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Biomedical subjects

D Fife

Publications and source records attributed to D Fife.

At least 19 recordsLinked to original sources
PubMed2004

Cyclic fatigue testing of ProTaper NiTi rotary instruments after clinical use.

PURPOSE: The purpose of this study was to evaluate the cyclic fatigue of ProTaper nickel-titanium (NiTi) rotary instruments (Tulsa Dental, Tulsa, Okla) after multiple clinical uses. STUDY DESIGN: Two hundred twenty-five ProTaper instruments were divided into 3 groups: A = 75 used as controls, B = 75 used in 2 molars (6-8 canals), and C = 75 used in 4 molars (12-16 canals). The number of rotations to breakage and the fractured tip length were recorded for each file and the mean was calculated by ANOVA. RESULTS: No S1-2 or F1-2-3 instrument separated during intracanal use, even if they were reused for a number of cases (x 4 molar cases). CONCLUSION: It is clear that prolonged reuse of NiTi rotary instruments strongly affects instruments' fatigue, but our data suggest the hypothesis that other factors (primarily errors and misuse) may be more accountable for intracanal instrument separation. Further studies could assess the cyclic fatigue of each instrument at different levels of the shaft by altering the radius of curvature.

Analysis of Variance↗
PubMed2003

Patient acceptance of self-sampling for human papillomavirus in rural china.

OBJECTIVE.: To test a new survey instrument and determine the acceptance and potential barriers of cervicovaginal self-sampling for high-risk human papillomavirus in rural Chinese women. MATERIALS AND METHODS.: Data from thirteen survey questions assessed acceptance of the self-sampling procedure. Pain, comprehension, and cultural beliefs were potential barriers evaluated by the survey. RESULTS.: A total of 1,560 women were surveyed. The average and mode number of steps of the self-sampling procedure recalled was 5 (out of 7). Ninety-one percent preferred performing the test at a clinic versus their home. The major barrier encountered was related to the educational level of the women. CONCLUSIONS.: The measure performed well in this population. The self-collection brush was well accepted by these women. Education is the largest hurdle to overcome in implementing a self-sampling screening program.

Journal Article↗
PubMed2001

Coprescribing and codispensing of cisapride and contraindicated drugs.

CONTEXT: Cisapride, an oral prokinetic drug indicated for the symptomatic treatment of nocturnal heartburn due to gastroesophageal reflux disease, was approved by the US Food and Drug Administration in July 1993. After reports of serious cardiac arrhythmias and deaths during administration of cisapride, most involving concomitant exposure to another drug, a series of label changes and warnings were issued in February 1995, October 1995, June 1998, and June 1999. Cisapride was removed from general distribution in July 2000. OBJECTIVE: To determine the frequency of contraindicted coprescribing and codispensings, in which cisapride and a contraindicated drug were prescribed or dispensed to the same patient for overlapping periods, and the proportion of contraindicated coprescribing by the same physicians and codispensing by the same pharmacies. DESIGN AND SETTING: Retrospective study of prescription claims from a managed care organization database for all patients with cisapride prescriptions between July 1993 and December 1998. PARTICIPANTS: A total of 38 757 adult and pediatric patients who had a cisapride prescription immediately preceded by at least 60 days of insurance eligibility. MAIN OUTCOME MEASURE: Proportion of cisapride prescriptions or dispensing occurring during the same treatment period as a drug contraindicated at that time prescribed by the same physicians or dispensed by the same pharmacies. RESULTS: Of 131 485 cisapride prescriptions dispensed after the warnings began, 4414 (3.4%) overlapped with at least 1 drug contraindicated in the labeling at the time of the prescription. Of all overlapping prescription pairs, 2190 (50%) were by the same physicians, 3908 (89%) were by the same pharmacies, and 765 (17%) were dispensed on the same day. CONCLUSION: Prescriptions dispensed by the same pharmacies accounted for a far higher proportion of contraindicated medication pairs than prescriptions from the same physicians. The pharmacy may be an important and underutilized intervention point to prevent contraindicated drugs from being used together.

Adolescent↗
PubMed2001

Contraindicated medications dispensed with cisapride: temporal trends in relation to the sending of 'Dear Doctor' letters.

PURPOSE: 'Dear Doctor' letters alert the prescribing community of drug labeling changes that contain new contraindications, warnings, adverse reactions, and precautions. There has been little assessment of the impact of these letters. We quantified the impact of two 'Dear Doctor' letters concerning interactions between cisapride and a series of drugs. A letter in 1995 described a risk of prolonged QT intervals and serious ventricular arrhythmia in patients who received macrolide antibiotics and imidazole antifungals in conjunction with cisapride. A June 1998 letter that expanded the list of contraindicated comedications had wider distribution than an earlier one, was accompanied by substantial Internet and media coverage, and was complemented by an effort to inform large pharmacy dispensing information organizations of the warnings against concurrent use of the named drugs. METHODS: Health plan members with one or more outpatient pharmacy claims for cisapride during the period 1 January 1995 through 31 May 1999 were identified among members of a large New England health insurer. A retrospective review of concurrent and nearly concurrent dispensings of cisapride and contraindicated comedications was undertaken in the automated pharmacy claims data using both graphical and statistical time-series analysis. We tabulated by month the fraction of cisapride dispensings that occurred in close temporal relation to dispensings of contraindicated comedications. Codispensings that occurred on the same day were taken as the most direct measure of prescriber responsiveness to the letters. Codispensings that occurred in windows of plus or minus 2 weeks (29 day window) and plus or minus 4 weeks (57 day window) were taken as measures of possible simultaneous consumption. Among overlapping dispensings, we counted the proportion dispensed by the same pharmacy. Time series regression analysis of secular, seasonal, and step-effects was conducted. RESULTS: There was a steady decline in codispensing of cisapride and contraindicated medicines, and a pronounced seasonal effect, arising principally from the seasonal use of macrolide antibiotics. Against this background, the isolated Dear Doctor letter of October 1995 had no discernible effect on prescribing practices. The 1998 letter and surrounding activity, by contrast, were followed by a 66% decline in same-day dispensings and a smaller, but still pronounced decline in dispensings in the wider time windows. For most codispensings of contraindicated medications with cisapride, both medications came from the same pharmacy. CONCLUSIONS: Publicity and direct intervention with dispensing pharmacies may be an important supplement to Dear Doctor letters when the goal is to eliminate the codispensing of drugs that should not be taken together.

Adolescent↗
PubMed2001

Temporal patterns of NSAID spontaneous adverse event reports: the Weber effect revisited.

OBJECTIVES: Determine whether recent US adverse event reports for several non-steroidal anti-inflammatory drugs (NSAIDs) conform to the temporal pattern observed by Dr JCP Weber in the UK in the early 1980s, i.e. a rising count in the first few years after launch presumably reflecting increased exposure, followed by a decline, presumably reflecting decreased enthusiasm for reporting as adverse events become well known. STUDY SETTING: US adverse event report data available from the US Food and Drug Administration, reformatted by a commercial vendor. METHODS: For the 5 NSAIDs launched in the US between 1987 and 1993 that had data suitable for this study, we tabulated by year from launch the number of reports and the reporting rate (number of reports per 1000 prescriptions). RESULTS: The number of reports for 3 of the 5 NSAIDs showed a temporal pattern approximating that described by Weber. The number of reports for the other 2 NSAIDs showed temporal patterns markedly different from that described by Weber. For 4 of the 5 NSAIDs, reporting rates did not decline consistently with time from launch. DISCUSSION: The temporal patterns of adverse event reports are more complex than those described in Weber's classic report. The number of reports does not reliably rise and then fall after launch and the reporting rate does not reliably decrease with time from launch.

Adverse Drug Reaction Reporting Systems↗
PubMed1997

Effects of brain injury on college academic performance.

Brain injury, a leading cause of mortality, morbidity and disability in the United States, has serious consequences and substantial costs. Although previous studies have assessed a variety of outcomes subsequent to brain injury, documentation of performance prior to brain injury using a case-control approach has not been included; preinjury performance differences may confound the estimate of the effects of brain injury on performance. The primary objective of this study was to compare academic performance before and after brain injury in a population of university undergraduate students to determine the extent to which the academic career of the brain-injured person was altered from what would have been expected in the absence of such an injury. Cases included all undergraduate students in a major university, between the ages of 17 and 27, who incurred a brain injury requiring hospitalization between 1980 and 1984 (n = 99). Two comparison groups were used to determine whether changes in academic performance were specifically related to brain injuries or injuries in general: (1) injured controls, i.e. 121 students between the ages of 17 and 27 years, hospitalized for injuries other than to the central nervous system, and (2) uninjured academic controls, i.e. 198 students with out injuries requiring hospitalization during the study period, matched 2:1 to the brain-injured students by age, gender, and completed course credits categorized as < 90, > or = 90. Although there were no differences when the total groups, including both males and females, were compared, there was a significant pre- to postinjury decrease in the grade point average for female cases when compared to their uninjured academic controls (p < 0.02). This difference was related to the effects of brain injury, and not to the effects of injury in general. No such difference was observed for the males. There were also no differences when the total groups, including males and females, were compared relevant to return to school. However, a significantly higher proportion of the female cases, compared with their uninjured academic controls, did not return to school after their injury; similar findings were identified for the injured controls as well. Thus, these differences were not specific to brain injury but rather to injury in general. In spite of this observation, the difference between female cases who returned and those who did not return was associated with neurological deficits, especially upper left limb motor deficits, as the time of hospital discharge. The findings from this effort are suggestive of gender differences in the consequences of brain injury and serve as a basis for further studies to evaluate the magnitude of this problem.

Adolescent↗
PubMed1993

Laboratory-based reporting of AIDS.

To improve the speed and completeness of AIDS reporting, the Philadelphia Board of Health adopted regulations requiring medical laboratories to report directly to the Department of Public Health all results indicative of AIDS-defining diagnoses. Reports were used to focus active AIDS surveillance on physicians who had requested laboratory reports whose results were likely to have diagnosed AIDS recently. One year after implementation, laboratories provided the first lead to 20% of all AIDS reports. Reports originating with laboratories reach our data base sooner after diagnosis and ascertain a slightly higher proportion of women than do other reports. Laboratory-based reporting offers a practical way to focus the limited resources available for active surveillance on health providers likely to have an AIDS diagnosis to report.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Private medical insurance among Philadelphia residents diagnosed with AIDS.

We used medical insurance information gathered on each Philadelphia resident with AIDS to examine time trends in private medical insurance at the time of diagnosis. The proportion of AIDS patients with private medical insurance decreased from 51.9% in July-December 1988 to 28.6% in July-December 1991. During the same time period, an increasing proportion of people diagnosed with AIDS were female, poor, members of minority groups, or abusers of injection drugs. A discrete multivariate model showed that the (point) prevalence of private medical insurance at AIDS diagnosis decreased significantly with time, even after adjustment for changes with time in the age, gender, race, estimated income, history of injection drug use, and history of homosexual contact of those who were affected with AIDS. Thus the decreasing prevalence of private medical insurance among people newly diagnosed with AIDS does not simply reflect changes in the demographic and behavioral characteristics of the people affected.

Acquired Immunodeficiency Syndrome↗
PubMed1992

AIDS incidence and income.

Since 1987, the annual increases of AIDS incidence among homosexual and bisexual men have slowed but the increases among other risk groups have continued unabated. Although indirect evidence suggests the incidence change is related to medical care for HIV disease delaying the onset of AIDS, other explanations are also possible. To examine the incidence change from a different perspective, we classified the residents of Philadelphia (PA, U.S.A.) with AIDS by the per capita income of their census tracts of residence. AIDS incidence increased steadily in the lowest income tercile, showed continuing but smaller increases after 1987 in the middle tercile, and was level after 1987 in the highest income tercile. The relationship between income and changes of incidence persisted after stratification on race or mode of infection with HIV. Income was associated with private medical insurance at the time of diagnosis of AIDS (59% privately insured in the highest income tercile, 24% in the lowest) and with median survival after a diagnosis of AIDS (467 days in the highest tercile of income, 359 days in the lowest). These observations are consistent with a medical treatment benefit that reaches the highest tercile of income and does not reach the lowest one.

Acquired Immunodeficiency Syndrome↗
PubMed1992

AIDS prevalence by income group in Philadelphia.

We sought to track recent changes in AIDS incidence and prevalence in the city of Philadelphia (PA, U.S.A.) using morbidity and mortality data reported to the health department. We stratified the data by the mean per capita income in census tracts where people with AIDS resided. Estimates made without adjustment for the time lag between events and their entry into the database undercount both recent AIDS diagnoses and recent AIDS deaths. Therefore, we used a previously published method to adjust for the lag in reporting diagnoses and developed a method to adjust for the lag in reporting deaths. We calculated prevalent cases as the difference between cumulative cases and cumulative deaths. Between 1988 and 1990, annual AIDS incidence per 100,000 Philadelphia residents increased by 21% (from 25.9 to 31.4) and AIDS prevalence per 100,000 population increased by 62% (from 30.2 to 48.8). AIDS prevalence increased 113% (from 29.8 to 63.6) in low-income tracts, 88% (from 27.8 to 52.3) in middle-income tracts, and 14% (from 32.5 to 37.2) in high-income tracts. The 62% increase in AIDS prevalence and the shift toward people in poorer neighborhoods imply a need for public funding for AIDS care that is far larger than would be suggested by the general 21% increase in AIDS incidence over the same period.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Stochastic methods for short term projections of symptomatic HIV disease.

We designed and implemented stochastic methods for short term projections of HIV disease at the local level, that accommodate various states or stages of the disease. We gave particular attention to projection of the number of patients with HIV disease who need care, when durations of stay in these various states depend on current methods for treating opportunistic infections. We consider two types of data as input to these projections. One concerns seroprevalence surveys conducted over time and from which we can obtain time series estimates of the numbers of HIV-infected individuals. The other is a reported time series of AIDS cases adjusted for delays in reporting. Several projections, with data from the City of Philadelphia, illustrate this method. In addition, we consider a Monte Carlo method for computing confidence bounds on a projection.

Confidence Intervals↗
PubMed1991

Cumulative AIDS incidence and altered mortality from mycobacterial disease: New Jersey.

Changes in mycobacterial disease mortality between 1980 and 1986 were examined among New Jersey residents aged 25 to 44 using single cause of death data. The demographic group with the highest cumulative incidence of acquired immune deficiency syndrome (AIDS) (non-white residents of the four urban counties adjacent to New York City) sustained an increase of 10.1 deaths/100,000 men/yr and 3.1 deaths/100,000 women/yr. Groups with lower cumulative incidence of AIDS sustained smaller increases in mycobacterial disease mortality. The group with the lowest cumulative incidence of AIDS (white residents outside the four urban counties adjacent to New York City) sustained the smallest increase in tuberculosis (TB) mortality. Using single cause of death data, it was not possible to identify a relationship between increased extrapulmonary TB deaths and AIDS cumulative incidence, but such a relationship was identifiable from multiple cause of death data. Of 30 mycobacterial disease deaths of all ages with cellular immune deficiency as a contributory diagnosis on the death certificate, 21 (70%) were known to the state's AIDS registry as AIDS cases and four more (13%) were known to the registry as having human immunodeficiency virus (HIV) disease not meeting the full clinical criteria for AIDS. Young populations with a high cumulative incidence of AIDS have experienced substantially increased mortality from mycobacterial diseases. The association of mycobacterial disease mortality with HIV disease may be underestimated from AIDS registry data and from searches of single cause of death data for mycobacterial disease deaths.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Changes in AIDS case reporting after hospital site visits.

In an effort to improve AIDS case reporting, site visits (meetings with hospital staff to encourage reporting) were made to all Philadelphia hospitals. Comparisons of hospitals visited during a 7-week period with hospitals not visited during that period indicated that the site visits were followed by a marked increase in case reports. No similar increase was observed at the comparison hospitals. The increased reporting was accompanied by an increased lag time from diagnosis to report, suggesting that the additional reports at visited hospitals were the result of the identification of previously missed cases rather than a speedup of reporting. Cases reported after the visits were more likely to have white-collar occupations or private medical insurance than were those reported before the visits.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Cumulative AIDS incidence and altered mortality from bacterial infections.

To determine whether populations with high cumulative incidence of acquired immunodeficiency syndrome (AIDS) experienced increased deaths from sepsis, central nervous system abscess, or endocarditis, New Jersey AIDS patients were grouped according to their age, sex, race, and residence-specific cumulative incidence of AIDS since the onset of the AIDS epidemic. Between 1980 and 1986, among 25-44 year olds in the highest cumulative incidence group for AIDS, sepsis mortality increased from 3.3 to 15.2 deaths/100,000/year, an increase of 11.9 deaths/100,000/year (95% confidence interval (6.9, 17.0) deaths/100,000/year); mortality from central nervous system abscesses increased from zero to 1.7 (0.1, 3.2) deaths/100,000/year; and mortality from endocarditis increased from 0.8 deaths/100,000/year to 2.4 deaths/100,000/year, an increase of 1.6 (-0.5, 3.7) deaths/100,000/year. Age-matched New Jersey patient populations with low cumulative incidence of AIDS did not sustain a similar increase. The HIV disease-associated increase in sepsis mortality among young populations represents a new component of the substantial increase in U.S. sepsis mortality that occurred over the last two decades, but was previously limited to older populations.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Matching fatal accident reporting system cases with National Center for Health Statistics motor vehicle deaths.

Motor vehicle traffic fatalities in the United States are described by two major data sources, the Fatal Accident Reporting System (FARS) and the National Center for Health Statistics Multiple Cause of Death data (NCHS). Certain data, such as the age and sex of the fatality, are reported by both sources. However, each source contains data absent from the other. For example, only the FARS describes the precise circumstances of injury, and only the NCHS identifies the anatomic injuries listed on the death certificate. Thus, it would be useful to have a single file that offers for each case all of the data provided in each of the separate files. Creation of such a file is impeded by the fact that neither file contains personal identifiers for the cases listed. The present paper describes a method of matching cases from the two files based on simultaneous agreement of several variables common to both files (age, sex, date of death, role in the crash, and state in which the injury occurred). Using this method, 85% of the FARS cases can be uniquely matched with a case in the NCHS data.

Accidents, Traffic↗
PubMed1989

Regional variation in motor vehicle accident reporting: findings from Massachusetts.

Differences in motor vehicle crash reporting may affect geographic comparisons of motor vehicle crash rates. Substantial differences have been reported between nations and, within the United States, between states, but little is known about more localized differences. Data from Massachusetts' 45 largest municipalities indicate substantial local variation in the percentage of reported injury-producing crashes for which a police report is available, from fewer than 20% in the lowest decile to more than 85% in the highest. For a given municipality, the percentage of crashes with police reports in 1979 was highly predictive of the percentage with police reports in 1983.

Accidents, Traffic↗
PubMed1989

Fatal motorcyclist injury from a hinged and rounded rearview mirror.

Rigidly mounted sharp projections from automobile exteriors have been replaced by flexibly mounted rounded structures believed to be less hazardous to unprotected road users. The present report of a fatality from an external rearview mirror indicates the continued potential for harm from a projecting structure in spite of a hinged mounting and rounded shape.

Adult↗