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Biomedical subjects

D Sadowsky

Publications and source records attributed to D Sadowsky.

At least 19 recordsLinked to original sources
PubMed1992

A model predicting dentists' willingness to treat HIV-positive patients.

Data for this study of dentists' willingness to treat HIV-positive (HIV+) individuals were derived from a survey of a probability sample of American general practitioner dentists (GPD). Data were received from 1,351 active GPD, which represented an 88% response rate. Because the outcome measure--willingness to treat HIV+ patients--is dichotomous, i.e., yes/no, logistic regression was selected as the statistical technique to be used for the creation of a predictive model. Seventeen independent variables were initially considered. The final and most parsimonious model contains six independent variables, of which perceived safety in treating HIV+ patients has the most predictive power. Fear of consequences for the practice, if HIV+ patients were seen, was also a powerful predictor, with a sense of ethical responsibility and a past history of treating HIV+ patients also being important predictive variables. Knowledge level about transmission of HIV and concern about risks associated with treating homosexuals were also significant.

Attitude of Health Personnel↗
PubMed1991

Cocaine in pregnancy: the effect of maternal administration of cocaine on the maternal and fetal pituitary-adrenal axes.

The effects of cocaine on the maternal and fetal pituitary-adrenal axis in vivo during pregnancy have not been reported. Six pregnant ewes and their fetuses underwent instrumentation at 113 to 119 days' gestation. Ewes were assigned to receive an intravenous bolus injection of vehicle or cocaine (0.5, 1.0, or 2.0 mg.kg-1) at 124 to 136 days' gestation. Maternal arterial blood gases, fetal pH and fetal PCO2 were unchanged after injection of cocaine or vehicle. After administration of 2.0 mg.kg-1 cocaine, arterial fetal PO2 fell 3.2 +/- 1.72 mm Hg (p less than 0.05) at +5 minutes, returning to baseline by +15 minutes. Maternal and fetal adrenocorticotropin levels rose within 5 minutes after the highest cocaine dose (p less than 0.05). There was a significant (p less than 0.05) increase in maternal cortisol at all doses of cocaine and in fetal cortisol at +15 minutes after the 2.0 mg.kg-1.

Adrenocorticotropic Hormone↗
PubMed1991

Lack of effect of fetal administration of cocaine on maternal and fetal plasma adrenocorticotropin, cortisol and lactate concentrations at 127-138 days gestational age.

Few in vivo studies have been done to characterize the effects of cocaine on the maternal and fetal pituitary-adrenal axis during pregnancy. We, therefore, administered cocaine (2 mg.kg-1) intravenously to 6 fetal sheep at 127-138 days of gestation. There was a transient reduction in fetal arterial pO2 with a concomitant increase in pCO2 and a prolonged fall in pH (p less than 0.05) following cocaine injection. No changes were seen in maternal pO2, pCO2 or pH. Maternal adrenocorticotropin (ACTH), cortisol and lactate were not affected by fetal administration of cocaine. Although there was a tendency for fetal plasma ACTH, cortisol and lactate to rise after administering cocaine, the increases were not statistically significant. Previous studies have shown that cocaine administration to the ewe at a similar stage of pregnancy results in increased fetal plasma ACTH concentrations. The results of the present study indicate that cocaine administration to the fetus compromises fetal gas exchange and acid-base balance but the effects on the fetal pituitary-adrenal axis are less pronounced than after maternal administration of cocaine.

Acid-Base Equilibrium↗
PubMed1991

Lack of effect of fetal administration of cocaine on maternal and fetal plasma adrenocorticotropin, cortisol and lactate concentrations at 127-138 days gestational age.

Few in vivo studies have attempted to characterize the effects of cocaine on the maternal and fetal pituitary-adrenal axis during pregnancy. We, therefore, administered cocaine (2 mg.kg-1) intravenously to 6 fetal sheep at 127-138 days of gestation. There was a transient reduction in fetal arterial pO2 with a concomitant increase in pCO2 and a prolonged fall in pH (p less than 0.05) following cocaine injection. No changes were seen in maternal pO2, pCO2 or pH. Maternal plasma adrenocorticotropin, cortisol and lactate were not affected by fetal administration of cocaine. Although there was a tendency for fetal plasma adrenocorticotropin, cortisol and lactate to rise after administering cocaine, the increases were not statistically significant. Previous studies have shown that cocaine administration to the ewe at a similar stage of pregnancy results in increased fetal plasma adrenocorticotropin concentrations. The results of the present study indicate that cocaine administration to the fetus compromises fetal gas exchange and acid base balance, but the effects on the fetal pituitary-adrenal axis are less pronounced than after maternal administration of cocaine.

Adrenocorticotropic Hormone↗
PubMed1991

Comparing dentists' attitudes and knowledge concerning AIDS: differences and similarities by locale.

A stratified random sample of 1,351 general practitioners in the continental United States was surveyed to determine dentists' attitudes relevant to treating AIDS/HIV+ patients and knowledge regarding the transmission of HIV infection. Survey results were analyzed nationally and by practice locale: high HIV+ prevalence urban areas, other urban areas, rural areas. While there are differences in fear-related HIV attitudes among GPs in the three locales, they are not present in attitude toward willingness to treat and knowledge of AIDS transmission. For dentistry, such findings in large part refute the National Commission on AIDS charges regarding the treatment of AIDS in rural America.

Acquired Immunodeficiency Syndrome↗
PubMed1991

The use of direct mail to increase clinician knowledge: an intervention study.

A probability sample of American general practitioner dentists, 40 years of age or older, in solo private practice, was the target of two direct mail interventions offered at two different times, to test whether knowledge regarding prophylaxis of patients at risk for infective endocarditis could be improved. Tests of knowledge were responses in a mail questionnaire to clinical vignettes, designed to elicit the content of antibiotic regimens used for patients at risk. The research design enabled detection of (1) the effect of the interventions; (2) the differences in their effect; (3) the attenuation of their effect; and (4) the effect of time. Where baseline knowledge was low, it was improved and did not rapidly disappear. Both mail interventions were equally effective, in most instances, and there was no attenuation of the interventions' effect and no effect of time on the control groups' knowledge over a 4 1/2 month period. The results suggest that it is possible to improve clinicians' knowledge of expert recommendations through direct mail intervention.

Adult↗
PubMed1991

Dentists' sources of information about patient medications and other issues of medical management.

The frequency of use of sources of information about medications used for patients and other issues of medical management are analyzed in a national sample of general practice dentists (GPs). Subgroups of urban/rural, solo/nonsolo, and younger/middle-aged/older dentists are examined for differences between groups. Assessing mean frequency of use for the entire group, the most frequently used sources of medical information are: 1) the consultant network; 2) the patient's physician; and 3) the Physicians' Desk Reference (PDR). Professional meetings, professional journals, and pharmaceutical detail people are the least frequently used sources. Frequency of use of information sources is related to solo/nonsolo status and to age, but not locale.

Adult↗
PubMed1991

Effect of maternal cocaine administration on maternal and fetal glucose, lactate, and insulin in sheep.

Although cocaine use during pregnancy is an important cause of perinatal morbidity and mortality, there are no reports of its effect on maternal and fetal carbohydrate metabolism. Six pregnant ewes and their fetuses were instrumented under halothane general anesthesia at 113-119 days' gestation. Between 124-135 days' gestation, the ewes received a single infusion of vehicle or cocaine (1.0 or 2.0 mg/kg) into the jugular vein. At least 24 hours was allowed between successive injections. Maternal and fetal blood samples were drawn at 30 and 20 minutes before and at 5, 15, 30, and 60 minutes after the injection. Both maternal and fetal glucose and lactate concentrations increased (P less than .05) after injection of cocaine at 2.0 mg/kg. There were no significant changes in maternal or fetal plasma insulin concentrations after vehicle or cocaine administration. Induction of hyperglycemia and lactacidemia could be mechanisms whereby cocaine exerts its adverse effects during pregnancy.

Animals↗
PubMed1979

Creutzfeldt-Jakob disease in France: II. Clinical characteristics of 124 consecutive verified cases during the decade 1968--1977.

One hundred twenty-four consecutive cases of Creutzfeldt-Jakob disease (CJD) in France, verified by biopsy or autopsy between 1968 and 1977, were analyzed with respect to their clinical characteristics. The series comprised equal numbers of men and women, with the most frequent age at onset being 60 to 64 years and the most frequent duration, two to three months. A prodromal illness was observed in more than one-third of the patients. Clinical presentations and symptom frequencies are tabulated, and a multifactor analysis has been performed to obtain those combinations of symptoms and signs which occurred at least as often as the triad of dementia, myoclonus, and a positive electroencephalogram. Two groups of atypical cases are also emphasized: one with sudden, strokelike presentation and rapidly evolving illness of less than 2 months' duration, and the other with a long clinical course of between 2 and 10 years.

Age Factors↗
PubMed1978

Familial multiple sclerosis: clinical, histocompatibility, and viral serological studies.

Evaluation of presumed "multiple sclerosis families" and comparison with recently reported families has led us to the following observations: (1) Seven of our original fourteen presumptive multiple sclerosis families had to be eliminated after personal clinical evaluation of family members failed to confirm the diagnosis in a second close relative. (2) No segregation of HLA type was noted between affected and unaffected individuals in our seven bona fide multiple sclerosis families, and no consistent segregation was noted in the twenty-eight families reported elsewhere. This supports other genetic evidence that there is not a single, major gene mapping in the HLA complex which predisposes to multiple sclerosis. (3) The DW2 antigen was increased in frequency among affected members of our families, and the A3 B7 haplotype was more frequent among affected members of other families reported. But unaffected members also tended to have an increased frequency of these same antigens. (4) No relationship was noted between HLA type and antimeasles antibody titer within our families.

Antibodies, Viral↗
PubMed1978

Ventilatory lung function studies in Pacific Island Micronesians.

In the first study of ventilatory lung function in people of the Micronesian race, observations in 182 normal subjects (117 males and 65 females) between the ages of 15 and 80 years were used to calculate regression equations for FVC, FEV1, and FEV1%. Mean values of FVC and FEV1 were found to be lower than those reported for Caucasians and Polynesians, but similar to Melanesians, Negroes and Chinese. Values of FEV1% were comparable among all races. The three Oceanic races showed a smaller reduction of FVC and a larger reduction of FEV1% with increasing age than did Caucasians. Although the biological significance of this variability of ventilatory function in different races is uncertain, the definition of racial norms is already proving useful in studies of pulmonary airway disease among Oceanic peoples.

Adolescent↗
PubMed1977

Second vertical osteotomy 15 years after initial operation.

A case of mandibular prognathism that existed 15 years after a previous attempt at correction has been presented. The initial procedure was the vertical osteotomy done via an extraoral approach. A second attempt at correction was undertaken with use of the same approach. The anatomic changes existing as a result of the first surgical procedure were of extreme interest. A decreased anteroposterior length of the sigmoid notch with posterior placement of the coronoid process was observed. Also, an increased thickness of the mandibular rami in a mediolateral plance was present. The clinical problems encountered as a result of these changes were difficulty in overlapping proximal and distal segments without definite osseous reductions and the inability to set back the mandible further without coronoidectomy. When these procedures were done, the patient's treatment was managed very successfully.

Adult↗