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Biomedical subjects

B J Powell

Publications and source records attributed to B J Powell.

At least 19 recordsLinked to original sources

Outcomes of co-morbid alcoholic men: a 1-year follow-up.

In this prospective, 1-year study, 360 males admitted to an inpatient alcoholism treatment program were administered a DSM-III compatible structured interview and subtyped by co-occurring psychiatric disorder. Forty percent satisfied diagnostic criteria for alcohol dependence while 27% met criteria for alcohol dependence and one additional psychiatric syndrome. The dually diagnosed patients were divided into: alcohol dependence plus drug abuse, alcohol dependence plus antisocial personality and alcohol dependence plus depression. These subtypes were compared on multiple dimensions at intake and at 1-year follow-up. At follow-up, all groups showed significant improvement in drinking and psychosocial functioning. The results suggest that subtyping alcoholics by co-morbid psychiatric disorders may be a good postdictor of clinical history, but a poor predictor of drinking outcome.

Adult

Lymphocyte levels in subjects with and without amalgam restorations.

The claim that mercury from dental amalgam produces "reduced immunocompetence" was examined by measuring the levels of the three major populations of lymphocytes on 37 subjects--21 with amalgam restorations and 16 without. The results of this study show no indication that amalgam restorations affect the human immune system nor do they support the "reduced immunocompetence" claim.

Adult

Antisocial alcoholics: are there clinically significant diagnostic subtypes?

Of 360 alcoholic male inpatients assessed with a diagnostic interview, 106 (29%) were found to have a co-occurring diagnosis of antisocial personality. Of these ASP alcoholics, 86 were further subdivided into those with only ASP and alcoholism (n = 38), those with ASP, alcoholism and drug dependence (n = 30) and those with ASP, alcoholism and depression (n = 18; 9 of whom also had drug abuse). Comparisons among the three antisocial groups indicated that they differed in measures of psychopathology and course and severity of alcoholism. When the ASP groups were compared to an alcoholism only group, an earlier onset, more rapid course and increased percentage of many alcoholism symptoms were found in the ASP groups, confirming the findings of other studies.

Adult

Subtyping male alcoholics by family history of alcohol abuse and co-occurring psychiatric disorder: a bi-dimensional model.

Six studies of 568 alcoholics in treatment are summarized to illustrate the interactive effects of familial alcoholism, other forms of family psychopathology and the lifetime prevalence of additional psychiatric disorder on the onset and course of male alcoholism. A family history of alcoholism as well as additional co-occurring psychiatric syndromes were associated with (1) earlier onsets of problem drinking, (2) a more virulent course and (3) greater heterogeneity of psychopathology among first degree relatives. A bi-dimensional method of classifying male alcoholics is proposed which combines a family history of abusive drinking and the presence or absence of co-morbid psychiatric disorders. Implications for the clinical researcher and practitioner are briefly discussed.

Adult

Examination of Cloninger's type I and type II alcoholism with a sample of men alcoholics in treatment.

Cloninger's clinical method of classifying alcoholics into two groups (Types I and II) was examined with data obtained from 360 VA hospitalized male alcoholic patients. For operational criteria, the Cloninger clinical method of subtyping alcoholics employs age-of-onset of problem drinking and symptom-clusters supposedly associated with each subtype. Marked overlap was found between the symptom-clusters used to define the two subtypes. Ninety-one percent of the entire sample satisfied criteria for both symptom-clusters. Dividing the sample by early-onset (Type II, less than or equal to 25 years) and late-onset (Type I, greater than 26 years) alcoholism did not substantially reduce the overlap between symptom-clusters; i.e., 96% of the early-onset and 83% of the late-onset subgroups were positive for both symptom-clusters. Only 21 men (6%) could be classified when both age-of-onset and the type-appropriate symptom-cluster were used to separate patients. In hospital settings, at least, these findings suggest that the two-group clinical alcoholism typology proposed by Cloninger basically reflects the age-of-onset of problem drinking.

Adult

Microleakage of IRM used to restore endodontic access preparations.

The effect on microleakage of varying the powder-to-liquid ratio (P/L) of IRM used to restore endodontic access preparations was evaluated. Crowns of noncarious, nonrestored extracted human teeth were used in this study. Microleakage was measured using a fluid filtration technique prior to access preparation to obtain control measurements. After access preparation, IRM restorations were placed using P/L of 2, 3, 4, 5, and 6 g/ml, using the manufacturer's recommended dispensing scoop and dropper, and using 2 P/L in a new capsulated IRM delivery system (IRM CAPS). Microleakage measurements were made after various time intervals and after thermal stress. The results indicated that the lower P/L provided the best seals. All groups demonstrated significant microleakage measurements after thermal stress. Significantly greater microleakage measurements were obtained with the P/L of 6 g/ml and the manufacturer's recommended dispensing scoop and dropper. A P/L of 2 g/ml demonstrated less microleakage than the other groups tested.

Dental Leakage

A comparison of familial and nonfamilial male alcoholic patients without a coexisting psychiatric disorder.

Both family history of alcoholism and the presence of additional psychiatric disorder in male alcoholic patients are associated with an earlier onset of problem drinking, greater alcoholism severity and poorer clinical outcomes. To assess the relative contribution of family history alone, a sample of 212 male alcoholics not positive for any other psychiatric disorder was selected and divided into those with a family history of alcoholism (FH+) or no family history of alcoholism (FH-) among first degree relatives. Although FH+ alcoholics reported a younger age of onset of problem drinking and greater severity of some alcohol-related sequelae, the differences were not as extensive or pronounced as those found in a previous study of a sample of psychiatrically heterogeneous patients (Penick et al., 1987). A bi-dimensional typology of alcoholism incorporating both additional psychiatric diagnoses and a positive family history of alcoholism is suggested.

Alcoholism

Alcoholics' attitudes toward and experiences with disulfiram.

We studied 345 alcoholic inpatients utilizing a 43-item questionnaire designed to assess these patients' attitudes toward and experiences with disulfiram. A surprisingly high number of patients who had received disulfiram drank ethanol while taking or within 1 week of stopping disulfiram and experienced a disulfiram ethanol reaction. This finding and others derived from the questionnaire are reported, and the potential implications of the findings are discussed.

Adult

Dentists' professional satisfaction with adolescent dentistry and its association with adolescent dental health behavior.

This study examines dentists' perceptions of behaviors felt to interfere with providing adequate dental care to adolescents. We analyzed gender differences, and whether the dentists' perceptions of adolescent patients were associated with their professional satisfaction. A stratified random sample of 227 graduates (males = 180, females = 47) from a Southern dental school were asked to complete a questionnaire assessing professional satisfaction. Based on Kruskall-Wallis analysis of variance tests, female dentists expressed generally higher levels of satisfaction than males with adolescent dentistry, diagnosis and treatment planning, patient education, preventive procedures, and the adolescent dentistry curricula during dental school. Male dentists felt that the male adolescents' failure to keep appointments, communication problems, seeking dental care only in emergency situations, and resentment of authority interfered more with their providing adequate dental care than did female dentists. Male dentists also felt that the female patients' menstrual period, communication problems, low tolerance of pain, seeking dental care only in emergency situations, and resentment toward authority were more significant problems than did the female dentists. Communication problems with both male and female adolescents were more strongly correlated with the dentists' satisfaction with adolescent dentistry than any other variable.

Adolescent

Microleakage of temporary restorations in complex endodontic access preparations.

The microleakage allowed by three temporary restorative materials used for the sealing of teeth with both endodontic access and multisurface cavity preparations was measured and evaluated. Extracted human incisor, canine, and premolar teeth with extensive carious involvement were prepared and restored with either Cavit, IRM, or TERM. Microleakage was measured by a fluid filtration technique at various time intervals and after thermal stress. The results indicated that the TERM restorations provided excellent seals and were statistically superior to Cavit and IRM for restoring complex endodontic access preparations. The IRM restorations demonstrated significantly greater microleakage after thermal stress, while the Cavit restorations were deemed clinically unacceptable because of extensive cracks, expansion, and extrusion from the tooth preparations. These defects were not observed with the IRM and TERM restorations.

Calcium Sulfate

The stability of coexisting psychiatric syndromes in alcoholic men after one year.

Alcoholic men (N = 241) were administered a criterion-referenced, structured, DSM-III compatible, diagnostic interview while hospitalized and again 1 year later as outpatients. This interview independently evaluates the lifetime prevalence of 15 major psychiatric disorders. In addition to alcoholism, the most frequently occurring coexisting disorders were depression, antisocial personality and drug abuse. After 1 year, the number of positive syndromes declined slightly (chi = 2.0 to 1.8). However, the absolute and relative number of additional psychiatric syndromes remained stable over 1 year for the entire sample. Across individuals, the overall rates of agreement for the 15 syndromes ranged from a high of 100% to a low of 85%. Similarly, the agreement for the current and lifetime diagnoses ranged from 86 to 99%. These data indicate that a substantial portion of male alcoholics experience symptoms that are common to other psychiatric disorders. They also suggest that the endorsement of multiple psychiatric symptoms is not due simply to the acute emotional and physical distress that often accompanies a recent hospitalization for alcoholism treatment. Instead, for many male alcoholics, the symptom patterns appear to reflect additional psychiatric disorders that are stable over time and a potential target of treatment.

Adult

A comparative study of familial alcoholism.

In a large multicenter study of 568 male alcoholics, structured interviews were used to compare the clinical characteristics of patients with a positive (65%) or negative (35%) family history of abusive drinking among first degree relatives. Alcoholics with a positive family history were found to have: an earlier onset of alcoholism, greater alcoholic severity, more medical and legal problems, a broader range of treatments, an increased lifetime prevalence of additional psychiatric disorders and a greater diversity of psychiatric disturbance among biological relatives. The degree of psychiatric heterogeneity in the patients roughly corresponded to the degree of psychiatric heterogeneity in their families. Assortative mating was proposed as a possible mechanism to account for clinical differences between the familial and nonfamilial alcoholic.

Alcoholism

The dropout in alcoholism research: a brief report.

Compared to 148 alcoholic men who were successfully followed up after 1 year in a controlled treatment evaluation study, the 18 treatment dropouts reported somewhat less alcohol impairment due to drinking and lower scores on measures of psychopathology when first seen.

Alcoholism

Primary and secondary depression in alcoholic men: an important distinction?

The primary-secondary depression distinction was investigated in male alcoholic patients from five Veterans Administration Medical Centers. The Psychiatric Diagnostic Interview, a DSM-III-compatible, criterion-referenced, structured interview, was administered to 565 patients admitted to the Alcoholism and Drug Treatment Units. Seventy-eight patients (13.8%) who exhibited only alcoholism and depression were divided into three subgroups based on the temporal onset of depression relative to the onset of alcoholism. Although few statistical differences were found, observed trends suggested more impairment in alcoholic patients with primary depression than in those with concurrent or secondary depression. The findings indicate that the primary-secondary depression distinction may have important clinical relevance and should be made whenever possible.

Adult