Biomedical subjects
Publications and source records attributed to J M Anthony.
Periodontal disease is multifaceted in nature. Problems occur, such as mucogingival problems, osseous deformities, and gingival enlargement, and they require multiple types of treatment. There is no one way to approach each problem or procedure. Philosophy, talent, experience, training, and objectives ultimately determine treatment selection.
Periodontal surgery requires the operator to have specific knowledge and skills. The use of proper equipment will improve the operator's skill and will decrease surgical time. It will also result in less tissue trauma, thus increasing healing time and reducing postoperative complications and patient discomfort. Various surgical procedures can be enhanced with the usage of equipment that is designed for specific tasks of the procedure. Proper care of equipment is essential for extended instrument life.
Current concepts of endodontic treatment have changed over the years; however, the fundamental principles remain constant. We in the veterinary field have seen rapid technological advances in the field of human endodontics that we have tried to adapt to our patients. Veterinary endodontists must continually evaluate new instruments, devices, and procedures with the overall goal in mind: to give the patient the best care possible by proper diagnosis, removal of intracanal irritants, and creation of an environment suitable for healing. The design is not as important as how the instrument is used. As a result, keep in mind patience, prudence, and practice. All instruments and techniques have limitations, but the most important limitation is within ourselves.
While thermally supported cats experienced a drop in body temperature during dental procedures, the drop was significantly greater in cats without thermal support. As cats are at risk of developing clinical hypothermia during dental procedures, steps should be taken to minimize the loss of body heat.
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Small animal dentistry is a rapidly growing area of interest and specialization internationally, offering tremendous benefits to patients, clients, and practitioners. To date, no studies have been done to determine the standard of small animal dental care in Canada. A national mail survey was designed to document the prevalence of dental disease in small animal patients, the types of veterinary dental procedures being provided by practitioners, as well as home care recommendations and compliance for 1994.
A cystic structure was identified radiographically in a four-year-old dog during routine dental prophylaxis. Surgical removal of the cyst lining was achieved by exposure of the site through extraction of the right first to third maxillary incisor teeth (101, 102, 103). The cyst lining was removed en-bloc. The cavity was curetted and filled with decalcified freeze-dried bone. Histological examination revealed a radicular cyst. The proposed etiology is blunt trauma to tooth 103, pulpal necrosis, apical granuloma and resulting cyst formation. Fourteen months following surgery, there was no recurrence of the cyst.
OBJECTIVE: Although measures of health perceptions have been routinely incorporated into assessments of individuals with rheumatoid arthritis (RA), the relationships of other characteristics of these individuals to their health perceptions is not fully understood. We describe the cross sectional associations of sociodemographic, disease, and functional status characteristics with perceived health in individuals with RA. METHODS: This description was generated through a 2-phase secondary data analysis using 2 statistical approaches: recursive partitioning of the sample and standard multivariate logistic regression techniques. RESULTS: Both methodological approaches identified education, race, depression, and physical activity as important correlates of self-assessed health in RA. Each approach, in its own way, also identified an interactive effect between physical activity and education and between depression and race in these models. CONCLUSION: An individual's sociodemographic, disease, and functional status characteristics form a complex model of the correlates of health perceptions of individuals with RA.
OBJECTIVES: The purpose of this study was to identify associations between specific medical conditions in the elderly and limitations in functional tasks; to compare risks of disability across medical conditions, controlling for age, sex, and comorbidity; and to determine the proportion of disability attributable to each condition. METHODS: The subjects were 709 noninstitutionalized men and 1060 women of the Framingham Study cohort (mean age 73.7 +/- 6.3 years). Ten medical conditions were identified for study: knee osteoarthritis, hip fracture, diabetes, stroke, heart disease, intermittent claudication, congestive heart failure, chronic obstructive pulmonary disease, depressive symptomatology, and cognitive impairment. Adjusted odds ratios were calculated for dependence on human assistance in seven functional activities. RESULTS: Stroke was significantly associated with functional limitations in all seven tasks; depressive symptomatology and hip fracture were associated with limitations in five tasks; and knee osteoarthritis, heart disease, congestive heart failure, and chronic obstructive pulmonary disease, were associated with limitations in four tasks each. CONCLUSIONS: In general, stroke, depressive symptomatology, hip fracture, knee osteoarthritis, and heart disease account for more physical disability in noninstitutionalized elderly men and women than other diseases.
OBJECTIVE: To assess the effect of hypertension on the development of renal functional deterioration, end stage renal disease and death in patients with systemic lupus erythematosus (SLE). METHODS: Person-years analysis using regression techniques to adjust for other baseline risk factors for adverse renal and patient survival outcomes. RESULTS: Six hundred eighty-five patients with SLE were followed for a total of 4,137 person-years. The risk of renal deterioration (doubling of serum creatinine) and endstage renal disease (ESRD) both increased with increasing baseline mean arterial pressure (MAP) (both p > 0.05). Even after adjustment for age, sex, baseline serum creatinine, C3, erythrocyte sedimentation rate, hematocrit, anti-DNA antibodies, and proteinuria, those in the highest quartile of MAP had 2.3 times the odds of renal deterioration at 12 months and 4.6 times the odds of ESRD compared to those in the lowest quartile of MAP (both p < 0.01 comparing highest to lowest quartile of MAP). Also, hypertension increased the risk of mortality, especially between one and 2 years after blood pressure determination. The effect of hypertension was also independent of corticosteroid dose. CONCLUSION: In patients with SLE, hypertension is a potent independent risk factor for adverse renal outcomes, and it also increases the risk of death.
OBJECTIVE: To evaluate the effect of weight loss in preventing symptomatic knee osteoarthritis in women. DESIGN: Cohort analytic study. SETTING: The Framingham Study, based on a sample of a defined population. PATIENTS: Women who participated in the Framingham Knee Osteoarthritis Study (1983 to 1985): Sixty-four out of 796 women studied had recent-onset symptomatic knee osteoarthritis (knee symptoms plus radiographically confirmed osteoarthritis) were compared with women without disease. MEASUREMENTS: Recalled date of symptom onset was used as the incident date of disease. Historical weight was defined as baseline body mass index up to 12 years before symptom onset. Change in body mass index was assessed at several intervals before the current examination. Odds ratios assessing the association between weight change and knee osteoarthritis were adjusted for age, baseline body mass index, history of previous knee injury, habitual physical activity level, occupational physical labor, smoking status, and attained education. RESULTS: Weight change significantly affected the risk for the development of knee osteoarthritis. For example, a decrease in body mass index of 2 units or more (weight loss, approximately 5,1 kg) over the 10 years before the current examination decreased the odds for developing osteoarthritis by over 50% (odds ratio, 0.46; 95% Cl, 0.24 to 0.86; P = 0.02). Among those women with a high risk for osteoarthritis due to elevated baseline body mass index (greater than or equal to 25), weight loss also decreased the risk (for 2 units of body mass index, odds ratio, 0.41; P = 0.02). Weight gain was associated with a slightly increased risk for osteoarthritis, which was not statistically significant. CONCLUSION: Weight loss reduces the risk for symptomatic knee osteoarthritis in women.
We have carried out a laboratory evaluation of an active heat and moisture exchanging filter (aHMEF). The device consists of a conventional heat and moisture exchanging filter (HMEF) with an additional heating element and water supply. It was compared with a standard HMEF using a model lung. The aHMEF with the heating element alone, reduced 2-hourly water loss compared with the HMEF (P < 0.001); with both the heating element and additional water, this was reduced further (P < 0.001). The mean catheter mount temperature with the HMEF and heater was 32.7 (SD 1.8) degrees C and with the complete aHMEF was 34.6 (1.6) degrees C. The maximum temperature with the heating element in use was 37.7 degrees C. We conclude that the aHMEF provided effective, controllable and convenient humidification of inspired gases.
A dolichocephalic canine skull was utilized to develop a teaching and study model for coronal access cavity preparation of the dentition. The teeth from the right side of the skull were extracted. Each tooth was radiographed in two planes to localize the "ideal" endodontic access point. Barium markers were placed over these points and each tooth was radiographed again to confirm the appropriate location of the marker. Access was created by drilling through the barium marker. Then, K-files were inserted through the access preparation into the root canal system. The teeth were radiographed with the K-files in place to verify straight pathways to the apices. Straight line access to the apex was obtained in all teeth. Creation of this model provides an opportunity for the veterinary dental student to develop and refine skills used in performing endodontic therapy. The model can be utilized by the veterinary dental practitioner in clinical practice.
The Quantitative Buffy Coat (QBC) system was used for the detection and identification of malaria parasites in blood specimens from 570 residents of Oksibil, an isolated highland valley in the eastern Jayawijaya Mountains of Irian Jaya (Indonesian New Guinea). The availability of a battery-powered centrifuge and a fiberoptic Paralens enabled us to complete and interpret the assay in this remote environment. Of 322 QBC tubes examined for 2-4 min each, results of 295 (92%) concurred with findings on the matched Giemsa-stained thick smear (GTS). The 27 discrepant results included 13 QBC+/GTS- that, upon reexamination, were found to be GTS+. When using the corrected GTS results as the standard, the sensitivity and specificity of the QBC were 94% and 96%, respectively. Because electricity was available only 3 hr per day, it was decided to decrease the examination for an additional 248 QBC to a maximum of 90 sec per tube. This shortened inspection time resulted in a reduction of sensitivity to 53% but specificity was preserved at 89%. Forty-two of 45 conflicting results, QBC-/GTS+ from cases of light Plasmodium falciparum infections with < 1 trophozoite or gametocyte per field, were resolved by reexamination of the QBC in the laboratory. Tubes held at 4 C could be reexamined, without noticeable loss of fluorescence, for at least 6 wk after collection. Despite some difficulty in the identification of Plasmodium species, it was concluded that the QBC is an easy, sensitive method for the rapid diagnosis of malaria in the field and that it provides the inexperienced microscopist with an additional means for on-site identification of individuals needing treatment.
Thiazide diuretics may preserve bone mass and prevent elderly women's osteopenic fractures, but studies have not distinguished between thiazide preparations or examined former users. We performed a case-control study looking at thiazide use and subsequent hip fracture in postmenopausal female members of the Framingham Study cohort. Cases who had experienced a first hip fracture (n = 176) were compared with age-matched controls (n = 672). Results showed a modest protective effect of any recent thiazide use (not significant). However, recent pure thiazide users experienced significant protection against fracture (adjusted odds ratio, 0.31; 95% confidence interval, 0.11 to 0.88), whereas recent users of combination drugs containing thiazides experienced no protection (adjusted odds ratio, 1.16; 95% confidence interval, 0.44 to 3.05). Combination drugs generally contained only 25 mg of hydrochlorothiazide, suggesting that the small amount of thiazide was insufficient to preserve bone mass. Former thiazide users were not protected against fracture. In sum, recent pure thiazide use in women protects against hip fracture.
This study was designed to document the clinical and health status of patients with recent-onset rheumatoid arthritis (RA). Three groups were studied: 108 patients who had had RA for greater than 1 year (established RA group), 313 patients who had had RA for less than or equal to 1 year (recent-onset RA group), and 188 healthy friend of the patients with recent-onset RA (no RA group). Clinical status was measured using tender joint count, erythrocyte sedimentation rate, and overall physician assessment. Health status was measured using the physical, psychological, pain, and arthritis impact scores of the Arthritis Impact Measurement Scales. Scores on all clinical and health status measures indicated substantial disease effects in the group with recent-onset RA. For most of these measures, effect size analysis indicated that clinical and health status impacts in the recent-onset RA group were similar in magnitude to those found in the groups with more established disease, with scores in both groups being substantially different from those found in the no RA group. These results document the magnitude of the clinical and health status impacts in recent-onset RA. They lend support to recent arguments advocating aggressive therapy earlier in the course of this frequently disabling disease.
Recent technological advances have created new approaches and techniques in endodontics while enhancing traditional criteria. The goal of this article is to present the best aspect of current techniques and materials to enable the practitioner to achieve success in the clinical practice of root canal therapy.