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Biomedical subjects

J Hardie

Publications and source records attributed to J Hardie.

At least 19 recordsLinked to original sources
PubMed1992

Problems associated with providing dental care to patients with HIV-infected and AIDS patients.

Numerous articles published during the last decade have discussed the significance of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) toward the practice of dentistry. However, only since 1987 have studies been undertaken on the attitudes and behavior of dentists toward HIV-positive patients. A detailed analysis of 15 such reports suggests that concerns regarding the perceived stigma of treating such patients, together with a fear that HIV is transmitted through dental treatment are major reasons why dentists are reluctant to care for HIV-positive and AIDS patients. Successful resolution of these concerns is time consuming and expensive but necessary if dentists are to satisfy their professional obligations to patients with HIV infection and AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1992

A 1992 update on hepatitis B vaccination.

Surveillance studies of people at high risk for hepatitis B, combined with almost 10 years of experience with the vaccine, have allowed cost effective vaccination programs to be devised. It would make good sense to incorporate the hepatitis B vaccination into the standard childhood immunization protocols. Present teenagers, who will not benefit from such a program, would be well advised to be vaccinated. All clinical dental staff should also be immunized. These three actions would be very effective in curbing the spread of this preventable disease.

Dental Staff↗
PubMed1992

Does HIV cause AIDS? A review.

It would require a detailed knowledge of virology, molecular biology, epidemiology, clinical medicine and politics, to appropriately compare and contrast the hypotheses on the causes of AIDS. The purpose of this review was not to do that, but to inform colleagues that alternative etiologies for AIDS have been considered. No doubt, this healthy questioning will continue until it has been demonstrated--via controlled studies of high-risk groups (both HIV positive and negative), matched for all other characteristics--that only those individuals with HIV positivity actually develop AIDS. It cannot be denied that a common theme to the hypotheses is the presence of high-risk activities. This has been used against the risk-AIDS hypothesis. How, for example, could it explain babies born with immunodeficiencies, K. Bergalis contacting AIDS from her dentist, the British nurse who died of AIDS after contracting HIV from her husband, or AIDS in the wives of hemophiliacs? It may be that these people died of specific diseases (leukemia, pneumonia, infections), which 20 years ago would have been diagnosed as such. Now, because these individuals are found to be HIV positive, they are viewed as AIDS patients. Alternatively, they may not have been asked about their nutritional status, use of psychoactive drugs, and immunosuppressive sexual practices. Additionally, it is possible that by the time AIDS was diagnosed they may have already received numerous antibiotic (immunosuppressive) drug treatments. In North America, for whatever reason, AIDS is associated with high-risk groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1992

The attitudes and concerns of Canadian dental health care workers toward infection control and the treatment of AIDS patients.

This survey indicates that while the majority of Canadian dental personnel would treat AIDS patients, they are concerned about the transmission of the causative agent and the efficacy of recommended infection control procedures. It is believed that a frank discussion of these reservations and anxieties is essential if dentists and their auxiliaries are to treat AIDS patients in an effective, comfortable manner.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Addressing the fears of HIV transmission in dental practice.

Recent surveys indicate that dental personnel are prepared to provide care for HIV+/AIDS patients, but do so with some reluctance. Their specific concerns have been identified and an attempt has been made to allay these fears by examining them from scientific, clinical, epidemiologic and historical perspectives. These somewhat pragmatic criteria suggest that HIV transmission in dental practice is extremely unlikely-if not impossible. However, the explanations offered to arrive at these conclusions may fail to resolve the suspicions that some dentists and their auxiliaries harbor toward individuals demonstrating lifestyles foreign to their own. If this is so, the advice of counsellors, social scientists and behavioral modification experts must be sought if dental personnel wish to provide care to HIV+/AIDS patients in an atmosphere of mutual trust, confidence and respect.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Concerns regarding infection control recommendations for dental practice.

It goes without saying that the members of any professional group are more likely to modify their behavior if they are provided with logical, rational reasons to enact the suggested change. In the mid 1980s, health care providers, including dental personnel, were advised to adopt universal precautions and to alter their infection control habits with minimal justification, apart from the general unease and paranoia surrounding AIDS. Therefore, it is understandable that some practitioners would react with scepticism to the idea that their traditional infection control techniques were less than adequate, while others would overwhelmingly embrace the new recommendations in the misguided belief that personal, patient, staff and family safety would be enhanced. This predictable confusion is epitomized by the dentist who "sterilizes" extraction forceps by immersing them in alcohol for 10 minutes, versus the dentist who wears gloves, mask and disposable gown to conduct a recall examination. And if dentists are perplexed, it is clear that their staffs are equally, if not more confused, since they are exposed to the exaggerated claims and counter claims of sales agents. The microbes encountered in dental practise, apart from the hepatitis B virus, pose no significant risk to dental personnel or their patients, and the danger of hepatitis B transmission is reduced most effectively by vaccination. In reality, the genesis of dentistry's current emphasis on infection control resides entirely with HIV disease. But there is no credible clinical evidence to suggest that HIV infection is transmitted via dental treatment. Indeed, it may be theorized that for such a transmission to occur, the blood stream of the susceptible recipient would have to be invaded directly by a pathogenic inoculum of the virus--an unlikely event in the normal practise of dentistry. Under such circumstances, infection control practises should ignore the danger of HIV transmission, but concentrate on: Sterilization of all surgical and invasive instruments to protect patients from potential cross-infection. All dental staff receiving hepatitis B vaccinations. Dental staff wearing gloves, especially while performing intraoral procedures with blood release, and handling used instruments, to protect them from direct contact with potential pathogens. Working in a clean environment, in which blood spills and splatters are removed mainly for esthetic reasons. Such measures reflect the actual potential for disease transmission, as it exists in dentistry. They are justified and economical, and will be implemented by concerned but knowledgeable dental staff.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Hormonal regulation of epidermal metamorphosis in vitro: control of expression of a larval-specific cuticle gene.

Fourth (penultimate) instar larval epidermis of the tobacco hornworm, Manduca sexta, was used to develop an in vitro culture system to study the hormonal control of metamorphosis at both the cellular and the molecular level. Immediate exposure to 4 x 10(-6) M 20-hydroxyecdysone (20-HE) for more than 8 hr, followed by hormone-free medium for 24 hr, caused the formation of a new larval cuticle. By contrast, incubation in hormone-free medium for more than 24 hr prior to exposure to 20-HE allowed pupal cuticle synthesis. The cessation of expression of the larval-specific cuticular gene LCP-14 occurred rapidly in response to 20-HE during the larval molt in vitro (half-life: ca. 6 hr), even in the presence of 3 x 10(-8) M JH I. This suppression by 20-HE was prevented by cycloheximide, indicating that 20-HE does not act directly on this gene. Incubation with alpha-amanitin showed that the half-life of LCP-14 was more than 10 hr. Thus, 20-HE must both suppress gene transcription and destabilize the mRNA. LCP-14 mRNA subsequently reappeared 24 hr after exposure to hormone-free medium, indicating that suppression was temporary. By contrast, when JH and its effects were absent after preincubation in hormone-free medium for 48 hr, 20-HE caused permanent suppression of LCP-14 mRNA, since the mRNA did not reappear after removal of 20-HE. Exposure of Day 2 fifth instar larval epidermis to 3 x 10(-7) M 20-HE, which causes pupal commitment in the absence of JH I, also permanently suppressed LCP-14 gene expression.

Animals↗
PubMed1990

An update on the human immunodeficiency virus and infection control.

This report is not an attempt to provide a comprehensive review of HIV infection, AIDS, and infection control. Rather it has highlighted some of the medical, ethical and legal aspects associated with the AIDS dilemma which are of significance to the dental profession. There would appear to be few if any valid professional reasons which a dentist may use to avoid treating an HIV infected or AIDS patient. In fact, dentists adopting such an attitude may be subject to litigation. From a research perspective, it is feasible that continuing monitoring of the oral manifestations of AIDS and its associated diseases will contribute much information regarding the responses of the oral tissues to immunosuppression. This, in turn, may result in a better appreciation of common dental diseases especially periodontitis. The information on infection control has emphasized how a knowledge of the basic microbiologic concepts regarding disease transmission should be used as the foundation for effective prevention of disease transmission.

Candidiasis, Oral↗
PubMed1990

Potentially fatal hereditary angioedema: a review and case report.

Hereditary angioedema is a disease based upon a biochemical deficiency which may result in sudden and unexpected death principally from respiratory distress due to swelling of the pharyngeal tissues. Dental treatment is not an uncommon initiator of such edema. To perform dental care safely, it is necessary to understand the etiology, diagnosis, and treatment of the condition. This article presents a review of these features, and indicates via a case report how knowledge of them was essential in conducting safe, effective and efficient dental treatment.

Angioedema↗
PubMed1990

Commonly prescribed medical drugs and their significance in dental therapy. Part I--The antibiotics.

An analysis of Tables I and II reveals that the 20 drugs most frequently prescribed by family practitioners may be classified into 10 therapeutic categories. The antibiotics constitute the numerically largest group. The medical use, adverse reactions, and dental significance of these antibiotics have been described. The remaining drugs will be discussed using a similar format in subsequent papers.

Anti-Bacterial Agents↗