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Biomedical subjects

C Meyerowitz

Publications and source records attributed to C Meyerowitz.

11 recordsLinked to original sources
PubMed1991

A case for early surgery in native left-sided endocarditis complicated by heart failure: results in 203 patients.

From January 1982 to December 1988, 203 consecutive patients were selected for early valve replacement (mean 10 days from time of admission) if they had clinical evidence of native valve endocarditis with 1) vegetations on echocardiography, 2) severe valvular lesions, and 3) heart failure. Surgery was performed within 7 days of admission in 56% of patients and was done urgently because of hemodynamic deterioration in 108 (53%). All vegetations were identified by echocardiography and confirmed macroscopically at surgery. One hundred ten patients had isolated aortic valve infection, 50 had isolated mitral valve infection (p less than 0.05 for aortic vs. mitral) and 43 had double-valve infection. Mean aortic cross-clamp time was 57, 38 and 67 min, respectively. Sixty-four patients (32%) had extensive infection involving the anulus or adjacent tissues, or both; such infection more frequently involved the aortic than the mitral valve (p less than 0.05). Thirty-eight patients (35%) with aortic valve infection had abscess formation compared with 1 patient (2%) with mitral valve infection (p less than 0.05). Only eight patients (4%) died in the hospital. There were seven patients (3%) with a periprosthetic leak and five patients (3%) with early prosthetic valve endocarditis. Long-term follow-up, available in 174 hospital survivors (89%), revealed 10 deaths and two new ring leaks at 38 +/- 22 months. In conclusion, among patients with endocarditis who need surgery for heart failure, aortic valve infection is more prevalent than mitral valve infection and is more often associated with extensive infection, including abscess formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Use of an intra-oral model to evaluate 0.05% sodium fluoride mouthrinse in radiation-induced hyposalivation.

The present study was undertaken to evaluate the effect of a twice-daily topical application of a 0.05% NaF mouthrinse on de- and remineralization in the oral cavities of subjects suffering from radiation-induced hyposalivation. Six subjects each wore a bonded intra-oral appliance containing a sound and a demineralized human enamel slab for four weeks. During that period, the subjects used 0.05% NaF rinses, twice daily, instead of the 1.1% NaF gel that had previously been a part of their preventive regimen. Salivary flow rates, plaque pH profiles following a 10% sucrose rinse, S. mutans and lactobacillus counts, fluoride clearance, and enamel microhardness were determined during the study. Sound enamel samples displayed no evidence of demineralization, and the previously demineralized enamel showed remineralization in the outer 50 microns in three of the six subjects. The results suggest that a twice-daily oral rinse with 0.05% NaF can prevent demineralization and enhance remineralization in subjects with radiation-induced hyposalivation.

Bacteria↗
PubMed1991

Geriatric dentistry and prevention: research and public policy (reaction paper).

The population of older adults is heterogeneous and can be divided into many subgroups: the young-old, the old-old, the healthy, the sick, the frail, the mentally and physically handicapped, the ambulatory, the chair-bound, house-bound or institution-bound, and the economically advantaged and disadvantaged. This diversity is extremely important to the discussion of the oral health needs, preventive health strategies, and research agenda for the elderly. As life expectancy increases, more attention is being paid to disease prevention so that the quality of life in old age can be improved. However, the link among oral health, systemic disease, and quality of life in the elderly needs to be better-defined. There is some evidence in the literature that indicates that coronal and root caries appear to be major health problems for the elderly. This needs to be corroborated in longitudinal studies. Although periodontal disease prevalence and severity are high in some subgroups of the elderly, these appear to be in decline in the general population. Dental health-care workers must be cognizant of the oral conditions associated with systemic disease and the use of medication, a major concern in older adults. Prevention of oral disease in the elderly requires early intervention, education of the dental health team, and innovative uses of well-established preventive agents such as fluoride. An extensive research effort is needed to answer basic and applied questions regarding the oral health needs of the elderly. Federal and private funding will be necessary. The dental profession will have to demonstrate and be persuasive that money spent on research and care for the elderly is money well spent.

Aged↗
PubMed1988

Extraction of the third molar and patient satisfaction.

Patient satisfaction is an important outcome measure of health care. This study was designed to evaluate patient satisfaction with extraction of the third molar in relation to certain criteria involving structure, process, and outcome. A 16-item patient-satisfaction questionnaire was developed and mailed to 262 patients who had third molars extracted in a university-based clinical department during an 18-month period. The returned questionnaires were subjected to a factor analysis by means of the varimax method; the analysis yielded three "clusters" that we labeled "general satisfaction," "interpersonal satisfaction," and "satisfaction with cost." Two-tailed Student's t tests were used to relate the clinical data to each area of satisfaction. There were a total of six statistically significant interactions in the data matrix at the 0.05 level. Three of these pertained to general satisfaction and three to interpersonal satisfaction. The methods used in this study can be used to relate components of patient satisfaction to elements of dental care.

Consumer Behavior↗
PubMed1988

Retention of topical fluoride in the mouths of xerostomic subjects.

The total fluoride concentration in unstimulated whole saliva was measured before and at selected intervals after a self-applied 1.1% neutral NaF topical fluoride gel or use of a 0.05% neutral NaF fluoride mouthrinse in both normal individuals and patients with radiation-induced xerostomia. As expected, the gel resulted in higher peak fluoride values than the rinse and was retained in the mouth for longer periods of time in both groups. The xerostomic group expressed a mean oral fluoride concentration of 575 micrograms fluoride per gram of saliva within 1 min after the gel application and 150 micrograms/g following use of the mouthrinse, whereas the normal group exhibited peak concentrations of 112 and 71 micrograms/g, respectively, within 1 min after the same two treatments. The initial high levels of fluoride observed in normal subjects following the gel application decreased rapidly to less than 1 microgram/g within 2 h, whereas fluoride levels in the xerostomic subjects remained elevated above 12 micrograms/g for longer than 2 h. Similarly, following use of the mouthrinse, normal subjects' saliva fluoride levels decreased to less than 1 microgram/g within 1 h, whereas xerostomic subjects' saliva fluoride levels remained above 4 micrograms/g for longer than 2 h.

Adult↗
PubMedDate not supplied

An educational consultative model for general practice training programs.

A behavioral science consultant has been retained by two hospital-based general practice residency (GPR) programs and one advanced program in general dentistry at the University of Rochester, and Eastman Dental Center, NY. This consultant is available throughout the year and serves as an external consultant who knows the programs well, and can be used as a source of information on various existing and potential issues and problems. The model used by the consultant has been inductive and is based on the expressed needs of faculty members, trainees, and directors. A number of issues or problems were identified, including faculty member morale, evaluation of residents' growth, resident and supporting staff relations, curriculum development, cooperation with other departments and institutions, and dealing with patients' anxiety to dental treatment. For each, a specific plan was developed. Various types of experiential techniques were used, including brainstorming, role playing, and taping and feedback. Didactic activities included minicourses and workshops in which standard teaching methods were used, such as lectures, seminar discussions, literature study, and demonstration. The model has evolved, and as each activity has succeeded, more faculty members have sought help from the consultant.

Consultants↗