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Biomedical subjects

B Chadwick

Publications and source records attributed to B Chadwick.

At least 19 recordsLinked to original sources

The reported impact of oral condition on children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys of the United Kingdom. AIMS: This paper is concerned with how children are reported to have been affected by their oral condition during the 12 month period immediately preceding the survey and how this relates to the children's experience of caries, their dental attendance behaviour and their social class. METHOD: The information was gathered by self-completion questionnaire distributed to the parents of half of the sample who were clinically examined in the dental survey. RESULTS: Some form of impact was reported by the parents of 22% of five-year-olds, 26% of eight-year-olds, 34% of 12-year-olds and 28% of 15-year-olds. The pattern of responses to the eight impact questions was broadly similar across age groups. The most frequently reported type of impact was pain in all age groups. Impacts on oral function, self-confidence, orally related activity and on the child's emotions were experienced by 4-10% of children of all ages. Fewer children (1-2%) were reported to have experienced more far reaching impacts affecting their social functioning, general health and life overall. CONCLUSIONS: Most children were reported not to have experienced any of the problems covered by the questionnaire. Of those who did, most reported a single problem and for most this was pain. Nevertheless there was a group of children for whom oral function, self-confidence, orally related activity, emotions, social functioning, their health or their life in general were reported to have been affected by their oral condition. The nature of dental care which is appropriate for such children needs to be determined.

Adolescent↗

The dentinal caries experience of children in the United Kingdom, 2003.

BACKGROUND: The 2003 Children's Dental Health Survey is the fourth in a series of decennial national children's dental health surveys. AIMS: This paper reports the survey-derived estimates of dentinal caries experience of children aged five, eight, 12 and 15 years, considering the trends over recent decades and the position in 2003 following changes in disease presentation and the use of additional criteria. METHODOLOGY: A representative UK sample of children in the four specified age groups were invited to participate in a clinical dental examination in school. A total of 12,698 children were sampled and 10,381 were examined (82%). Examinations were undertaken in school by trained and calibrated examining teams using reclining chairs and portable lights, the criteria were visual, limited to dentine caries and no diagnostic aids were employed. In order to compare trend data with 1993 and earlier surveys the criteria allowed the re-classification of the full 2003a results (those including cavities and visual dentine caries - D(3cv)MFT/d(3cv)mft) according to the previous criteria to produce results labelled 2003b (those restricted to dentinal cavities--D(3c)MFT/d(3c)mft). RESULTS AND CONCLUSIONS: The experience of obvious dentinal caries in children within the UK has continued to change over the last decade and patterns are different for the two dentitions. While continuing overall improvements are evident for permanent teeth across the UK (D(3c) for 15-year-old children falling from 42% in 1983, via 30% in 1993 to 13% in 2003 for example), trends amongst those experiencing dentinal caries are more concerning and there have been no statistically significant improvements for primary teeth (the mean number of teeth with obvious dentine decay (d(3c)) at age five years being 1.3 in 1983 and 1.4 in both 1993 and 2003). The inclusion in the criteria of visual dentinal caries resulted in higher estimates of mean caries and mean caries experience in the permanent dentition (at age 15 years D(3) increasing from 0.2 to 0.8, D(3)MFT increasing from 1.6 to 2.0 for example) but not the primary dentition (where the estimates for % d(3)mft at age five years were identical at 43%). Geographic variations also persist across the UK (% with D(3cv)MFT at 12 years being 41% for England, 54% Wales, 73% Northern Ireland and 43% for the UK; % with d(3cv)mft at age 5 years: 41% for England, 52% Wales, 61% Northern Ireland and 43% for the UK). These survey results have implications for planning and for daily practice, but must be interpreted carefully acknowledging the specific survey conditions and diagnostic criteria employed.

Adolescent↗

Tissue-specific expression of a splicing mutation in the IKBKAP gene causes familial dysautonomia.

Familial dysautonomia (FD; also known as "Riley-Day syndrome"), an Ashkenazi Jewish disorder, is the best known and most frequent of a group of congenital sensory neuropathies and is characterized by widespread sensory and variable autonomic dysfunction. Previously, we had mapped the FD gene, DYS, to a 0.5-cM region on chromosome 9q31 and had shown that the ethnic bias is due to a founder effect, with >99.5% of disease alleles sharing a common ancestral haplotype. To investigate the molecular basis of FD, we sequenced the minimal candidate region and cloned and characterized its five genes. One of these, IKBKAP, harbors two mutations that can cause FD. The major haplotype mutation is located in the donor splice site of intron 20. This mutation can result in skipping of exon 20 in the mRNA of patients with FD, although they continue to express varying levels of wild-type message in a tissue-specific manner. RNA isolated from lymphoblasts of patients is primarily wild-type, whereas only the deleted message is seen in RNA isolated from brain. The mutation associated with the minor haplotype in four patients is a missense (R696P) mutation in exon 19, which is predicted to disrupt a potential phosphorylation site. Our findings indicate that almost all cases of FD are caused by an unusual splice defect that displays tissue-specific expression; and they also provide the basis for rapid carrier screening in the Ashkenazi Jewish population.

Alternative Splicing↗

Challenges with studies investigating longevity of dental restorations--a critique of a systematic review.

OBJECTIVES: A systematic review is a method of evaluating the published and unpublished literature relating to a specific area or topic. The objectives of this paper are to identify and discuss problems encountered in synthesising the available literature; and to make recommendations for the future conduct and reporting of clinical trials that aim to determine the longevity of dental restorations. DATA SOURCES: Studies were identified by a wide search of published and unpublished material in any language using a large number of general and specialist data bases, hand searching of key dental journals and searching of abstracts from conference proceedings. STUDY SELECTION: Pre-defined inclusion criteria based on objective outcome measures of restoration longevity and study designs were applied to determine study selection. CONCLUSIONS: A review of the longevity of dental restorations completed recently encountered substantial problems in designing an appropriate protocol to address this issue. The review found that many of the factors reported previously as affecting restoration longevity could not be confirmed using the agreed systematic review protocol that incorporated an objective study design. Further, the multiplicity of study designs, and reporting methods found in the literature made meta-analyses impossible. A proforma is proposed in order to aid the design of future research into the longevity of restorations.

Dental Materials↗

Undergraduate orthodontic & paediatric dentistry education in Europe--the DentEd project.

As a result of a European Union funded project (DentEd), a programme of visits to dental schools throughout Europe has been underway since 1998. This report describes the philosophy behind DentEd, gives a brief description of the features of a visitation, and covers the orthodontic and paediatric dentistry teaching as reported in 26 different dental schools in 16 different countries. It is based on a report submitted to DentEd from a small working group that looked at various aspects of educational provision within the two disciplines across Europe. The value of this information to teachers within the two disciplines and to the wider dental community is briefly discussed. The report recommends the adoption of an integrated course for orthodontics and paediatric dentistry. The main objectives are that the student should be able to understand orofacial and psychosocial growth and development of the child, recognize aberrant growth and development, and manage the behaviour of the child, their straightforward preventive, restorative and occlusal needs, and to make appropriate and timely referral.

Curriculum↗

Sucking cup caries.

Explore the source record for details and available documents.

Child, Preschool↗

Report on the Fifth International Workshop on Chromosome 9 held at Eynsham, Oxfordshire, UK, September 4-6, 1996.

The Fifth International workshop on chromosome 9 comprised a gathering of 36 scientists from seven countries and included a fairly even distribution of interests along chromosome 9 as well as a strong input from more global activities and from comparative mapping. At least eight groups had participated in the goal set at the previous workshop which was to improve the fine genetic mapping in different regions of chromosome 9 by meiotic breakpoint mapping in allocated regions and this has resulted in some greatly improved order information. Excellent computing facilities were available and all contributed maps were entered not only into SIGMA (and thence submitted to GDB) but also into a dedicated version of ACEDB which can be accessed on the Web in the form of one of 28 slices into which the chromosome has been arbitrarily divided. It was generally agreed that the amount of data is now overwhelming and that the integration and validation of all data is not only unrealistic in a short meeting but probably impossible until the whole chromosome has been sequenced and fully annotated. Sequence-ready contigs presented at the meeting totalled about 3 MB which is about one fiftieth of the estimated length. The single biggest barrier to integration of maps is the problem of non-standard nomenclature of loci. In the past 2 workshops efforts have been made to compare traditional 'consensus' maps made by human insight (still probably best for small specific regions) with those generated with some computer assistance (such as SIGMA) and those generated objectively by defined computer algorithms such as ldb. Since no single form of map or representation is entirely satisfactory for all purposes the maps reproduced in the published version of the report are confined to one of the genetic maps, in which Genethon and older markers have been incorporated, a Sigma map of the genes as symbols together with a listing of known 'disease' genes on chromosome 9, and a revised assessment of the mouse map together with a list of mouse loci predicted to be on human chromosome 9. One of the 28 ACEDB slices is also shown to illustrate strengths and weaknesses of this approach. Workshop files include not only all maps available at the time but also details of loci and details of the meiotic breakpoints in the CEPH families (http:/(/)www.gene.ucl.ac.uk/scw9db.shtml) .

Animals↗

A computerised method of monitoring and assessing undergraduate clinical activity.

This article describes the development and use of an electronic data acquisition system for monitoring and assessing the clinical activity of undergraduate dental students. The advantages of such a system over a paper-based one is that it can generate reports quickly and easily, showing the variety of clinical experience gained by the undergraduates and an assessment of the level of skill displayed. It also relieves academic staff of the tedious, repetitive task of collecting and collating data by hand.

Clinical Competence↗

Sequenase sequence profiles used for HLA-DPB1 sequencing-based typing.

Sequencing-based HLA typing (SBT) is a PCR based high resolution HLA typing method in which polymorphic regions of the gene are sequenced and directly used for typing. Currently, for class II SBT, alleles are identified by comparison of the exon 2 sequence with their corresponding allele sequence library. Routine SBT requires reliable identification of heterozygosity, and automated assignment of the alleles. In sequencing strategies different enzymes can be used for primer extension. The most characteristic difference between sequences obtained by two protocols using Sequenaseregistered, or Taq-cycle sequencing, respectively, is a difference in incorporation of nucleotides in the primer extension leading to different sequence profiles. In Taq-cycling sequencing variable nucleotide incorporation results in irregular, but reproducible peak patterns, whereas Sequenase incorporates nucleotides in nearly equal amounts, resulting in more even peak patterns. In a previously published multi-center study we evaluated HLA-DPB1 SBT using Taq-cycle sequencing, and showed that typing can reliably be performed, considering the specific sequence profiles. In this study the applicability of Sequenase for HLA-DPB1 SBT was tested. A panel of samples were typed by SBT at five test sites which participate in the Sequencing Based Typing component of the 12th International Histocompatibility Workshop. The panel represents the existing polymorphism at all known polymorphic positions of exon 2, both in homozygous and heterozygous combinations. The assignment of homozygosity and heterozygosity was validated by Multi-Sequence Analysis, performing cluster analysis of chromatographic data of all sequences at each position. Sequence characteristics were examined and considered for appropriate assignment. Data reveals that Sequenase sequencing can also reliably be used for HLA-DPB1 typing.

Bacteriophage T7↗

The current status of dental health education in the training of midwives and health visitors.

In some areas of the United Kingdom, the dental health of young children is deteriorating, with levels of disease reverting to those of ten years ago. The recent enquiry into the education and training of personnel auxiliary to dentistry recognised that other health care staff working in primary care have an important role to play in the education of parents with young children and should be trained accordingly. This study sought to investigate, by questionnaire survey, the current status of dental health in the education of midwives and health visitors. It was found that the majority of courses in health visiting but only two-thirds of those in midwifery now include dental health in their curricula. The use of inappropriately qualified tutors may place these professionals at a disadvantage in providing advice on the prevention of oral disease to parents and prospective parents.

Adolescent↗

Quantification of lymphadenopathy in experimentally induced feline immunodeficiency virus infection in domestic cats.

Nine cats experimentally infected with feline immunodeficiency virus (FIV) and six FIV-negative cats were necropsied to assess the effect of FIV infection on lymph nodes. The FIV infected cats were inoculated with 10(5) TCID50 21-22 weeks previously. The combined weights of all lymph nodes and the combined lymph node to organ weight ratios were significantly greater in FIV-infected cats when compared to uninfected cats. Additionally, by examining all nodes in the body, a regionally severe lymphadenopathy in FIV-infected cats was evident involving the lymph nodes of the hindlimb, forelimb, and head, in decreasing order of severity, with little evidence of enlargement in lymph nodes of the alimentary tract. Use of 99% confidence intervals showed that 9/9 FIV infected cats had enlarged lymph nodes of the hindlimb and forelimb region. In contrast, 7/9 and 3/9 FIV-infected cats exhibited enlargement of the nodes of the head region and alimentary tract, respectively. Similarly the combined weights of both left and right popliteal lymph nodes were enlarged in 9/9 FIV-infected cats whereas 0/6 in uninfected cats were not. The enlargement of the popliteal lymph nodes observed at necropsy was reflected microscopically by an increase in the size and number of germinal centres and an increase in the number of plasma cells, especially in the medullary cords. Because of the regional variation in lymph node size and numbers, it is suggested that the popliteal lymph node is a good indicator node for the assessment of lymph node status in FIV infection.

Animals↗

Necrotizing meningoencephalitis of Maltese dogs.

The clinical and pathologic features of five young Maltese dogs with a necrotizing meningoencephalitis were studied and compared with published reports of the necrotizing meningoencephalitis of Pug dogs. The ages of the Maltese dogs ranged from 9 months to 4 years. Four dogs were male, and one was female. The dogs had a history of seizures with or without other neurologic signs for 3 days to 20 weeks prior to death. Cerebrospinal fluid examination in three dogs revealed a pleocytosis and elevated levels of protein. At necropsy, the cerebrum was asymmetrically swollen in four dogs, with a loss of distinction between the gray and white matter and mild to moderate asymmetrical dilation of the lateral ventricles. Histologically, there was extensive necrosis and nonsuppurative inflammation of the cerebral gray and white matter, overlying meninges, and adjacent thalamus and hippocampus. The 4-year-old dog had the longest duration of clinical signs and had little inflammation but extensive atrophy of affected areas, with astrocytosis. The clinical course and pathologic changes in these Maltese dogs are indistinguishable from those in reported cases of necrotizing meningoencephalitis of Pug dogs, indicating that this lesion is probably not unique to Pug dogs.

Animals↗

Laband syndrome. Report of two cases, review of the literature, and identification of additional manifestations.

Twenty-six persons with Laband syndrome have been reported in the literature to date. We report two further unrelated cases and suggest that a skeletal anterior open bite and symmetric soft tissue swelling of the vault of the palate be added to the variable features associated with the syndrome. There is clear evidence in the literature of autosomal dominant inheritance but our analysis indicates that in some cases recessive transmission is likely.

Abnormalities, Multiple↗

Nucleotide sequences of Australian isolates of the feline immunodeficiency virus: comparison with other feline lentiviruses.

Proviral DNA from four Australian isolates of feline immunodeficiency virus (FIV) was amplified by PCR and the nucleotide sequence determined for two conserved regions within gag (p15/p24) and pol (RT) genes. Comparison with the nucleotide and deduced amino acid sequence of two previously described U.S. isolates from California (Petaluma and PPR), and a third from Maryland (MD) as well as the Japanese isolate TM2, revealed a close similarity between the Australian and Californian isolates with 95-97% nucleotide and 96-99% amino acid homologies. By contrast, the Maryland and Japanese isolates were more distantly related with only 84-87% nucleotide and 90-94% amino acid homology with either the Australian or Californian isolates. The relationship of the Australian FIV isolates to other domestic isolates as well as eight lentiviral isolates from wild felidae (panthers) published previously, was investigated further by constructing a phylogenetic tree based on the pol sequence. This revealed two subgroups of FIV, an Australian/Californian group and a less tightly clustered Maryland/Japanese group. These results suggest that the genomic variability of FIV is reflected by more than simply geographic distance. Furthermore, the relative genetic homogeneity found between Australian isolates suggest a shorter period of evolution of the virus in Australia than in North America.

Amino Acid Sequence↗

Tuberculosis in wild seals and characterisation of the seal bacillus.

Tuberculosis was diagnosed in 3 otariid seals found dead on beaches at 3 locations on the south coast of Western Australian between May 1990 and March 1991. This confirms that tuberculosis is present in the 2 native seals (Neophoca cinerea and Arctocephalus forsteri) in Western Australian waters. Mycobacterium sp isolated from the lungs of 2 of the seals were studied to determine the similarity of the strains to each other, to the strains isolated during 1986 from Australian sea lions and New Zealand fur seals kept in captivity at a marine park near Perth, Western Australia, and to a strain isolated in 1988 from a seal trainer who worked with the infected captive seals for 3 years. After restriction endonuclease analysis (REA) with the endonucleases Bst EII, Bcl I and Pvu II, one of the wild seal strains appeared to have identical DNA fragment patterns to the strains from the captive seals and the seal trainer. The other wild seal isolate had identical REA profiles using Bst EII and Bcl I, but a minor difference was detected using Pvu II. Differences in these isolates were more clearly seen in restriction fragment length polymorphisms after hybridisation with two DNA probes. The secretory protein MPB70, present in M bovis, was not detected in wild seal isolates using sodium dodecyl sulphate polyacrylamide gel electrophoresis and Western blotting techniques. Analysis of protein and DNA fragment profiles indicated that seal tuberculosis isolates form a unique cluster within the M tuberculosis complex.

Animals↗

Dependence of enhanced maximal exercise performance on increased peak skeletal muscle perfusion during long-term captopril therapy in heart failure.

Maximal oxygen uptake (VO2), skeletal muscle blood flow by xenon-133 washout technique and femoral vein arteriovenous oxygen difference and lactate were measured at rest and during maximal bicycle exercise in eight patients with severe congestive heart failure before and after 8 weeks of therapy with captopril. During therapy, skeletal muscle blood flow at rest increased significantly from 1.5 +/- 0.6 to 2.6 +/- 1.0 ml/100 g per min (p less than 0.05), with a concomitant decrease in the femoral arteriovenous oxygen difference from 10.0 +/- 1.7 to 8.3 +/- 1.9 ml/100 ml (p less than 0.05). Maximal VO2 increased significantly from 13.4 +/- 3.0 to 15.5 +/- 4.1 ml/kg per min (p less than 0.05). In four patients, the increase in maximal VO2 averaged 3.7 ml/kg per min (range 2.7 to 4.9), whereas in the remaining four patients, it was less than 1 ml/kg per min. Overall, peak skeletal muscle blood flow attained during exercise did not change significantly during long-term therapy with captopril (19.6 +/- 6.2 versus 27.6 +/- 14.3 ml/100 g per min, p = NS). However, the four patients with a significant increase in maximal VO2 experienced substantial increases in peak skeletal muscle blood flow and the latter changes were linearly correlated with changes in maximal VO2 (r = 0.95, p less than 0.001). Femoral arteriovenous oxygen difference at peak exercise was unchanged (12.6 +/- 2.6 versus 12.6 +/- 2.4 ml/100 ml). Thus, improvement in maximal VO2 produced by long-term therapy with captopril is associated with an increased peripheral vasodilatory response to exercise, and this improvement only occurs when the peak blood flow is augmented.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effects of acute angiotensin converting enzyme inhibition on renal blood flow in patients with stable congestive heart failure.

Renal blood flow was serially measured as the left renal vein blood flow using the continuous thermodilution technique during acute angiotensin converting enzyme inhibition in 20 patients with stable congestive heart failure. Eleven patients received captopril orally, and the remaining nine patients received enalaprilat intravenously. During the control period, left renal vein blood flow and cardiac output did not correlate closely (r = 0.57). Following administration of captopril or enalaprilat, stroke volume index increased from 20 +/- 7 to 25 +/- 8 ml/M2 (p less than 0.001), while pulmonary capillary wedge pressure decreased from 26 +/- 8 to 19 +/- 8 mm Hg (p less than 0.001). Left renal vein blood flow increased in all patients despite a consistent reduction in systemic arterial pressure. At peak effect, left renal vein blood flow increased from 295 +/- 86 to 443 +/- 122 ml/min (p less than 0.001), while mean systemic arterial pressure fell from 81 +/- 13 to 71 +/- 14 mm Hg (p less than 0.001). Thus, in patients with stable congestive heart failure, acute angiotensin converting enzyme inhibition, although decreasing substantially systemic arterial pressure, consistently enhances renal blood flow.

Adult↗