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Biomedical subjects

K D Patil

Publications and source records attributed to K D Patil.

At least 37 records · Page 2Linked to original sources
PubMed1993

A review of longitudinal studies that compared periodontal therapies.

There have been numerous longitudinal periodontal studies that have compared the effects of two or more therapies on various clinical parameters. These studies are reviewed and their results are compiled. Both surgical and non-surgical therapy produced improvement in periodontal health. Surgical therapy tended to create greater short-term probing depth reduction than non-surgical therapy; however, the advantage was lost in some studies over time. In shallow probing depths, surgery produced a greater loss of probing attachment than non-surgical therapy. In deeper probing sites, the short-term results comparing mean probing attachment change following non-surgical and surgical therapy were mixed. In most studies, no long-term differences in mean probing attachment level change were present between non-surgical and surgical therapy. There were no differences between surgical and non-surgical therapy in any of the gingival inflammatory indices.

Clinical Trials as Topic↗
PubMed1993

Results of liver transplantation in diabetic recipients.

BACKGROUND: The results of orthotopic liver transplantation (OLTx) in patients with diabetes mellitus (DM) are not well defined. METHODS: Between 1985 and 1991, 45 adult patients with pretransplantation DM (5 type I, 40 type II) underwent OLTx at our center as identified by retrospective chart review. We compared this diabetic recipient group to a case-control nondiabetic group matched for age, gender, primary liver disease, weight, and timing of OLTx. A total of 30 variables were collected and analyzed with McNemar's test for categorical data, paired t tests for continuous data, and survival and repeated measures analysis for longitudinal data. RESULTS: No differences between diabetic and nondiabetic recipients were noted in patient or graft survival, the incidence or severity of rejection, blood transfusions, operative complications, readmissions, major infections, or number of hospital days after OLTx. However, the incidence of minor bacterial (p = 0.046) and minor fungal (p = 0.035) infections were higher in the DM group. Serum blood urea nitrogen (p = 0.02) and creatinine (p = 0.03) levels were also higher in patients with diabetes versus control patients during the first year after OLTx. CONCLUSIONS: In carefully selected patients with pretransplantation DM, OLTx can be accomplished with results similar to nondiabetic recipients in spite of a higher incidence of minor infections and renal dysfunction.

Diabetes Complications↗
PubMed1992

Total indoor smoking ban and smoker behavior.

METHODS: To assess smoking policy support and effects, 1,083 hospital employees (203 smokers) were surveyed by anonymous questionnaire 1 year after the announcement (5 months after implementation) of a new total indoor smoking ban. A second follow-up, limited to smoker respondents only, was conducted 2 years postannouncement. RESULTS: A total indoor smoking ban was supported by the vast majority of nonsmokers (89%) and ex-smokers (86%) and by nearly half of the then-smoking population (45%). Consistent with previous reports, the smoking ban was associated with a significant decrease in cigarette use during work hours, particularly among moderate to heavy smokers. However, the ban did not result in increased institutional quit rates. Light smokers (< 10 cig/day), compared with heavy smokers (> or = 30 cig/day), were more likely to support the no-smoking policy and had fewer problems observing the ban. They were also less apt to report a decrease in work productivity. CONCLUSION: A total indoor smoking ban had little effect on overall institutional quit rates. Heavy smokers will, predictably, experience the greatest difficulty complying with a total indoor nonsmoking policy.

Air Pollution, Indoor↗
PubMed1992

Patient preference regarding 4 types of periodontal therapy following 3 years of maintenance follow-up.

It has been shown that certain types of periodontal therapy result in greater post-therapy gingival recession. It has been suggested that this recession may lead to maintenance complications for patients. This study evaluated patient perceptions 3 years following the completion of 4 types of periodontal therapy (coronal scaling (CS), root planing (RP), modified Widman surgery (MW), and flap with osseous resectional surgery (FO)). 75 individuals completed split-mouth therapy and 3 years of maintenance follow-up. An interview survey of all patients categorized their perception for each treatment of their mouth concerning difficulty in cleaning, sensitivity to temperature, general "feeling" of the region, prevalence of localized symptoms, food retention, comfort of oral examination, and attitude toward repeating therapy. Responses to questions showed no statistically significant differences between treatment regions. Patterns demonstrated that FO-treated regions were perceived to have less food retention, but were more difficult to clean. It was generally found that at the end of 3 years of maintenance, patients felt their mouths were "normal", they experienced few localized symptoms, and were very willing to repeat any of the treatment regimens if necessary.

Chi-Square Distribution↗
PubMed1991

Clinical spectrum of fungal infections after orthotopic liver transplantation.

During a 50-month period, we identified 91 episodes of fungal infection in 72 liver transplant recipients (23.8%). Candida species accounted for 83.5% of cases. Clinical patterns of fungal infections included disseminated infection (19), peritonitis (17), pneumonitis (15), multiple sites of colonization (13), fungemia (11), and other sites (16). The diagnosis of fungal infection was usually made in the first 2 months (84.7% of cases), at a mean time of 16 days after transplantation. Risk factors for fungal infections included retransplantation, Risk score, intraoperative transfusion requirement, urgent status, Roux limb biliary reconstruction (in adults), steroid dose, bacterial infections and antibiotic therapy, and vascular complications. Fungal infections were successfully treated with amphotericin B in 63 cases (74.1%) but were associated with diminished patient survival (50% vs 83.5%). Fungal infection is a frequent source of early morbidity and can be related to well-defined risk factors, suggesting the need for effective prophylaxis.

Adolescent↗
PubMed1991

Reproducibility of the signal-averaged electrocardiogram.

Variation in measurements made from signal-averaged electrocardiograms was examined. Averaging 200 beats in 18 normal subjects, pairs of high-frequency QRS and low-amplitude signal durations correlated at immediate, short-term, and long-term intervals. The percent high-frequency (60 Hz to 120 Hz) voltages in the late potential region had modest correlations. However, 95% confidence intervals of differences in paired measurements were as much as 7% for high-frequency QRS, 20% for a low-amplitude signal, and 53% for percent high-frequency, similar at all time intervals. With electrocardiograms averaged to 0.3 microV noise, high-frequency QRS and low-amplitude signals prolonged, but variation was similar to that of 200 beat pairs. In contrast, low noise reduced percent high-frequency and lessened variation to 29%. Therefore variation in signal-averaged electrocardiographic measurements was considerable (high-frequency voltage greater than durations). Noise did not appreciably influence variation in durations but was critical to consistent voltage measurements in the frequency domain.

Adult↗
PubMed1990

Smoking cessation in the workplace: evaluation of relapse factors.

Relapse factors associated with a well-supported worksite smoking cessation program were examined in a prospective study. Of 104 employee-participants, 81 (78%) were confirmed as abstinent at 8 days after quit day. Forty-six employees (44%) continued to report total abstinence at 1 year. Stepwise regression analysis of baseline variables found two significant, but weak, predictors of 1-year smoking status: Fagerstrom score and number of other smokers residing in the home. Analysis of tobacco withdrawal symptom data of confirmed abstainers found only self-reported anxiety scores to be predictive of smoking status at 1 year. Early abstainers with elevated anxiety scores appear to be at high risk for smoking relapse.

Anxiety↗
PubMed1990

Responses of four tooth and site groupings to periodontal therapy.

The responses of four tooth/site groupings to periodontal therapy were evaluated. Eighty-two patients with periodontitis were treated in a split mouth design with coronal scaling, root planing, modified Widman surgery, and flap with osseous resectional surgery. Patients were evaluated prior to therapy, 4 weeks post-Phase I therapy, 10 weeks post-Phase II therapy, and at yearly intervals during 2 years of maintenance therapy. The tooth/site groupings evaluated were: 1) interproximal sites of single rooted teeth (T1), 2) facial and lingual sites of single rooted teeth (T2), 3) nonfurcation sites of molar teeth (T3), and 4) furcation sites of molar teeth (T4). Following 2 years of maintenance, no clinically significant differences in probing depth reduction or probing attachment loss were present between the four tooth/site groupings in 1 mm to 4 mm sites. T2 had the greatest decrease of probing depth in 5 mm to 6 mm sites followed by T1, T3 and T4. T1 and T2 showed a greater gain of probing attachment followed by T3 and T4. T1 and T2 had the greatest decrease of probing followed by T3 which was greater than T4 in greater than or equal to 7 mm sites. T4 had significantly less probing attachment gain than the other groups. There was a trend for T1 and T2 to have less gingival bleeding post-therapy and for T2 to have less plaque accumulation than the other groups at both pre- and post-therapy examinations.

Bicuspid↗
PubMed1990

Relationship of gingival bleeding, gingival suppuration, and supragingival plaque to attachment loss.

This study evaluated the relationship between the presence of gingival bleeding, gingival suppuration, and supragingival plaque at 3 month appointments to the incidence of probing attachment loss during a 2-year period of maintenance therapy. The data included in this report were taken during the second and third year of maintenance from 75 periodontal patients who had previously received active therapy in an ongoing longitudinal study. The diagnostic sensitivity, specificity, and positive and negative predictive values were calculated for different frequencies of positive responses for each clinical parameter in relation to sites demonstrating greater than or equal to 2 mm probing attachment loss. Gingival bleeding and plaque were not prognosticators and gingival suppuration was a weak prognosticator of attachment loss during a 2 year maintenance period.

Dental Plaque↗
PubMed1990

Evaluation of gingival suppuration and supragingival plaque following 4 modalities of periodontal therapy.

This study evaluated the effect of coronal scaling (CS), root planing (RP), modified Widman surgery (MW) and flap with osseous resectional surgery (FO) upon the presence of gingival suppuration and supragingival plaque. 75 patients completed split-mouth therapy and 2 years of maintenance care. Data were collected prior to the initiation of therapy, following initial therapy, following surgical therapy and yearly during 2 years of maintenance care. All 4 types of therapy reduced the prevalence of suppuration with RP, MW and FO producing a greater reduction than CS in sites greater than or equal to 5 mm. Sites were grouped according to presence of suppuration at 2 consecutive examinations. The mean changes in probing depth and probing attachment level for each time period were compared. Sites that began to suppurate between 2 exams or were suppurating at both exams had a less favorable response in mean probing depth reduction and mean probing attachment gain when compared to sites that stopped suppurating between exams or did not suppurate at either exam. The prevalence of supragingival plaque decreased during active therapy and 2 years of maintenance. There was no difference in the prevalence between the therapy groups except for FO-treated sites showing more plaque accumulation after surgical therapy. The presence or absence of supragingival plaque at specific sites was dynamic, frequently converting to a new status between 2 examinations.

Alveoloplasty↗
PubMed1989

Dystocia in late labor: determining fetal position by clinical and ultrasonic techniques.

A failure of adequate progression during late labor occurs often and may prohibit an accurate determination of the fetal head position from scalp edema or caput formation. This investigation was undertaken to determine whether ultrasonic evaluation could confirm or correct the digital examination impressions of the fetal head position. Eighty-six attempted vaginal deliveries had recent evidence for arrested cervical dilation after 7 cm or more. An occiput transverse position in 24 (28%) cases was diagnosed accurately, with the need for additional ultrasonic information only in the presence of scalp edema. Distinguishing between a persistent occiput posterior (15 cases, 17%) or anterior (47 cases, 55%) position was often inexact by palpation alone. Combined clinical and ultrasonic impressions allowed for a significantly more precise diagnosis. Ultrasonic imaging allowed for more security while waiting, more confidence with midforceps application, or a prompter decision for cesarean section, depending on the head position.

Adult↗
PubMed1989

Evaluation of gingival bleeding following 4 types of periodontal therapy.

This study evaluated the effects of 4 types of periodontal therapy (coronal scaling (CS), root planning (RP), modified Widman surgery (MW), and flap with osseous resectional surgery (FO] and subsequent maintenance care upon bleeding on probing (BOP). 75 individuals completed split mouth therapy and 2 years of maintenance followup. Data were obtained by 1 calibrated examiner prior to the initiation of therapy, following the hygienic phase and surgical phase of active therapy and yearly during maintenance care. All types of therapy reduced the prevalence of BOP. At the end of 2 years of maintenance therapy, regions greater than 5 mm treated by CS demonstrated a significantly (p less than 0.05) greater prevalence of BOP sites than regions treated by the other modalities. Generally, sites associated with deeper probing depths exhibited a greater tendency to bleed and sites with associated plaque accumulation bled more frequently. RP resulted in a significantly (p less than 0.05) higher % of bleeding sites that stopped following active therapy than did CS. Throughout the study, BOP was extremely dynamic, with 15-88% of sites converting to a new status between any 2 examination periods. This dynamic nature may explain the inability of previous investigations to establish BOP as a reliable predictor of periodontal breakdown.

Alveoloplasty↗
PubMed1988

Blood histamine and solid malignant tumors.

A clinical study was performed to determine whether patients with a newly diagnosed solid malignant tumor manifest an alteration in whole-blood histamine levels. Our results indicate that such patients have blood histamine nearly three times greater than either normal, healthy individuals or noncancerous disease controls. Following surgical removal of the tumor, blood histamine levels remained high for 2 months and then dropped close to the normal range 3 months after surgery. Basophil counts did not change significantly in the presence of a malignant tumor. Patients receiving either chemotherapy or radiation therapy, and terminal cancer patients who were no longer receiving any therapy except for pain control had blood histamine within or below the normal range. By analogy with animals studies, we suggest that nascent histamine synthesis is increased in the presence of a developing tumor. The clinical usefullness of this observation remains to be determined.

Basophils↗
PubMed1988

Evaluation of four modalities of periodontal therapy. Mean probing depth, probing attachment level and recession changes.

Eighty-two periodontally involved patients were treated in a split mouth design such that one quadrant received coronal scaling (CS), root planing (RP), modified Widman surgery (MW), and flap with osseous resection surgery (FO). The therapy was performed in three phases: Phase I: the teeth previously designated to receive RP, MW, and FO were thoroughly root planed and the teeth designated to receive CS were scaled with no subgingival instrumentation, plaque control was initiated and reinforced for the entire mouth; Phase II: the designated teeth received MW or FO surgery; and Phase III: maintenance therapy every three months. The CS teeth received coronal scaling and polishing during maintenance appointments, while RP, MW, and FO teeth received supragingival instrumentation, subgingival instrumentation and polishing. Clinical measurements were taken initially, four weeks post-Phase I, 10 weeks post-Phase II, and after each of two years of maintenance care. All therapy modalities resulted in a decrease of mean probing depth with the FO producing the greatest decrease followed by MW, RP, and CS. The deeper the initial probing depth, the greater was the mean reduction of probing depth. FO created a loss of mean probing attachment in the 1 to 4 mm category. RP and MW produced the greatest gain of mean probing attachment in the 5 to 6 mm category. RP, MW, and FO produced similar gains in the greater than or equal to 7 mm category. FO created the most gingival recession followed by MW, RP, and CS.

Adult↗
PubMed1988

Evaluation of furcation region response to periodontal therapy.

Five hundred fifty-eight molars were treated with one of four types of periodontal therapy: coronal scaling (CS); root planing (RP); modified Widman surgery (MW); or flap with osseous resectional surgery (FO). This report presents the probing depth and probing attachment changes in the furcation region following therapy and two years of maintenance follow-up. All types of therapy were effective in reducing probing depths. FO was the most effective in reducing probing depth followed by MW, RP, and CS. Reduction in probing depth was primarily due to gingival recession. FO resulted in a loss of probing attachment in both a vertical and horizontal direction following therapy. Following two years of maintenance care, sites treated with FO continued to exhibit a mean net loss of vertical probing attachment. A mean net loss of horizontal probing attachment was present after two years of maintenance care, regardless of the treatment modality employed. Many more sites were initially removed during osseous resectional surgery to achieve treatment criteria than were initially removed from the other groups. FO treated teeth demonstrated a lesser percentage of furcation sites demonstrating clinically significant breakdown during the two years of maintenance care.

Dental Scaling↗
PubMed1988

Patient-controlled analgesia for post-cesarean section pain.

Recent reports have suggested that patient-controlled analgesia is an effective means of narcotic administration in postoperative patients. This prospective investigation was undertaken to determine the efficacy and safety of patient-controlled anesthesia infusion after cesarean section. During a recent ten-month period, 130 patients were assigned randomly to receive meperidine by pump or intramuscular injection. Meperidine consumption using the device varied widely to meet individual needs. Overdosage and drug dependence were not encountered with the prescribed drug concentrations. The patient-controlled analgesia method provided less sedation and more immediate pain relief without the need for painful injections. The additional cost of renting the infuser device was offset by combined patient and nursing satisfaction. We conclude that patient-controlled infusion of meperidine is safe and effective in satisfying individual patient needs after cesarean section.

Analgesia↗