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1.  Factors Involved In Dental Surgery Fires: A Review of the Literature 
Anesthesia Progress  2014;61(1):21-25.
Surgical fires are well-characterized, readily preventable, potentially devastating operating room catastrophes that continue to occur from 20 to 100 times per year or, by one estimate, up to 600 times per year in US operating rooms, sometimes with fatal results. The most significant risk factors for surgical fires involve (a) the use of an ignition source, such as laser or electrocautery equipment, in or around an oxygen-enriched environment in the head, neck, and upper torso area and (b) the concurrent delivery of supplemental oxygen, especially via nasal cannula. Nonetheless, while these 2 conditions occur very commonly in dental surgery, especially in pediatric dental surgery where sedation and anesthesia are regularly indicated, there is a general absence of documented dental surgical fires in the literature. Barring the possibility of underreporting for fear of litigation, this may suggest that there is another mechanism or mechanisms present in dental or pediatric dental surgery that mitigates this worst-case risk of surgical fires. Some possible explanations for this include: greater fire safety awareness by dental practitioners, incidental ventilation of oxygen-enriched environments in patient oral cavities due to breathing, or suction used by dental practitioners during procedures. This review of the literature provides a background to suggest that the practice of using intraoral suction in conjunction with the use of supplemental oxygen during dental procedures may alter the conditions needed for the initiation of intraoral fires. To date, there appear to be no published studies describing the ability of intraoral suctioning devices to alter the ambient oxygen concentration in an intraoral environment. In vivo models that would allow examination of intraoral suction on the ambient oxygen concentration in a simulated intraoral environment may then provide a valuable foundation for evaluating the safety of current clinical dental surgical practices, particularly in regard to the treatment of children.
PMCID: PMC3975610  PMID: 24697822
Surgical fire; Operating room; Dentistry; Dental treatment; Airway fire
2.  Neonatal Handling Increases Cardiovascular Reactivity to Contextual Fear Conditioning in Borderline Hypertensive Rats (BHR) 
Physiology & behavior  2008;95(1-2):72-76.
Much research has demonstrated that events occurring in early life can have a profound influence on future biobehavioral responses to stressful and emotion provoking situations. The purpose of these studies was to determine the effects of an early environmental manipulation, handling (HAN) on cardiovascular (CV) reactivity, freezing behavior and corticosterone (CORT) responses to contextual fear conditioning in the borderline hypertensive rat (BHR), which is susceptible to environmental stressors. HAN subjects were separated from the nest for 15 min/day on post-natal days 1–14, while non-handled (NON-HAN) controls remained in the home cage. Adult subjects were exposed to the contextual fear conditioning procedure and returned to the chamber 24 h later for a 10 min test period. HAN subjects displayed significantly more freezing behavior compared to NON-HAN(92%±2.2 vs 80.7%±5.7, p < .05). Although resting MAP did not differ between groups, HAN subjects had increased MAP reactivity when re-exposed to the chamber. In addition, HAN subjects had significantly lower CORT levels at the end of the 10 min test period (174.2±9 ng/ml vs 237.2±12.9 ng/ml, p < .05). In the second experiment, CORT responses to 60 min of restraint stress and recovery following return to the home cage were assessed in separate groups of HAN and NON-HAN subjects. HAN subjects showed reduced CORT levels in response to acute restraint stress. These results indicate that neonatal handling can modulate biobehavioral responses to contextual fear conditioning in BHR and may suggest a useful model with which to study emotionality and susceptibility to CV disease.
PMCID: PMC2562466  PMID: 18538802
contextual fear conditioning; neonatal handling; mean arterial pressure; rats; corticosterone
3.  Maternal Separation Enhances Neuronal Activation and Cardiovascular Responses to Acute Stress in Borderline Hypertensive Rats 
Behavioural brain research  2007;183(1):25-30.
There is much evidence suggesting early life events, such has handling or repeated separations from the nest, can have a long term effect on the biological and behavioral development of rats. The current study examined the effect of repeated maternal separation (MS) on the behavioral, cardiovascular, and neurobiological responses to stress in subjects vulnerable to environmental stressors as adults. Borderline hypertensive rats (BHR), which are the first generation offspring of spontaneously hyperternsive and Wistar-Kyoto rats, were separated from the dams for 3 hours per day from post-natal day 1 through 14. Non-separated controls remained in the home cage. When allowed to explore the open field chamber for 60 minutes as adults, MS subjects had significantly greater locomotor activity compared to controls. All subjects were exposed to 30 minutes of restraint stress during which time mean arterial pressure (MAP) and heart rate (HR) were measured. Although both groups had comparable increases in MAP, MS animals displayed significantly higher HR throughout the stress period. Finally, MS subjects had significantly more stress-induced Fos positive cells, an estimate of neuronal activation, in the central nucleus of the amygdala (CeA), paraventricular nucleus of the hypothalamus (PVN), and the bed nucleus of the stria terminalis (BNST), each of which plays an important role in organizing the biobehavioral response to stress. These results suggest that maternal separation can further enhance stress reactivity in this model and may represent a useful approach for studying the relationship between early life events and future vulnerability to stressful situations.
PMCID: PMC1994156  PMID: 17604851
maternal separation; stress; open field; cardiovascular; rats; Fos
4.  The Use of Office-Based Sedation and General Anesthesia by Board Certified Pediatric Dentists Practicing in the United States 
Anesthesia Progress  2012;59(1):12-17.
The purpose of this study is to explore the use of office-based sedation by board-certified pediatric dentists practicing in the United States. Pediatric dentists have traditionally relied upon self-administered sedation techniques to provide office-based sedation. The use of dentist anesthesiologists to provide office-based sedation is an emerging trend. This study examines and compares these two models of office-based sedations. A survey evaluating office-based sedation of diplomates of the American Board of Pediatric Dentistry (ABPD) based on gender, age, years in practice, practice types, regions, and years as a diplomate of the ABPD was completed by 494 active members. The results were summarized using frequencies and percentages. Relationships of dentist age, gender, and number of years in practice with the use of intravenous (IV) sedation was completed using two-way contingency tables and Mantel-Haenszel tests for ordered categorical data. Relationships of office-based sedation use and the type of one's practice were examined using Pearson chi-square tests. Of the 1917 surveys e-mailed, 494 completed the survey for a response rate of 26%. Over 70% of board-certified US pediatric dentists use some form of sedation in their offices. Less than 20% administer IV sedation, 20 to 40% use a dentist anesthesiologist, and 60 to 70% would use dentist anesthesiologists if one were available.
PMCID: PMC3309296  PMID: 22428969
Office-based; Dentist-anesthesiologist; Pediatric dentist
5.  Demand in Pediatric Dentistry for Sedation and General Anesthesia by Dentist Anesthesiologists: A Survey of Directors of Dentist Anesthesiologist and Pediatric Dentistry Residencies 
Anesthesia Progress  2012;59(1):3-11.
This study describes what training programs in pediatric dentistry and dental anesthesiology are doing to meet future needs for deep sedation/general anesthesia services required for pediatric dentistry. Residency directors from 10 dental anesthesiology training programs in North America and 79 directors from pediatric dentistry training programs in North America were asked to answer an 18-item and 22-item online survey, respectively, through an online survey tool. The response rate for the 10 anesthesiology training program directors was 9 of 10 or 90%. The response rate for the 79 pediatric dentistry training program directors was 46 of 79 or 58%. Thirty-seven percent of pediatric dentistry programs use clinic-based deep sedation/general anesthesia for dental treatment in addition to hospital-based deep sedation/general anesthesia. Eighty-eight percent of those programs use dentist anesthesiologists for administration of deep sedation/general anesthesia in a clinic-based setting. Pediatric dentistry residency directors perceive a future change in the need for deep sedation/general anesthesia services provided by dentist anesthesiologists to pediatric dentists: 64% anticipate an increase in need for dentist anesthesiologist services, while 36% anticipate no change. Dental anesthesiology directors compared to 2, 5, and 10 years ago have seen an increase in the requests for dentist anesthesiologist services by pediatric dentists reported by 56% of respondents (past 2 years), 63% of respondents (past 5 years), and 88% of respondents (past 10 years), respectively. Predicting the future need of dentist anesthesiologists is an uncertain task, but these results show pediatric dentistry directors and dental anesthesiology directors are considering the need, and they recognize a trend of increased need for dentist anesthesiologist services over the past decade.
PMCID: PMC3309300  PMID: 22428968
Demand for services; Dental anesthesiologist; Pediatric dentist
6.  Effects of genistein in the maternal diet on reproductive development and spatial learning in male rats 
Hormones and behavior  2010;57(3):313-322.
Endocrine disruptors, chemicals that disturb the actions of endogenous hormones, have been implicated in birth defects associated with hormone-dependent development. Phytoestrogens are a class of endocrine disruptors found in plants. In the current study we examined the effects of exposure at various perinatal time periods to genistein, a soy phytoestrogen, on reproductive development and learning in male rats. Dams were fed genistein-containing (5 mg/kg feed) food during both gestation and lactation, during gestation only, during lactation only, or during neither period. Measures of reproductive development and body mass were taken in the male offspring during postnatal development, and learning and memory performance was assessed in adulthood. Genistein exposure via the maternal diet decreased body mass in the male offspring of dams fed genistein during both gestation and lactation, during lactation only, but not during gestation only. Genistein decreased anogenital distance when exposure was during both gestation and lactation, but there was no effect when exposure was limited to one of these time periods. Similarly, spatial learning in the Morris water maze was impaired in male rats exposed to genistein during both gestation and lactation, but not in rats exposed during only one of these time periods. There was no effect of genistein on cued or contextual fear conditioning. In summary, the data indicate that exposure to genistein through the maternal diet significantly impacts growth in male offspring if exposure is during lactation. The effects of genistein on reproductive development and spatial learning required exposure throughout the pre- and postnatal periods.
PMCID: PMC2834867  PMID: 20053350
genistein; phytoestrogen; anogenital distance; water maze; spatial learning

Results 1-6 (6)