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Biomedical subjects

H S Goodman

Publications and source records attributed to H S Goodman.

At least 19 recordsLinked to original sources
PubMed1998

An assessment of oral cancer prevention curricula in U.S. medical schools.

BACKGROUND: Oral cancer is readily detectable through routine examination, but five-year survival rates remain low. Physicians bear the same responsibilities as dentists in the early detection of oral cancers, because high-risk patients utilize medical services more often than dental services. METHODS: Because physicians' practices are largely influenced by their training, this study assessed the level of oral cancer education provided to undergraduate U.S. medical students. Health history and physical diagnosis course curricula were assessed for relevant content. RESULTS: The response rate from the U.S. medical schools was 63.2%. When compared with the "gold standard," the average score was 43% of the optimum. Seven percent of the schools did not require inspection of the mouth, 29% required inspection of all oral structures, and intraoral palpation was advocated by 43% of the schools. Although most schools included questions about alcohol and tobacco use, only 13% asked about sunlight exposure. CONCLUSION: Preliminary oral cancer training in medical schools regarding physical assessment and elicitation of signs, symptoms, and high-risk behaviors lacks both adequacy and comprehensiveness.

Curriculum↗
PubMed1998

Maryland adults' knowledge of oral cancer and having oral cancer examinations.

OBJECTIVES: This study sought to determine (1) knowledge of risk factors for oral cancer, (2) knowledge of signs and symptoms of oral cancers, and (3) factors associated with having had an oral cancer examination among 916 Maryland adults 18 years of age and older. METHODS: A statewide, random-digit dial, computer-assisted telephone survey was conducted. The pretested instrument consisted of 32 questions that required 12 minutes to complete. RESULTS: Overall, level of knowledge about risk factors for and signs and symptoms of oral cancers was low; misinformation was high. Although 85 percent reported hearing about oral or mouth cancer, only 28 percent of the respondents reported having had an oral cancer examination. Of these, 20 percent had the exam during the past year--the recommended frequency for persons 40 years of age or older. In logistic regression analysis, adults more likely to have had an oral cancer examination included those who thought personal behavior causes more cancer than environmental factors; had more knowledge about risk factors for oral cancer; and were 40-64 years of age, white, and better educated than their counterparts (P < .05). The primary reasons for not having an exam were "no reason/didn't know I should" and "doctor/dentist didn't recommend." CONCLUSIONS: These results demonstrate a need for interventions designed to increase knowledge levels of risk factors for, signs, and symptoms of oral cancers and the need for oral cancer examinations; and to increase oral cancer examinations.

Adolescent↗
PubMed1998

Knowledge, opinions and practices of general dentists regarding oral cancer: a pilot survey.

The authors mailed a pilot survey to 500 randomly selected general dentists. Although most dentists reported their knowledge of oral cancer to be current, their actual knowledge of oral cancer risk factors and signs and symptoms was inconsistent. Conflicting data were also found between their level of knowledge and their provision of oral cancer examinations. Most respondents agreed that patients should undergo an oral cancer examination annually, yet many do not provide this service.

Adolescent↗
PubMed1996

The need for health promotion in oral cancer prevention and early detection.

OBJECTIVES: This review paper provides a rationale for using health promotion to help reduce morbidity and mortality due to oral cancers by identifying barriers to prevention and early detection of these cancers and discussing strategies for change. METHODS: A literature review of the following areas was conducted: epidemiology of and risk factors for oral cancers; knowledge, opinions, and practices of health care providers and the public regarding prevention, early detection, and control of oral cancers; and policies and regulations that either enhance or act as barriers to the prevention and early detection of oral cancers. RESULTS: Overall, the public is ill-informed about risk factors for and signs and symptoms of oral cancers and relatively few US adults have had an oral cancer examination. Further, health care providers are remiss in providing oral cancer examinations and detecting early oral cancers. CONCLUSIONS: To achieve the 13 oral cancer objectives contained in "Healthy People 2000," health care providers and the public must know the risk factors for these cancers as well as their signs and symptoms. Further, health care providers need to provide oral cancer examinations routinely and competently. Equally important, the public needs to know that an examination for oral cancer is available and that they can request one routinely. Thus, a vigorous agenda that includes education, policy, and research initiatives is needed to enhance oral cancer prevention and early detection.

Adolescent↗
PubMed1995

Assessing physicians' and dentists' oral cancer knowledge, opinions and practices.

Oral cancer is responsible for more than 8,000 deaths each year. This mortality may be attributed to lack of effective oral examinations by dental and medical primary care clinicians. This pilot project assessed the knowledge, opinions and practices of a group of Maryland physicians and dentists in oral cancer prevention, diagnosis and detection. Dentists performed more oral cancer examinations, although physicians saw more high-risk patients.

Adult↗
PubMed1995

Assessment of alcohol and tobacco use in dental schools' health history forms.

Health history forms are an integral component of students' clinical and didactic training in physical assessment and often serve as a model for students to use in their future practices. This study examined how alcohol and tobacco use are assessed in patient health history forms used in the dental schools of the United States and Canada (n = 63). Deans of schools were requested to send a copy of their health history and other supplemental forms used for patient care. The response rate was 98 percent. Almost 25 percent of the schools' forms did not address either alcohol or tobacco use; 37 percent failed to address one or both risk behaviors; 25 percent did not request tobacco information; and 36 percent did not address alcohol use. Major inconsistencies regarding the inclusion, content, and quantity of alcohol and tobacco questions were noted. Consensus among dental schools as to which questions to include in their health forms was not apparent.

Alcohol Drinking↗
PubMed1994

Sterilization of dental instruments and devices: an update.

Dental sterilization techniques have become a focus of attention as a result of disclosure of occupational HIV transmission from an infected dentist to a cluster of patients. Although there has never been a confirmed report of a patient acquiring an infectious blood-borne disease from a dental instrument or device, recommendations for universal sterilization of dental handpieces and other devices have recently been implemented. Because of the higher rate of hepatitis B virus transmissability in the dental health care environment, an upgrade in sterilization protocols may be warranted. Stringent sterilization standards are especially necessary in higher-risk institutional dental care settings. However, a high rate of dental sterilization errors has been reported and traced to operator error. Recent institutional dental sterilization policy changes have been developed to reduce the chance of sterilization error, further diminishing the risk of cross contamination.

Dental Equipment↗
PubMed1993

Oral cancer mortality in Maryland.

Oral cancer mortality is one of the most preventable types of cancer deaths when the lesion is detected early. The survival rate is quite low, however, when oral cancer is diagnosed at an advanced stage. While the Maryland oral cancer incidence rate is lower than the US average, the state ranks fourth in the country for overall age-adjusted oral cancer mortality; Maryland's African-American population has the highest oral cavity and pharyngeal mortality rate. Delayed diagnosis may explain this occurrence since groups at high risk for developing oral cancer, such as the elderly and minority groups, do not have ready access to the Maryland oral health care system. As the elderly annually use physicians' services almost twice as much as they use dentists' services, physicians are encouraged to routinely complete an oral cavity and pharyngeal examination. Inclusion of oral health services into a Maryland health system reform benefits package would also improve routine screening frequency for oral cancer.

Female↗
PubMed1991

The tyrosine-225 to phenylalanine mutation of Escherichia coli aspartate aminotransferase results in an alkaline transition in the spectrophotometric and kinetic pKa values and reduced values of both kcat and Km.

Tyrosine-225 is hydrogen-bonded to the 3'-hydroxyl group of pyridoxal 5'-phosphate in the active site of aspartate aminotransferase. Replacement of this residue with phenylalanine (Y225F) results in a shift in the acidic limb of the pKa of the kcat/KAsp vs pH profile from 7.1 (wild-type) to 8.4 (mutant). The change in the kinetic pKa is mirrored by a similar shift in the spectrophotometrically determined pKa of the protonated internal aldimine. Thus, a major role of tyrosine-225 is to provide a hydrogen bond that stabilizes the reactive unprotonated form of the internal aldimine in the neutral pH range. The Km value for L-aspartate and the dissociation constant for alpha-methyl-DL-aspartate are respectively 20- and 37-fold lower in the mutant than in the wild-type enzyme, while the dissociation constant for maleate is much less perturbed. These results are interpreted in terms of competition between the Tyr225 hydroxyl group and the substrate or quasi-substrate amino group for the coenzyme. The value of kcat in Y225F is 450-fold less than the corresponding rate constant in wild type. The increased affinity of the mutant enzyme for substrates, combined with the lack of discrimination against deuterium in the C alpha position of L-aspartate in Y225F-catalyzed transamination [Kirsch, J. F., Toney, M. D., & Goldberg, J. M. (1990) in Protein and Pharmaceutical Engineering (Craik, C. S., Fletterick, R., Matthews, C. R., & Wells, J., Eds.) pp 105-118, Wiley-Liss, New York], suggests that the rate-determining step in the mutant is hydrolysis of the ketimine intermediate rather than C alpha-H abstraction which is partially rate-determining in wild type.

Aspartate Aminotransferases↗
PubMed1990

Dental health personnel planning: a review of the literature.

Dental personnel planning is important in formulating policy in dental education, dental public health programs, and dental care delivery systems. The purpose of this literature review is to illustrate the use of dentist-to-population ratios, need-based models, and demand-based models in the determination of appropriate supply of dental personnel. A historical perspective is provided that demonstrates how political manipulation and subjectivity have characterized the use of these models by organized dentistry, the federal government, and others. The lack of pertinent data and the inability to predict economic, social, political, and epidemiologic trends weaken the applicability of each model in determining future personnel levels. Considering the long-term consequences of the use of each model in personnel planning, caution is urged in using any of the presently available models.

Dental Health Services↗
PubMed1990

Transcriptional analysis of the mouse beta-casein gene.

These studies were designed to further elucidate the relative contributions of transcriptional and posttranscriptional mechanisms involved in beta-casein gene regulation in the mammary epithelial cell line designated COMMA-D and a clonal subline desginated HC-11. Primary transcripts were mapped under various hormonal and substratum conditions using the technique of nuclear run-on transcription and single stranded sense and antisense probes spanning the beta-casein gene. In the presence of insulin alone very little sense transcription is detectable, but antisense transcription is observed, which originates at least 150 basepairs upstream of the normal start site of transcription and is present regardless of hormonal, cell substratum, cell type, or gene activity. Antisense transcription is also detectable in the 3' end of the gene. Insulin, glucocorticoids, and PRL are all necessary for a maximal increase in transcription. A 2- to 4-fold increase in transcriptional activity is observed in the presence of insulin and PRL compared to insulin alone, and this is accompanied by a 125-fold increase in the level of beta-casein mRNA. All three hormones act synergistically to induce a 10-fold increase in transcriptional activity, but the transcriptional increase across the gene is not equimolar. The 5' half of the gene is transcribed at a level that is 2- to 10-fold lower than that of the 3' half of the gene. These studies reveal a significant transcriptional component to beta-casein gene regulation which was not heretofore detected using double stranded cDNA probes representative of only the 3' half of the gene.

Animals↗