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Biomedical subjects

A Senthilselvan

Publications and source records attributed to A Senthilselvan.

At least 19 recordsLinked to original sources
PubMed1998

Effect of impact and injury characteristics on post-motor vehicle accident temporomandibular disorders.

OBJECTIVES: The objective of this study was to assess the potential effects of motor vehicle accident impact and injury characteristics on post-motor vehicle accident temporomandibular disorders in terms of presenting signs and symptoms, diagnoses, treatment regimens, and outcomes. STUDY DESIGN: A retrospective chart review of 50 patients with post-motor vehicle accident temporomandibular disorders from a private oral medicine practice was undertaken. Various demographic data and data related to temporomandibular disorders and motor vehicle accident impact and injury characteristics were collected. Chi-square and Fisher exact tests and multiple regression analyses were performed. RESULTS: Patients involved in front-end collisions or motor vehicle accidents resulting in severe vehicle damage reported more direct orofacial injury. However, those in rear-end collisions or accidents resulting in minimal vehicle damage required more treatment. Direct head or orofacial injury was therefore not a prognostic indicator. From multiple regression analyses, indicators of a poorer prognosis were minimal vehicle damage, lack of headrest use, driver position, and settlement of insurance claim. CONCLUSIONS: In this patients group several prognostic indicators for patients with post-motor vehicle accident temporomandibular disorders were identified; these indicators may influence the management approach for this patient population.

Accidents, Traffic↗
PubMed1997

The association of cardiovascular disease risk factors with abdominal obesity in Canada. Canadian Heart Health Surveys Research Group.

OBJECTIVE: To assess the degree of association of abdominal obesity with blood pressure and plasma lipid levels and to determine which anthropometric measures of obesity are most closely associated with these cardiovascular risk factors. DESIGN: Population-based, cross-sectional surveys. SETTING: Five Canadian provinces (Alberta, Manitoba, Ontario, Quebec and Saskatchewan) between 1989 and 1992. PARTICIPANTS: A probability sample of 16,007 men and women aged 18 to 74 was selected using health insurance registration files in each province and invited to participate. A complete set of measurements was available for 8974 (56%) adults. OUTCOME MEASURES: Initially, simple correlation analyses by age and sex were performed between the anthropometric variables-body mass index, waist circumference (WC), hip circumference (HC), ratio of waist to hip circumference (WHR)- and cardiovascular disease risk variables-systolic blood pressure (SBP), diastolic blood pressure (DBP), levels of total cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and triglycerides (TRIG) and the TC/HDL ratio. Canonical correlation analyses were performed to determine the multivariate associations between the anthropometric and risk variables. RESULTS: The simple correlations between anthropometric variables and cardiovascular disease risk variables were highest for SBP; moderate for DBP, HDL, TRIG and TC/HDL; and lowest for LDL and TC. Of the anthropometric variables, WC demonstrated the greatest correlations with the risk variables. The first canonical correlations were significant (p < 0.0001) in men (0.58) and women (0.61) of all ages. Of the anthropometric variables, WC consistently demonstrated the highest loading values in the first canonical variable in men (0.56) and women (0.59). Of the risk variables in both sexes, the loadings of TRIG were generally the largest, those of HDL, SBP, DBP intermediate and those of LDL the smallest. In men, the strength of these associations generally decreased with age, whereas in women they peaked in the 35-54 year age group. CONCLUSION: Considerable association was seen between measures of abdominal obesity and blood pressure and plasma lipid levels. WC is the measure of abdominal obesity most highly correlated with these cardiovascular disease risk factors.

Abdomen↗
PubMed1997

Temporomandibular disorders, headaches, and neck pain after motor vehicle accidents: a pilot investigation of persistence and litigation effects.

STATEMENT OF PROBLEM: There is a lack of long-term follow-up studies that involve post-motor vehicle accident temporomandibular disorders and compensation. PURPOSE OF STUDY: The purposes of this retrospective pilot study were (1) to assess patients who had previously been treated for temporomandibular disorders after motor vehicle accidents to determine the nature of their symptoms in terms of jaw, head, and neck pain and jaw dysfunction and (2) to determine whether there was a difference in the pain and dysfunction between those who had settled and those who had not settled their insurance claims. MATERIAL AND METHODS: Thirty previously treated patients with temporomandibular disorders after motor vehicle accidents were questioned by telephone regarding litigation status and current jaw, head, and neck pain and jaw dysfunction symptoms. They did not differ substantially from a smaller group who were not able to be interviewed. Descriptive statistics were calculated and statistical tests were performed. A total of 22 patients had their claims settled. RESULTS: Approximately three fourths had persistent complaints of jaw pain, jaw dysfunction, and headache, and more than 80% reported persistent neck pain. No apparent differences were found between those who had and had not settled their insurance claims. CONCLUSION: Jaw, head and neck pain, and jaw dysfunction continued to be problems for the majority of this patient population, regardless of litigation status in this retrospective study.

Accidents, Traffic↗
PubMed1997

Observer error and birthweight: digit preference in recording.

We investigated the presence of digit preference in the recording of birthweight by a retrospective analysis of an official dataset of birth registrations. All births occurring in the Province of Saskatchewan in Canada from 1981 to 1991, but excluding 1988, were considered for this analysis. Preference for the terminal digit 0 increased progressively with increasing birthweight over the whole range of birthweights. Correction for digit preference led to an increase of 1.8% in the number of low birthweight babies and a concomitant increase of 0.1% in the actual incidence of low birthweight. Epidemiological applications of birthweight should take into account the observer error caused by digit preference.

Bias↗
PubMed1997

Positive human health effects of dust suppression with canola oil in swine barns.

A crossover trial was conducted to evaluate the acute human health effects of a dust control technology in a swine confinement facility. Twenty lifetime nonsmoking male subjects, with no evidence of allergy or asthma and no previous swine barn exposure, participated in the study, which included a laboratory session (baseline), 5-h exposure in a swine room sprinkled with canola oil (treatment) and 5-h exposure in a traditional swine room (control). Mean values of inhalable dust concentrations and endotoxin levels in the control room were significantly greater than those observed in the treatment room. Mean shift changes in FEV1 from preexposure to end of exposure were 1.1% (standard error, 0.63%) on baseline day, -1.9% (0.63%) on treatment day, and -9.9% (1.12%) on control day; the differences in the shift changes were statistically significant. Mean value of methacholine concentration that reduced the FEV1 by 20% (PC20) in bronchoprovocation tests on baseline day was significantly different from that on treatment day (p = 0.04) and that on control day (p < 0.001). Significant increases were also observed in white blood cell counts and nasal lavage cell counts on the control day in comparison with the other two days. Blood neutrophil counts after control room exposure were twice those observed on baseline and after exposure to the treatment room. Significant differences were also observed in IL-1 beta, IL-6, and IL-8 nasal lavage cytokines and in IL-6 serum cytokine. These results suggest that the canola oil dust control method is effective in improving indoor air quality in swine barns and reducing acute health effects in naive healthy subjects.

Adolescent↗
PubMed1997

Accelerated lung function decline in swine confinement workers.

We conducted a longitudinal study to determine the annual rate decline in pulmonary function measurements in male swine confinement workers. For comparison, a grain farming group and a nonfarming rural-dwelling control group were also chosen for the longitudinal study. Two hundred seventeen swine confinement workers, 218 grain farmers, and 179 nonfarming control subjects had valid pulmonary function measurements at the baseline observation conducted in 1990 to 1991 and at the second observation conducted in 1994 to 1995. The swine confinement workers were younger (mean age=38.3+/-11.7 [SD] years) than the nonfarming control subjects (42.6+/-10.4 years) and the grain farmers (44.5+/-11.9 years). When stratified by age, nonfarming control subjects had the lowest mean annual rate decline in FEV1 and FVC in all age categories. The swine confinement workers had the largest annual rate decline in FEV1 and FVC, and this was most obvious in the middle age categories. After controlling for age, height, smoking, and baseline pulmonary function, swine confinement workers had excess annual decline of 26.1 mL in FEV1 (p=0.0005), 33.5 mL in FVC (p=0.0002), and 42.0 mL/s in forced expiratory flow between 25% and 75% of FVC (FEF[25-75%]) (p=0.02) over nonfarming control subjects. Grain farmers had excess annual decline of 16.4 mL in FEV1 (p=0.03), 26.7 mL in FVC (p=0.002), and 11.2 mL/s in FEF(25-75%) (p=0.38) over control subjects. These findings suggest that workers engaged in the swine industry and grain farmers appear prone to accelerated yearly losses in lung function and may therefore be at risk for the future development of chronic airflow limitation.

Adult↗
PubMed1997

A comparison of TMD patients with or without prior motor vehicle accident involvement: initial signs, symptoms, and diagnostic characteristics.

The role of trauma in the etiology of temporomandibular disorders (TMD) is controversial. The objectives of this study were to compare presenting signs, symptoms, and diagnoses in patients who had motor vehicle accident trauma-related TMD to patients who had nontrauma-related TMD. Files of 50 trauma and 50 matched nontrauma TMD patients were reviewed. Information concerning presenting pain, temporomandibular joint (TMJ) and related symptoms, examination findings, and diagnoses was recorded. Posttraumatic TMD patients reported higher facial (P = .006) and headache (P = .0001) pain ratings, neck symptom frequency (P < .01), ear-related symptoms (P = .02), sleep disturbance (P < .001), and occupational and avocational disability frequencies (P < .0001). They had greater masticatory muscle (P < .001), neck muscle (P < .001), and TMJ tenderness (P = .01) scores and myofascial pain (P = .006) and arthralgia/capsulitis (P = .008) diagnoses. The nontrauma group had more subjective (P = .02) and objective (P = .05) TMJ crepitus and higher self-reports of parafunctional jaw habits (P = .05). Trauma may be an important etiologic factor for some TMD patients.

Accidents, Traffic↗
PubMed1997

A comparison of TMD patients with or without prior motor vehicle accident involvement: treatment and outcomes.

The influence of previous trauma in the management of patients with temporomandibular disorders (TMD) is controversial. The objectives of this study were to compare treatment regimens and outcomes in motor vehicle accident trauma-related versus nontrauma-related TMD patients. Files of 50 trauma and 50 matched nontrauma TMD patients were reviewed. Information concerning treatment received, progress of symptoms with treatment, and findings from the final examination were recorded. As a whole group, posttraumatic TMD patients tended to receive more types of treatment (P < .0001), have more medications prescribed (including analgesics, P < .001; nonsteroidal anti-inflammatory drugs, P = .001; muscle relaxants, P = .001; and tricyclic antidepressants, P < .001), have more oral medicine clinic visits (P = .07) over a longer period of time (P = .06), and have a poorer treatment outcome (P < .001) as compared to the nontrauma group. When the patients were separated into TMD diagnostic classification subsets, only some of these differences between trauma and nontrauma patients were seen, but the subset group sizes were small and only a few of the groups could be compared. There did not seem to be a significant effect from settling insurance claims prior to the last clinic visit. Trauma may be an important prognostic factor in the management of some TMD patients.

Accidents, Traffic↗
PubMed1996

Persistent wheeze in grain elevator workers should not be ignored.

We investigated the relationship between annual change in pulmonary function and changes in respiratory symptoms among male grain elevator workers who participated in a health surveillance program mandated by Labour Canada. The surveillance was conducted every 3 yr starting from the period 1978 to 1981. The 1,211 workers who participated in the second (1981 to 1984) and fifth (1990 to 1993) surveillance were included in the analysis and the mean duration of the follow-up was 8.6 yr. In the analysis we also included the pulmonary function measurements that were available for some subjects at the third and fourth surveillance. The subjects who reported persistent wheeze had the largest mean annual rate change in FEV1 (-44.4 ml/yr) and FVC (-55.3 ml/yr). When adjusted for age, height, weight change, smoking, baseline lung function, location of grain elevators, and duration of employment, the subjects with persistent wheeze had an annual rate change of -28.3 ml/yr (SE 10.5; p = 0.007) in FEV1 and -37.3 ml/yr (SE = 12.3; p = 0.003) in FVC in comparison to subjects without any respiratory symptoms. The subjects who reported new onset of wheeze had significantly greater annual rate changes only in FEV1 (-13.7 ml/yr; SE 6.0; p = 0.02) in comparison to asymptomatic subjects' symptoms. Persistent wheeze is an important predictor of decline in lung function among grain elevator workers and should not be ignored in surveillance programs or clinical evaluations.

Adolescent↗
PubMed1995

Increased asthma hospitalizations among registered Indian children and adults in Saskatchewan, 1970-1989.

We investigated asthma morbidity in children and adults among Registered Indians in Saskatchewan using hospitalization data for 1970-1989. In Registered Indians, significant increases were observed in the asthma hospitalization rates from 1979 to 1989 in boys and girls under 4 years, boys aged 5-14 years, and female adults aged 15-34 years respectively. In children under 4 years, the asthma hospitalization rates increased from 12.7 per 1000 in 1979 to 21.7 per 1000 in 1989. Asthma hospitalizations were higher among Indian boys than girls in the age group 0-4 years but this was reversed in the age groups 15-34 and 35-64 years. When compared with other Saskatchewan populations, the Indian population in age groups 0-4 and 35-64 years had significantly increased risk for hospitalization for asthma. Even though asthma was reported to be rare among Indians before 1975, we observed increases in asthma morbidity in recent years among Indian children and young adults.

Adolescent↗
PubMed1995

Effect of readmissions on increasing hospital admissions for asthma in children.

BACKGROUND: Previous studies have reported increases in the number of hospital admissions for asthma in children. The aim of the present study was to examine the effect of readmissions on these increased hospital admissions and to investigate gender differences in asthma readmissions. METHODS: The Provincial Government of Saskatchewan provides universal health care to its residents. Hospital admissions data for asthma were obtained from the Saskatchewan Health Department for all 134 hospitals in the province between 1980 and 1989. Age-specific and sex-specific hospital admission rates for asthma were calculated for each calendar year using first admissions and all admissions. The ratio between the number of readmissions and all admissions in a year was defined as the readmission rate for that year. RESULTS: Although rates based on all admissions for asthma were greater than rates based on first admissions, trends and sex differences were similar for the two rates. Despite the higher hospital admission rates for boys aged 10-14 years, girls in this age group had higher readmission rates for asthma from 1981 to 1989 (odds ratio (OR) 1.6 for girls; 95% confidence intervals (CI) 1.3 to 1.9). Similar increases were observed in readmission rates for asthma among children aged 5-9 years from 1985 to 1989 (OR 1.3 for girls; 95% CI 1.1 to 1.5). CONCLUSIONS: Readmissions for asthma do not seem to explain the increasing trend in hospital admissions for asthma in children. In children aged 10-14 years girls had higher hospital readmission rates for asthma than boys, and further studies are required to find factors related to the increased readmissions among girls in this age group.

Adolescent↗
PubMed1994

Longitudinal estimates of pulmonary function decline in grain workers.

We conducted a cohort analysis of longitudinal changes in pulmonary function test values in male grain elevator workers in five regions of Canada over a 6-yr period involving three observations. Pulmonary function tests were obtained approximately each 3 yr during an observation interval called a "cycle". The periods of the cycles were 1978-81 (Cycle I), 1981-84 (Cycle II), and 1984-87 (Cycle III), respectively. Data on respiratory symptoms and pulmonary function tests were collected on the same 881 workers in Cycles I and II (mean ages +/- SE: 37.0 +/- 0.48 yr at Cycle I), on the same 1,294 workers in Cycles I, II, and III (34.6 +/- 0.34 yr at Cycle I), and on the same 1,021 workers in Cycles II and III (33.9 +/- 0.38 yr at Cycle II) for a total of 3,196 workers with two or more observations over the 6-yr period. The proportion of current smokers decreased from Cycle I to Cycle III. Autoregression analysis of longitudinal changes in lung function data showed that predictors of FEV1 were height, years in the industry, smoking status, and geographic region. The mean annual losses in FEV1 (FVC) were 28.7 ml (26.4 ml), 38.4 ml (41.9 ml), and 41.7 ml (32.3 ml) for nonsmokers, ex-smokers, and current smokers, respectively. The annual loss of FEV1 (FVC) was 9.2 ml (21.1 ml) for those who were in the grain industry for less than 5 yr and 52.6 ml (60.8 ml) for those who were exposed for 20 yr or more.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Predictors of asthma and wheezing in adults. Grain farming, sex, and smoking.

We investigated predictors for asthma and wheeze in 1,634 men and women in the age group 20 to 65 yr from the town of Humboldt, Saskatchewan. On the basis of questionnaire responses, subjects were classified into mutually exclusive groups as asthmatic (n = 62), wheezing (n = 444), asymptomatic (n = 908), and symptomatic (n = 220) groups. After excluding the symptomatic group, we used polytomous logistic regression models to determine predictors of asthma and wheezing. Significant predictors for asthma were grain farming (odds ratio [OR] = 1.9, 95% confidence interval [Cl]: 1.1-3.5; p = 0.03) and sex (OR = 1.9, Cl: 1.1-3.2; p = 0.03; males compared with females). Significant predictors for wheezing were smoking (former smoker: OR = 1.8, Cl: 1.3-2.5, p < 0.001; current smoker: OR = 5.0, Cl: 3.8-6.7, p < 0.001; in comparison to nonsmoker) and grain farming (OR = 1.7, Cl: 1.3-2.4, p < 0.001). Age, level of education, and physical activity at work were not significant predictors for asthma or wheezing. None of the interaction effects between the predictors was significant. When stratified by sex, grain farming was a significant predictor of asthma in men but not in women. Nevertheless, smoking and grain farming were significant predictors of wheezing in both men and women. Our study raises the possibility that grain farming might be a risk factor for asthma and asthma-like symptoms.

Adult↗
PubMed1993

Relationship between pulmonary test variables and asthma and wheezing: a validation of self-report of asthma.

We investigated the relationship between the pulmonary test variable measurements and self-reported asthma and wheezing from a cross-sectional study conducted in Saskatchewan. Based on the responses to the questionnaire, the subjects were classified into asthmatic, wheezing, and asymptomatic groups. For both male and female subjects the mean values of forced expiratory volume in 1 s (FEV1), forced expiratory flow during the middle half of the forced vital capacity (FEF25-75), and FEV1/FVC ratio were lowest in asthmatics, followed by wheezing and asymptomatic groups, respectively. This trend was also observed in forced vital capacity (FVC) for men but not for women. After adjusting for current smoking status, the trend in the means across the three groups was statistically significant in men for FEV1 (p = 0.03), FEF25-75 (p = 0.002), and FEV1/FVC ratio (p = 0.002) and in women for FEF25-75 (p < 0.001) and FEV1/FVC ratio (p < 0.001). The differences in the adjusted means of FVC, FEV1, FEF25-75, and FEV1/FVC ratio between asymptomatic subjects and the other two groups were significant in both male and female subjects. Significant differences were also observed between asthmatics and wheezing groups in the adjusted means of FEF25-75 and FEV1/FVC ratio in male and female subjects. We conclude that the self-report of asthma has a high level of validity against the criterion of concurrently measured pulmonary test variables.

Adult↗
PubMed1992

Air quality and respiratory disease in Newcastle, New South Wales.

OBJECTIVE: To investigate respiratory illnesses in the Newcastle region, their change over time, and their geographic relationship to industrialised areas. DESIGN: We analysed admissions to public hospitals by postcode area in the Newcastle region, for all causes and for all the various respiratory causes, for the years 1979-1988. Comparisons were made between the State of New South Wales and the Newcastle area, and between geographic areas within Newcastle. Changes over the 10-year period were noted. RESULTS: For both all causes and respiratory causes, admission rates to Newcastle hospitals, 1979-1988, were significantly lower than those for the rest of New South Wales in 1986. There was a correlation between living in the industrial part of the city and hospital admission for all causes and respiratory causes. There was also a correlation between mean disposable family income and hospital admissions, with those areas with the higher incomes having lower admission rates. Over the 10 years studied there was a statistically significant decline in admissions for respiratory causes, both in absolute terms and after controlling for changes in admissions for all causes. In children aged 0-14 years a significant increase in admissions for asthma occurred between 1979 and 1988, which could not be explained by diagnostic shift. CONCLUSIONS: On the basis of hospital statistics, the members of the Newcastle population seem little different from those in the remainder of New South Wales. From 1979-1988, the efforts by industry, with the support of the community, to reduce industrial pollution have been accompanied by a reduction in hospital admission rates for respiratory diseases in general and for chronic obstructive lung disease in older people. Other contributing factors include reduced smoking rates and improved medical management. Correlations between geographic location and respiratory admission rates may be a manifestation of social class rather than poor air quality, although a contribution from the latter cannot be discounted. A concomitant rise in asthma admission rates in children aged 0-14 is likely to be unrelated to any change in air quality.

Adolescent↗
PubMed1992

Improving presentation skills of family medicine residents: a randomized controlled study.

A randomized controlled time series design was used to evaluate the influence of an educational intervention designed to improve the presentation skills of family medicine residents. Each resident gave three presentations, with the educational intervention occurring between the first and second presentations in the experimental group, and between the second and third presentations in the control group. The presentations were evaluated using a standardized format. The experimental group, in contrast to the control group, showed significant improvement in scores for all major criteria after receiving the educational intervention between presentations 1 and 2. This improvement continued with repetition between presentations 2 and 3. After receiving the educational intervention between presentations 2 and 3, the control group also demonstrated significant improvement in several key areas. We conclude that an educational intervention can improve the presentation skills of family medicine residents. Education coupled with repeated opportunities for presentation will produce a greater improvement in resident performance than repeated presentations alone.

Clinical Competence↗
PubMed1992

Evaluation of a new periodontal curet. An in vitro study.

Removal of plaque and calculus from subgingival root surfaces is a fundamental aspect of periodontal therapy. A new type of periodontal curet (Gracey Curvette Sub-0) has been designed to better adapt to the root surfaces that may be encountered in periodontal pockets of incisor teeth. The new curet (test) was compared to a Gracey curet 1/2 (conventional) in their ability to remove deposits from the subgingival root surfaces of incisor teeth in an in vitro model. A dentiform model mounted on a dental chair was used with artificial gingiva, 6 mm pocket depths and subgingival root surfaces covered with black enamel paint. 2 groups of 12 hygienists used, on a timed basis, either the test or conventional curet on 4 of the incisor teeth and then switched to the alternate instrument for the remaining four incisors. The extent of surface material removal was determined using a computerized video routine. The test curet removed significantly (p less than 0.001) more of the surface material from all subgingival incisor root surfaces than the conventional curet (60.7% versus 46.3%). Both instruments were most effective at labial surfaces. The test curet was least effective at proximal surfaces and the conventional curet least effective at lingual surfaces. The greatest statistical difference between instruments was apparent at lingual surfaces of maxillary incisors and the least at mesial surfaces of mandibular incisors.

Alveolar Bone Loss↗
PubMed1992

Association of asthma with use of pesticides. Results of a cross-sectional survey of farmers.

We investigated the association of self-reported asthma and pesticide use in 1,939 male farmers. Regardless of age, smoking pack-years, and nasal allergic reactions, the prevalence of asthma was significantly associated with the use of carbamate insecticides (prevalence odds ratio = 1.8, 95% confidence interval: 1.1 to 3.1, p = 0.02). Self-reported asthmatics, in comparison with nonasthmatics, had significantly lower mean values for lung function test variables after adjusting for age and height and a higher prevalence of respiratory symptoms. These findings raise the possibility that exposure to agriculture chemicals could be related to lung dysfunction in exposed farmers.

Adult↗