PubMed HealthSearch

Biomedical subjects

E Truelove

Publications and source records attributed to E Truelove.

8 recordsLinked to original sources

Decision making in dentistry. Part I: A historical and methodological overview.

The study of clinical decision making provides a common model on which to base dental practice and thus promotes standardization of care and treatment. Decision analysis can assist in identifying missing data in clinical problems and thus generate clinically relevant research agendas. In Part I of this article several of the leading methods of decision analysis are briefly described with examples of how they can be applied in dentistry. The methods presented are Bayes' theorem, decision-tree design, receiver-operating-characteristic curves, sensitivity analysis, and utilities assessment.

Decision Making

Decision making in dentistry. Part II: Clinical applications of decision methods.

The study of clinical decision making provides a common model on which to base dental practice and thus promotes standardization of care and treatment. Decision analysis can assist in identifying missing data in clinical problems and thus generate clinically relevant research agendas. Part II reviews the current literature focusing on three areas of decision making in dentistry: diagnosis, treatment planning, and disease prediction. The growing body of literature indicates that wide variation exists among the treatment plans made by dentists. Considerable bias arises from many sources of uncertainty in decision making, including the limitations of human memory and judgment. Literature pertaining to computer application of decision analysis in dentistry and to policy making are reviewed.

Decision Making

Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls.

An epidemiologic study of clinical signs and symptoms of temporomandibular disorders (TMD) was conducted with a probability sample of adults enrolled in a major health maintenance organization (HMO). This report presents data from a first wave field examination and interview conducted by trained, calibrated dental hygienist field examiners. Significant gender differences for vertical jaw opening measures were observed but no significant age differences were found for the distribution of clinically relevant findings. Clinic cases showed smaller amounts of vertical range of jaw motion but did not differ from community cases or controls on extent of lateral, protrusive, or retrusive mandibular movements; on classification of occlusion; or on dentally related variables. Clinic cases had more pain during all jaw excursions as well as during muscle and joint palpation. Joint clicking sounds were also observed more frequently in clinic cases.

Adolescent

Oral mucosal lesions: association with the presence of antibodies to the human immunodeficiency virus.

To assess the relationship between oral lesions and antibodies to the human immunodeficiency virus, oral examinations of 803 homosexual males were conducted at the time of serologic testing. Nineteen percent were HIV seropositive. Thirty percent of antibody-positive subjects had one or more oral lesion(s), as compared with 7% of antibody-negative subjects (p less than 0.001). The presence of oral lesions was significantly associated with HIV seropositivity: a subject was 5.7 times as likely to have serum antibodies if he had one or more oral lesions (95% confidence interval, 3.5 to 9.1; p less than 0.001). This significant association with HIV seropositivity was only partially explained by cigarette smoking (adjusted odds ratio 3.1; 1.4-6.8; less than 0.006). Specific conditions that were significantly associated with seropositivity included candidiasis, hairy leukoplakia, periodontal disease, and Kaposi's sarcoma. Other diseases identified included acute necrotizing ulcerative gingivitis, mucocutaneous ulcerations, and oral warts. Oral findings may occur earlier in the natural history of infection than previously reported.

Adult

Autonomic regulation of potassium release from human labial salivary glands in vitro.

Labial salivary-gland slices from normal human subjects were incubated in vitro according to various protocols. The autonomic regulation of these was significantly different from that of most major salivary glands. K release was stimulated by incubation with a cholinergic agonist but not with alpha- or beta-adrenergic agonists. The cholinergically-induced K release was dependent on agonist concentration and was inhibited by the addition of atropine, and by the removal of Ca in the presence of EGTA.

Adult

Electron microprobe analysis of human labial gland secretory granules in cystic fibrosis.

X-ray microanalysis of freeze-dried labial gland cryosections revealed that Na concentration was doubled and the Ca/S concentration ratio was decreased in secretory granules of labial glands from patients with cystic fibrosis (CF) when compared with glands from normal subjects. Other results suggested that the decrease in the Ca/S concentration ratio resulted from an increase in S concentration. These findings imply that mucous granules in labial saliva showed a CF-related increase in Na and S content, and such changes would be expected to affect the rheology of the mucus after exocytosis. In contrast with a previous study in human parotid glands, no evidence was found for CF-related changes in cytoplasmic or nuclear Na, K, and Ca concentrations. Significant elemental differences were found between secretory granules and nuclei and cytoplasm of control cells.

Adolescent

Age-dependent decreases in human submandibular gland flow rates as measured under resting and post-stimulation conditions.

Submandibular saliva samples were obtained with a new collection device, under resting and post-stimulation conditions, from 28 healthy individuals between 70 and 91 years of age, and from 30 healthy individuals between 18 and 39 years of age. The salivary flow rates were significantly decreased in the aged group compared with the control group. The mean resting and post-stimulation flow rates for the aged group averaged 22% and 39%, respectively, of control values.

Adolescent