooth with a complete crown can still be assessed by thermal means. Correlating the histologic condition of a pulp directly with the patient's response to pulp testing is difficult32 Therefore, such results should be combined with other clinical data that result from careful patient history information and examination. Seeking the opinion of an endodontist is often a good idea (Fig. 32-16). Radiographs provide useful information about the presence of periapical pathosis. Teeth with fixed restorations should be reviewed radiographically every few years. The use of a standardized...
The correct choice of treatment for any patient depends on a thorough history and examination and an accurate diagnosis and prognosis. Decisions concerning the restoration of abutment teeth involve many factors-caries, existing restorations, tooth vitality, shape and angulation, oral hygiene, and cost and experience-and these must all be assessed and evaluated. Only then is the selected treatment likely to achieve the planned outcome based on the functional requirements of the patient.
MSCT and CT are excellent at defining an abdominal mass, either benign or malignant. CT characterizes the mass by measuring its density, it localizes the mass and demonstrates its extension, both with high precision. In most instances it is possible to locate the organ or site of origin of a mass. In a malignancy, tumor spread may be accurately recognized, as well as enlarged or unenlarged lymph nodes, as possible metastatic manifestations. The degree of uptake of systemically introduced contrast material by a solid mass allows estimation of its perfusion (i.e., vitality) and, conversely, the lack of perfusion may point toward necrosis of the mass. The same applies to MRI. Perfusion criteria may be valuable when evaluating a potentially metastatic lesion using either method. MSCT and CT are most accurate and practical for diagnosing nephroblastoma, its spread and further complications within the regions of the abdomen, chest and skull. Two-dimensional and Doppler US for the evaluation...
During the initial data collection, attention must be directed toward potential endodontic needs of the patient. The clinical examination should include vitality testing of all teeth in the dental arch. This may be done with an electric pulp tester, an ice pencil Patients who have definite symptoms seldom present problems in diagnosis, because pain is generally their chief complaint. When there is doubt concerning pulpal health, however, patients should be examined radiographically during the mouth preparation phase, and the films should be carefully inspected for signs of periapical disease (a radiolu-cency or widening of the PDL space). When there is doubt regarding the endodontic prognosis of a tooth, radiographic findings (Fig. 6-12) should always be evaluated in reference to the results of percussion and vitality tests.
Probably the most widely tested instrument used for general health assessment today is the SF-36 Health Survey, or some form of it.11 This 36-item survey measures 8 domains of general health grouped into physical and mental health areas. In a study of 165 patients presenting to otolaryngologists with chronic sinusitis, patients with chronic sinusitis demonstrated significant decrements from expected normative levels of functioning when tested with this survey in such areas as physical role functioning, bodily pain, general health, vitality, and social functioning.10 Whenever a quality-of-life measurement is reported, it is important to put it into perspective. For example, the vitality score reported in chronic sinusitis refractory to medical therapy can be thought of as indicating that one-fourth of these patients would be expected to report that they are tired most or all of the time. As a generic measure, the SF-36 also permits comparisons between diseases, to understand the...
After cementation, it is no longer feasible to perform electric vitality testing of an abutment tooth. The conductivity of the metal interferes with the test. This can be a disadvantage if future complications occur, although thermal tests occasionally will yield the necessary information.
In this anal hydraulic model, those resisting routine processing may be regarded as old farts by higher ups holding their nostrils erect. Such salty slang sometimes unmasks the barbarism institutional doublespeak strives to conceal with platitudes We are just downsizing and rightsizing to do otherwise would be dumbsizing and wrongsizing. Trained to follow orders and not question, to focus on production, to expedite movement of labor units through the corporate digestive tract, managers serving the cult of innovation believe systemic vitality depends on prodding stubborn ones into going with the flow. Obstinate curmudgeons must be squeezed to the back door to be dropped off unceremoniously without further ado.
In addition to the therapeutic context, FAP is well suited to guide effective clinical supervision of trauma cases. This kind of supervision would direct the supervisor and the supervisee to be attentive to emotional avoidance in the supervision session, and would promote an analysis of the practicality and function of such avoidance. Parallels are drawn between the supervision and the therapy being supervised. Therapists are encouraged to address emotional avoidance in supervision in the service of promoting vitality both in supervision and in therapy. And, of course, the vitality of emotional engagement is an important aspect of the intimate relationships that we hope to help our clients attain.
To their children than parents of children with asthma and parents of healthy children. The findings obtained were equivalent for the mothers and the fathers. We believe that, in order to be able to count their child among the lucky ones who will survive the disease, parents create an image of vitality and zest for life. This positive attribution by parents of children with cancer may be a beneficial coping strategy as long as the emotional feelings of children are not underestimated. Caregivers should be aware of this coping strategy, especially if this coping strategy is out of balance or pathological. It can also be possible that children give their parents the impression they are doing fine to protect their parents from the more negative emotions resulting from the stressful situation.
To identify the presence of a clinical syndrome of cancer-related fatigue these patients also completed self-report measures offatigue, depression, and health-related quality of life. Comparisons among independent raters demonstrated high rates of reliability for the presence or absence of a cancer-related fatigue syndrome and its symptoms. Twenty-one percent of the patients met diagnostic criteria for a cancer-related fatigue syndrome. These patients reported more severe, frequent, and pervasive fatigue than did patients who did not meet diagnostic criteria they also demonstrated poorer role function, less vitality, and more depressive symptomatology. Thus, this newly developed clinical syndrome approach appears to have great utility in identifying patients who experience clinically significant, illness-related fatigue.
In addition to cell lines derived from tumors, cells from humans and animals can be directly cultured. Primary cells, taken from a specific tissue or organ, can be ideal for testing since many are fully differentiated and express numerous features typical of the entire organ of origin. However, this end-stage differentiation can also limit their usefulness. Most primary cells are limited in their ability to proliferate and thus have a defined lifetime. Hepatocytes and neurons, like oocytes, must be harvested from a donor when more cells are needed. Other primary cells capable of division can be cultured only for a limited number of passages, typically about 10, before their properties change or vitality diminishes. Indeed, all primary cells in culture can lose expression of particular features such as receptors or morphology over time.7 One challenge has been to find a way to prevent primary cells, with all their special structures and functions, from reverting to a less...
The TNO-AZL Questionnaire for Adult's Health-related Quality of Life (TAAQOL) consists of 45 questions divided into twelve scales (most of them consist of four items each) gross motor functioning, fine motor functioning, cognition, sleep, pain, social contacts, daily activities, sex, vitality, happiness, depressive mood, and anger. The TAAQOL questionnaire measures just like the TACQOL the emotional impact of self-reported functional problems and has no parent form. Objective To examine the impact of previously operated complex congenital heart disease on health related quality of life and subjective health status and to determine the relation between these parameters and physical status. Design Cross sectional information on medical follow up was sought retrospectively. Setting Patients were randomly selected from the archives of the paediatric cardiology department, Leiden University Medical Centre, Leiden, The Netherlands, and approached irrespective of current cardiac care or...
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