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Biomedical subjects

A Maguire

Publications and source records attributed to A Maguire.

At least 19 recordsLinked to original sources
PubMed2006

Is the fluoride/creatinine ratio of a spot urine sample indicative of 24-h urinary fluoride?

OBJECTIVE: The main aim of this study was to determine how representative the fluoride/creatinine (F/Cr) ratio of a spot urinary sample is of the fluoride content of a 24-h urine sample in young children aged 12-36 months. Subsidiary objectives were to: (a) evaluate the use of 24-h urine samples in monitoring fluoride exposure and (b) estimate the retention of fluoride in very young children. METHODS: Seven healthy children residing in a fluoridated area completed the study. Dietary information was obtained using a 3-day estimated food diary followed by an interview on the fourth day. Samples of foods and drinks were analysed for fluoride content. Ingestion of fluoride from toothpaste was also measured. A 24-h urine sample and a morning spot urine sample were collected from each child. RESULTS: The mean age of the children was 32 months (range: 16-36 months). The mean total daily intake of fluoride was 0.71 (+/-0.41) mg or 0.05 (+/-0.02) mg/kg bodyweight, of which 37% came from the diet, the remainder being from toothpaste ingestion. None of the children used any other sources of fluoride such as fluoride tablets or fluoridated salt. The mean F/Cr ratio was 1.49 (+/-0.63) mg F/g creatinine. A positive correlation (Pearson's correlation=0.76, P=0.05) between fluoride excretion estimated using the F/Cr ratio in a morning spot urine sample and fluoride excretion in a 24-h urine sample was found. There was also a positive correlation (Pearson's correlation=0.83, P=0.02) between total daily fluoride intake and 24-h urinary fluoride excretion. Less than half (43%) of the total daily fluoride intake was retained in the body. CONCLUSIONS: The F/Cr ratio of a morning spot urine sample may be used to estimate mean 24-h urinary excretion of fluoride and therefore has potential application for larger-scale epidemiological studies where 24-h samples are impractical. Estimates of 24-h urinary fluoride excretion can be used to gauge fluoride exposure.

Beverages↗
PubMed2006

Factors affecting treatment outcomes following complicated crown fractures managed in primary and secondary care.

The aims of this retrospective observational study were to determine the factors which affect treatment provision and the Median Survival Time (MST) for maintenance of tooth vitality following complicated crown fracture. The survey was carried out for patients treated at Newcastle Dental Hospital (NDH) according to departmental guidelines over a 2-year period following the introduction of a new protocol for management of these types of injuries. Seventy-three cases of complicated crown fracture were identified in 69 children with a mean age of 10.3 years (SD = 2.5 years). Seventy-one percent of the fractures occurred in males (M:F ratio was 2.5:1). Fifty-one percent of the complicated crown fractures were in immature teeth. Of the 73 traumatised teeth, 45% presented initially in general dental practice (GDP), 37% at the dental hospital and 8% at local accident and emergency departments with the remaining 10% seen at other or unrecorded locations. Of the 41 fractures, which presented initially at a location other than the dental hospital, 38% were referred to the dental hospital without the provision of an emergency pulp bandage. The overall definitive treatments provided for the 37 open apex teeth included pulp cap (19%), partial pulpotomy (32%), cervical pulpotomy (8%) and pulpectomy (35%), while for the 36 closed apex teeth it was pulp cap (28%), pulpotomy (11%), and pulpectomy (61%). Of the 30 teeth, which underwent vital pulp therapy (18 open and 12 closed apex), the MST for the 15 teeth treated with pulp caps was 1460 days (95% CI: 1067, 1853) while for the 15 teeth treated with pulpotomies it was 1375 days (95% CI: 964, 1786). There was no statistically significant difference in the MST between teeth treated with pulp caps and pulpotomies. In conclusion, the proportion of patients referred to secondary care with complicated crown fractures without provision of a pulp bandage is of some concern. More conservative treatment of closed apex teeth sustaining complicated crown fractures, utilizing vital pulp therapy techniques would appear to be appropriate.

Adolescent↗
PubMed2005

Management of dental trauma in primary care: a postal survey of general dental practitioners.

OBJECTIVES: To determine the self-perceived knowledge and attitudes of general dental practitioners (GDPs) concerning management of dental trauma in primary care. To identify potential barriers to the management of dental trauma in primary care. DESIGN AND SETTING: A self-completion postal questionnaire survey of 417 GDPs in six local health authority districts in northeast England. MAIN OUTCOME MEASURES: Likert scale responses to 20 statements designed to test self-perceived knowledge and attitudes. Following descriptive statistical analysis. Factor analysis with principle components analysis was undertaken to identify areas of correlation in questionnaire responses, followed by Chi squared test, Spearman's Rank Correlation and analysis of variance (ANOVA) to measure association between variables. RESULTS: The response rate was 74%. Enamel and dentine fractures were the most common injury, with 45% of GDPs responding seeing more than 10 cases of dental trauma in the preceding year and 53% of respondents seeing one to three cases of complicated crown fracture. Seventy-eight per cent believed that NHS remuneration was inadequate, but only 8% would refer patients with dental trauma to secondary care for this reason. Half of the GDPs believed that trauma could be treated more effectively in practice if NHS payments were greater. GDPs were significantly more likely to agree with this statement if they had previously undertaken a postgraduate course in the treatment of dental trauma (p=0.002). Single handed GDPs were statistically significantly more likely to agree with the statements 'I would not treat dental trauma cases at my practice because the NHS payment is inadequate' (p=0.008) and 'Treating dental trauma at my practice requires too much of my clinical time to be worthwhile' (p=0.002). Ninety-six per cent of GDPs disagreed that treatment of dental trauma rested solely within secondary care. Ninety-six per cent of GDPs agreed that they had a responsibility to provide initial emergency treatment for trauma patients prior to referral. Eighty-eight per cent of GDPs felt that aids to management would be useful. CONCLUSIONS: Although GDPs believed that financial remuneration was inadequate, this did not prevent them treating trauma cases. They strongly agreed that they had responsibility for the management of dental trauma in primary care and that they believed trauma could be treated more effectively in practice if payment was greater. Time constraints were perceived as a barrier to long-term management of complex trauma cases in primary care. GDPs would welcome the use of management aids.

Analysis of Variance↗
PubMed2005

Bioavailability of fluoride in drinking water: a human experimental study.

It has been suggested that systemic fluoride absorption from drinking water may be influenced by the type of fluoride compound in the water and by water hardness. Using a human double-blind cross-over trial, we conducted this study to measure c(max), T(max), and Area Under the Curve (AUC) for plasma F concentration against time, following the ingestion of naturally fluoridated hard and soft waters, artificially fluoridated hard and soft waters, and a reference water. Mean AUC over 0 to 8 hours was 1330, 1440, 1679, 1566, and 1328 ng F.min.mL(-1) for naturally fluoridated soft, naturally fluoridated hard, artificially fluoridated soft, artificially fluoridated hard, and reference waters, respectively, with no statistically significant differences among waters for AUC, c(max), or T(max). Any differences in fluoride bioavailability between drinking waters in which fluoride is present naturally or added artificially, or the waters are hard or soft, were small compared with large within- and between-subject variations in F absorption. Abbreviations used: F, fluoride; AUC, Area under the Curve for plasma F concentration against time; AUC(0-3), Area under the Curve for plasma F concentration against time for 0 to 3 hours following water ingestion; AUC(0-8), Area under the Curve for plasma F concentration against time for 0 to 8 hours following water ingestion; c(max), maximum plasma F concentration corrected for baseline plasma F and dose (i.e., F concentration of individual waters); T(max), time of c(max).

Adult↗
PubMed2003

Fluoride content of still bottled waters available in the North-East of England, UK.

OBJECTIVE: The aims of this study were to measure the fluoride content of still bottled waters on sale in the UK and to estimate and compare the fluoride intake from tap and bottled water for British children. METHODS: Three bottles of 25 commercial brands of bottled water were purchased from supermarkets, grocery stores and health shops in the North-East of England. All samples were still spring, mineral or distilled waters, sold in plastic bottles. The fluoride content of all samples was determined, in duplicate, using a Fluoride Ion Selective Electrode. RESULTS: The mean (+/- SD) fluoride content of the bottled waters was 0.08 (+/- 0.08) mg L(-1) with a range from 0.01-0.37 mg L(-1) which is below the accepted standard for optimally fluoridated water. The mean fluoride intake for 4-18-year-olds when the source of water intake is solely fluoridated tap water was estimated to be 0.26 mg F per day; compared with 0.16 mg F per day, when a combination of tap and bottled water is consumed. CONCLUSIONS: Bottled water, from those sampled, is unlikely to make an important contribution to total fluoride intake in British diets. Consumption of bottled water containing a negligible amount of fluoride in preference to fluoridated tap water might result in less than optimal fluoride ingestion in young people.

Adolescent↗
PubMed2003

Oral health and related factors in cystic fibrosis and other chronic respiratory disorders.

AIM: To compare the prevalence of dental caries, dental calculus, and enamel defects in children with cystic fibrosis (CF) and children with other chronic respiratory disorders. METHODS: A cross sectional observational survey. One examiner (AN) undertook oral examinations to assess dental caries, periodontal health, and enamel defects in children attending respiratory outpatient clinics. RESULTS: A total of 74 patients with CF (35 male; mean age 10.7 years, range 2.5-16.5) were compared with a control group of 106 patients with other chronic respiratory disorders (52 male; mean age 9.1 years, range 3.0-16.5). There were significantly more defects of enamel in the permanent teeth of CF patients, compared with the teeth of those children with other chronic respiratory disorders. In addition, non-significant trends towards a lower caries prevalence in both dentitions, increased numbers of sextants with calculus deposits, and a reduced number of healthy gingival sextants were observed in the patients with cystic fibrosis. CONCLUSIONS: Enamel defects, particularly enamel opacities, which can be disfiguring, are more common in CF patients. Early, regular dental visits may prevent such defects becoming dentally disabling and would also permit the removal of dental calculus deposits. The use of long term antibiotics and pancreatic enzymes may confer some protection against the development and progression of dental caries in patients with cystic fibrosis. The inclusion of a specialist paediatric dentist, as part of the multiprofessional team managing the care of these children, would be an advantage.

Adolescent↗
PubMed2002

Structure-activity relationship of indomethacin analogues for MRP-1, COX-1 and COX-2 inhibition. identification of novel chemotherapeutic drug resistance modulators.

We report the screening of analogues of indomethacin to investigate the structure-activity relationship (SAR) of indomethacin-mediated multidrug resistance associated protein-1 (MRP-1) inhibition. By examining the activities of compounds with minor variations of the parent structure, we were able to separate MRP-1, glutathione-S-transferase (GST), cyclooxygenase (COX)-1 and COX-2 inhibitory activities. Combination cytotoxicity assays were utilised to identify agents which possess synergistic potential in MRP-1-expressing cell lines. MRP-1 Inside Out Vesicles (IOVs) were utilised to demonstrate the ability of the indomethacin analogues to inhibit the pump directly. Most of the indomethacin analogues active as MRP-1 inhibitors were poor GST inhibitors when compared with the GST-inhibitory activity of indomethacin. Two of the MRP-1 inhibitory analogues were found to have no COX-1 inhibitory activity and low COX-2 inhibitory activity, suggesting potentially reduced clinical toxicity. One MRP-1 inhibitory indomethacin analogue was also found to have low COX-1 inhibitory activity, but significant COX-2 inhibitory activity, making this analogue again interesting in terms of low potential toxicity, but with the possibility of direct inhibitory effects on tumour growth.

Cyclooxygenase 1↗
PubMed2001

Rhinocerebral zygomycosis in childhood acute lymphoblastic leukaemia.

The hazards associated with invasive candidiasis and aspergillosis in oncology patients are well recognised. These conditions typically present late in treatment, often after prolonged or recurrent episodes of neutropenia. We report the occurrence of Absidia corymbifera infection causing rhinocerebral zygomycosis in two children with acute lymphoblastic leukaemia, early in the induction phase of treatment and within a 3-month interval, in the same oncology unit. The initial presentation of facial pain was rapidly followed by the development of cranial nerve palsies, cavernous sinus thrombosis, diabetes insipidus, seizures and death within 9 days of symptom onset, despite aggressive management with high-dose liposomal amphotericin (Ambisome), surgical debridement and local instillation of amphotericin solution. These cases highlight the need for awareness of zygomycosis as a potentially lethal fungal infection that can present even with short duration exposure to the usual risk factors. Their occurrence within a limited time period raises questions as to the relative importance of environmental exposure. The failure of medical and surgical intervention to impact on the course illustrates the need to develop appropriate preventative strategies which may have to incorporate measures to reduce the environmental exposure of susceptible patients.

Absidia↗
PubMed2001

Prevalence of dental trauma in 5-6- and 12-14-year-old boys in Riyadh, Saudi Arabia.

This study involved 354 boys aged 5-6 years and 862 boys aged 12-14 years, attending 40 schools in Riyadh. All children were examined at school by a single dental examiner, using criteria similar to those employed in the survey of children's dental health in the United Kingdom. The prevalence of dental trauma in 354 Saudi boys aged 5-6 years was 33%. The most common type of dental trauma was fracture of enamel (71%) followed by loss of tooth due to trauma (13%), fracture into enamel and dentine (7%), discolouration (5%), pulp involvement (4%). No relationship between the degree of overjet and the occurrence of dental trauma in the primary dentition was observed. The prevalence of dental trauma in 862 12-14-year-old boys was 34%. The commonest dental trauma was fracture of enamel (74%) followed by fracture into enamel and dentine (15%), fracture into enamel-dentine and pulp (5%), loss of tooth due to trauma (3%), and discolouration (0.4%). A significant relationship (P=0.02) between the increased overjet (> or = 6 mm) and the occurrence of dental trauma in the permanent dentition was reported. The present study found no evidence of dental care provided for traumatised primary incisors in 5-6-year-old boys. The treatment of dental trauma in 12-14-year-old boys was negligible (2.4%). The present Saudi Arabian study showed higher prevalence of dental trauma in 5-6- and 12-14-year-old boys than the reported results of the United Kingdom Children's Dental Health Survey of the same age groups.

Adolescent↗
PubMed2001

Comparison of the effects of intravenous alfentanil and esmolol on the cardiovascular response to double-lumen endobronchial intubation.

We compared the effect of alfentanil 10 microg.kg-1 and esmolol 1.5 mg.kg-1 on the cardiovascular responses to laryngoscopy and double-lumen endobronchial intubation in two groups of 20 ASA 2-3 patients undergoing pulmonary surgery, in a randomised double-blind study. Arterial pressure and heart rate decreased after induction of anaesthesia and increased after intubation in both groups (p < 0.05) but remained at or below baseline values, and changes were comparable in both groups. Plasma catecholamine concentrations decreased after induction of anaesthesia in both groups (p < 0.05). Epinephrine concentrations increased in the esmolol group after intubation (p < 0.05) but remained below baseline in the alfentanil group (p < 0.05). Norepinephrine concentrations increased significantly in both groups after intubation but were higher in the esmolol group (p < 0.05). Although both esmolol 1.5 mg.kg-1 and alfentanil 10 microg.kg-1 similarly attenuated the arterial pressure and heart rate response to endobronchial intubation, plasma catecholamine concentrations increased in the esmolol group to values greater than previously reported after tracheal intubation.

Adrenergic beta-Antagonists↗
PubMed2001

X-linked cerebellar ataxia and sideroblastic anaemia associated with a missense mutation in the ABC7 gene predicting V411L.

Two brothers with X-linked ataxia (XLA) were found to have hypochromic red cells and increased erythrocyte protoporphyrin despite normal iron stores. The mother was unaffected by ataxia and had normal iron stores but showed evidence of some red cell hypochromia with heavy basophilic stippling that stained positive for iron. Bone marrow biopsy confirmed the presence of ring sideroblasts in one of the brothers. The absence of mutations in the ALAS2 gene and the predominance of zinc over free protoporphyrin led to a search using a combination of DNA and cDNA analysis for the presence of mutations in the ABC7 gene. ABC7 encodes a mitochondrial half-type ATP Binding Cassette transporter involved in iron homeostasis. The published cDNA sequence was used to search databases for the genomic sequence of which 12 exons spanning 23.4 kb were mapped leaving the most 5' nucleotides unaccounted for. The identified exons and their exon-intron boundaries were amplified from DNA while the most 5' sequence including the initiation codon was amplified from cDNA of peripheral blood cells. Direct sequencing revealed hemizygosity in the brothers and heterozygosity in the mother for a G-->C transversion at position 1299 of the published cDNA. This predicts a V411L substitution at the beginning of the last of six putative transmembrane regions of the protein. Restriction enzyme digestion confirmed the presence of this mutation in the three family members but could not detect it in 200 normal alleles. An uncle affected by ataxia also carried this mutation. This study supports the recently hypothesized involvement of the ABC7 gene in XLSA/A and highlights a protein structure region of importance to this syndrome.

ATP-Binding Cassette Transporters↗
PubMed2001

External beam irradiation of subfoveal choroidal neovascularization complicating age-related macular degeneration: one-year results of a prospective, double-masked, randomized clinical trial.

OBJECTIVES: To determine the effects of low-dose external beam irradiation compared with observation on the visual function of eyes with subfoveal choroidal neovascularization (CNV) complicating age-related macular degeneration (ARMD). DESIGN: Prospective, double-masked, randomized clinical trial. Patients randomized to the radiation group received external beam irradiation at a dose of 14 Gy in 7 fractions of 2 Gy. Patients randomized to the observation group received sham radiation. SETTING: Tertiary care retinal referral practice. PATIENTS: Individuals with classic, mixed, or occult subfoveal CNV secondary to ARMD. MAIN OUTCOME MEASURES: Change in visual acuity from baseline to specified time periods. Secondary outcome variables were contrast sensitivity and fundus photographic/fluorescein angiographic progression. RESULTS: Forty-two eyes were randomized to observation; 41 eyes, to radiation. Baseline characteristics and demographics did not differ between groups. The median distance visual acuity (DVA) in radiation-treated eyes decreased from 20/80 at baseline to 20/320 (mean loss rate, 4.14 lines) at 1-year follow-up. The median DVA in observation group eyes decreased from 20/125 at baseline to 20/250 (mean loss rate, 3.39 lines) at 1-year follow-up. There were no statistically significant differences in changes in DVA, contrast sensitivity, or fluorescein angiographic progression from baseline between groups at any follow-up period. CONCLUSIONS: At 1-year follow-up, low-dose external beam irradiation at 14 Gy in 7 fractions of 2 Gy is neither beneficial nor harmful for subfoveal CNV complicating ARMD.

Aged↗
PubMed2000

Prevalence of long-term use of medicines with prolonged oral clearance in the elderly: a survey in north east England.

AIM: To determine the prevalence of long-term use by the elderly of prescribed and over-the-counter (OTC) medicines with prolonged oral clearance (POC), with regard to sugars content, dose form and therapeutic groups of medicines used. DESIGN AND SETTING: Two cross-sectional observational surveys in ten general medical practices in north-east England during 1996. METHODS: Computerised patient records of all elderly patients (aged 60 years and over) were surveyed for prescribed medicines use. Within these practices, 50% of elderly patients registered with ten general medical practitioners were surveyed by postal questionnaire to assess over-the-counter (OTC) medicines use. RESULTS: Of 20,731 elderly patients registered, prevalence of use of prescribed prolonged oral clearance (POC) medicines was 9.8% (95% CI: 8.2%, 11.3%) and use in females aged 75 years and older was significantly more likely (P < 0.0001). Of 2,796 prescribing instances (PIs) for 143 POC medicines used long-term, 53% were gastrointestinal and 72% were sugars-free; however, 82% of 542 PIs for generic liquids were sugars-containing compared with 8% of 685 PIs for proprietary liquid oral medicines. Of 1,532 elderly respondents to a postal questionnaire, 17 were using 13 different OTC medicines with POC regularly and long-term (mean prevalence; 1.1%). Of the 17 instances of regular long-term use of OTC medicines, 59% were sugars-free. CONCLUSIONS: Prescribed medicines represent the bulk of regular, long-term medicines use in the elderly. Generic prescribing is more likely to result in sugars-containing medicines being dispensed. Generic medicines manufacturers must be encouraged to provide sugars-free alternatives to POC medicines used long-term, and health professionals should be vigilant when prescribing and dispensing these medicines to the increasingly dentate elderly.

Administration, Oral↗
PubMed2000

Adaptation of dental plaque to metabolise maltitol compared with other sweeteners.

UNLABELLED: There is some evidence that plaque can adapt to regular exposure to some bulk sweeteners, leading to increased metabolism and acidogenic potential of the sweetener. This potential for adaptation varies between non-sugar sweeteners and has important implications for manufacturers of food, confectionery and medicines used long-term. Maltitol (99% purity crystalline D-maltitol) is a relatively newly approved non-sugar sweetener and appears to have potentially good dental properties. OBJECTIVES: To compare plaque adaptation to pure sucrose, sorbitol, xylitol or maltitol and the effect of their prolonged use on acid production by plaque from sucrose, in vivo. METHODS: Two series of plaque pH experiments were carried out. Each experiment involved a 14 day adaptive period when four 5 g lozenges of the sweetener were taken between meals each day. Each experiment was separated by a 14 day wash-out period. Acid production was quantified as: (a) minimum pH; and (b) cH area (difference between plaque pH curve and resting value, expressed as cH units). RESULTS: Thirteen adults, of mean age 41 years completed the study. When adaptation of dental plaque to the metabolism of sweeteners was compared, there was a statistically significant difference (p = 0.033) between xylitol and sorbitol, and between xylitol and sucrose but not between xylitol and maltitol. When the effect of prolonged use of sweeteners on acid production after sucrose rinsing was compared, there were no statistically significant differences between the sweeteners. CONCLUSION: Dental plaque does not adapt to metabolise xylitol or maltitol following prolonged exposure over 14 days.

Adaptation, Physiological↗
PubMed2000

Consumption of prescribed and over-the-counter medicines with prolonged oral clearance used by the elderly in the Northern Region of England, with special regard to generic prescribing, dose form and sugars content.

As the longevity and population of elderly people has increased, the use of regular long-term medication for chronic medical problems has become more common. Medicines with prolonged oral clearance, for example syrups and chewable tablets, are commonly used in the elderly, many of whom retain their natural teeth into old age. These medicines may threaten dental health if they contain acidogenic sugars and are used long-term. As a part of an overall study of medication use in the elderly, three surveys were undertaken to assess the numbers of prescriptions and quantities of prescribed and 'over-the-counter' medicines with prolonged oral clearance dispensed during a 1 y period (1994), nationally and regionally. Of the 0.51 million litres of liquid oral medicines dispensed potentially for regular and long-term use by the elderly in the Northern Region in 1994, 94% was prescribed in primary care and 4% was sold over-the-counter from community pharmacies. When the effect of generic prescribing upon the sugars content of these medicines was considered, 96% of the volume of proprietary liquid oral medicines dispensed in primary care was sugars-free compared with 9% of generic liquid oral medicines. Of the 0.1 million litres of 'over-the-counter' liquid oral medicines sold in the Northern Region during 1994, 49% were sugars-free. In conclusion, although many prolonged oral clearance medicine preparations are sugars-free, due to generic prescribing a large proportion of the quantities dispensed for possible long-term use in the elderly are sugar-containing liquid oral medicines. In view of the increasing numbers of dentate elderly who require long-term medication, this is of some concern. The role of health professionals in raising awareness of the impact of generic prescribing on the sugars content of medicines is crucial if consumers are to benefit from the sugars-free option.

Administration, Oral↗