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Biomedical subjects

L Gilbert

Publications and source records attributed to L Gilbert.

At least 55 records · Page 3Linked to original sources
PubMed1994

Future dental human resource needs--a qualitative approach.

As part of the National Oral Health Survey, dentists in private practice were asked to give their views and opinions on the future planning of human resource needs for South Africa. The data, which were qualitative in nature, yielded 2600 responses. After computing a frequency distribution of these responses it was possible to classify these data into five major categories. These were a) "too many dentists/fewer should be trained" b) "more dentists for developing areas" c) "more auxiliaries in general" d) "greater need for preventive and health education services" and e) "high cost of running and maintaining private dental practices". The predominant view was that fewer dentists and more auxiliaries should be trained, while the need for preventive and health education services received considerably less support.

Black or African American↗
PubMed1994

Oral health, oral health care and dental services--the consumer perspective.

As part of a National Oral Health Survey conducted in 1988/89, community knowledge of and attitudes towards oral health and oral health care were examined in the various population groups in South Africa. A wide range of issues were explored. These included amongst others, help-seeking and oral health behaviour, sources of health information and attitudes to dentists and dental care. Given the major political change that has recently occurred in the country, the results of the survey suggest that these findings could profitably be used in future dental personnel planning as well as in the re-structuring of the health services that is currently taking place.

Attitude to Health↗
PubMed1994

The impact of a mobile dental system on a school community. Part II--Responses of recipients and providers of care.

This paper is concerned with the impact of a Mobile Dental System (MDS) on the providers and recipients of oral health care. It focuses more specifically on children as patients of the MDS and MDS personnel as clinicians and oral health educators. Data, which were quantitative and qualitative in nature were collected from children and MDS members by means of questionnaires and interviews. Results indicate that the children had acquired some oral health information from the MDS, but many were fearful of clinical procedures. MDS personnel were gratified that they were able to provide a service to an otherwise underserved community, but also considered themselves inadequate child managers and oral health educators. The lack of a permanent career structure created feelings of insecurity amongst MDS staff. Recommendations arising from this investigation are the need for permanent and comprehensive services for all members of the community, and improved working conditions and continuing education courses for MDS personnel.

Adolescent↗
PubMed1994

The impact of a mobile dental system on a school community. Part III--Teachers and parents response to a mobile dental system at school.

According to the principles of the Primary Health Care Approach, planning and implementation of community health programmes should be carried out with the full participation of the community concerned (WHO, 1978). The introduction of the Mobile Dental System to the school environment is an example of a "Community health care/technology approach" where the programme was determined by the professionals for the community and not by the community for itself. Teachers play an important role in the implementation of oral health care programmes in the school, while parents provide the vital and appropriate context and continuity for the success of such programmes. This paper, therefore, deals with the responses of teachers and parents to an introduction of a mobile dental system at their school. A self-administered mostly open-ended questionnaire was distributed to all teachers in the four schools that participated in preventive programmes and were served by the Mobile Dental System. Based on the results it seems that both the teachers and the parents were apathetic in their commitment to the programme although they were quite willing to participate. Their participation was confined to compliance with instructions or suggestions given by the health professionals. It is clear that under these conditions the potential to sustain the momentum created by the introduction of the MDS is limited. It seems that only if the community is involved in the determination of their preferential needs, planning of the appropriate programme and playing an active role in its implementation, will the programme have a chance of long term success.

Adolescent↗
PubMed1993

DNA inoculation induces neutralizing immune responses against human immunodeficiency virus type 1 in mice and nonhuman primates.

DNA, or genetic, inoculation mimics aspects of attenuated vaccines in that synthesis of specific foreign proteins is accomplished in the host. These proteins can be processed and presented on the relevant major histocompatibility complex (MHC) antigens and ultimately become the subject of immune surveillance. Very recently, we have described the use of the new technology to generate immune responses in mice against the human immunodeficiency virus type 1 (HIV-1) envelope using a gp160 DNA construct. Further analysis of this technology specifically in regard to HIV vaccine design is clearly important. In this report, we describe the analysis of additional HIV constructs as immunogens in both mice and report the use of this genetic immunization technology in nonhuman primates. In these studies, successful seroconversion occurs in more than 70% of the mice following the second immunization with 100 micrograms of construct DNA; three and four immunizations result in routinely 100% seroconversion of the mice. Furthermore, the same strategy has successfully seroconverted primates following their second inoculation, resulting in the generation of both antiviral and neutralizing antibodies in this animal species. These studies are the first report of which we are aware that demonstrate successful immunization of nonhuman primates through genetic vaccination technology and the first to describe genetic immunization of primates against HIV antigens. This technology has relevance for the development of safe and efficacious immunization strategies against HIV because it provides for relevant antigen production in vivo without the use of infectious agents.

AIDS Vaccines↗
PubMed1993

A pilot study of pi-class glutathione S-transferase expression in breast cancer: correlation with estrogen receptor expression and prognosis in node-negative breast cancer.

PURPOSE AND METHODS: Previous studies have indicated that RNA levels for pi-class glutathione S-transferase (GST pi), a phase II, drug-metabolizing enzyme, were inversely related to estrogen receptor (ER) and progesterone receptor (PR) levels in human breast tumors. Because GST pi also is expressed in normal breast epithelium, an immunohistochemical assay that uses affinity-purified polyclonal antibodies to GST pi was developed to examine the possible relationship between GST pi expression in breast cancer cells and hormone receptor expression, as well as prognosis, in patients with primary breast cancer. RESULTS: A strong inverse correlation between GST pi expression and ER (two-sided P [P2] = .002) and PR status (P2 = .023) was found in our study of 189 patients with primary breast cancer. GST pi expression was not related to tumor size, nodal metastasis, nuclear grade, histology, or age of the patient. In node-negative breast cancer (n = 72), increased GST pi expression was associated with decreased disease-free survival (DFS) and overall survival (OS). When GST pi expression was divided into categories of negative (no GST pi-positive tumor cells), intermediate (1% to 70% GST pi-positive tumor cells), and high (> 70% GST pi-positive tumor cells), the relative risk of tumor recurrence in patients with node-negative breast cancer was increased 3.39-fold for each successive category of expression (P2 = .0045; 95% confidence interval, 1.46 to 7.87) and the relative risk of death was increased 4.49-fold for each successive category (P2 = .0003; 95% confidence interval, 2.02 to 10.42). The actuarial 5-year OS was 100%, 79%, and 51%, and the DFS was 94%, 77%, and 44%, for the negative, intermediate, and high tumor groups, respectively. Among the factors studied in multivariate analysis (ER status, PR status, nuclear grade, and tumor size), GST pi expression was the factor that most accurately predicted shorter DFS and OS in node-negative patients. CONCLUSION: GST pi expression is inversely related to hormone receptor status in breast cancer. This pilot study also suggests that increased GST pi expression may be an important predictor of early recurrence and death in node-negative breast cancer patients that merits additional investigation.

Breast Neoplasms↗
PubMed1993

Predictors of changes in sexual behavior among women on methadone.

This study identified predictors of reported sexual risk reduction among 109 female injection drug users enrolled in methadone clinics. Univariate analyses were used to examine the individual effects of each variable on the outcome of sexual behavior change over the past 6 months. Multiple logistic regression was then used to identify which of these variables were independently associated with such a change. Women with more than one sexual partner were more likely than women with one or no sexual partner to report changing their sexual behavior. African-American women were less likely than White Anglo or Latina women to report changing their sexual behavior. Women who held stronger beliefs that luck plays the largest role in getting AIDS were less likely to report changing their sexual behavior. Change in sexual behavior was associated with feeling comfortable asking partners to use condoms, higher depression scores, and loss of friends or family to AIDS. The observed relationship between personal susceptibility and depression suggests that risk reduction interventions should also address the depressive symptomatology associated with feelings of vulnerability.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Transient aplasia of the red progenitor cells manifest in a child with double heterozygote Hb SC carriership: the role of human parvovirus B19 (HPV-B19)].

Severe pure red cell anaemia due to B19 parvovirus infection is reported in a child with haemoglobin SC disease. B19 parvovirus infection was demonstrated by specific IgM. Although hypoplastic crisis occurring in SC children is usually less frequent and more benign than in sickle- cell anaemia, it necessitated several blood transfusions in our patient. The child recovered rapidly and was discharged after 12 days. This case again illustrates the role of HPV-B19 in the development of transient red cell aplasia occurring in patients with haemolytic anaemia. However, it is unusual since in the few reported children with HbSC disease and HPV-B19 infection, aregenerative anaemia remained moderate and did not generally require blood transfusions.

Anemia, Aplastic↗
PubMed1992

Cell surface characteristics and virulence in mice of Pasteurella multocida.

The virulence of three avian strains of Pasteurella multocida was evaluated in mice. Strains P-1059I (serotype A:3) and its uncapsulated variant P-1059B and strain 2723 (serotype A:16) were compared. Capsular material thickness after polycationic ferritin labelling of dextrose starch agar (DSA)-grown P. multocida was shown to vary with the strain and was not always related to virulence. Addition of alpha,alpha' bipyridyl (BIP) (160 microM) to the culture medium did not affect capsule production but increased virulence of strains P-1059B and 2723. None of the strains tested showed dermonecrotic activity. Using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), outer membrane protein (OMP) profiles indicated for strains P-1059I and P-1059B three proteins of 30, 35, and 38 KDa with the 30 KDa protein being the major one. Strain 2723 showed the same OMP profile but the 38 KDa protein was the major one. DSA + BIP-grown strains showed the same OMP profiles. Whole cell profiles were similar for all strains tested. However, addition of BIP to the culture media increased the virulence of strains P-1059B and 2723 and for all strains a 39 KDa protein was induced by the iron chelator. The results indicate that encapsulation may be important for virulence, but other surface components such as OMPs may be required as well.

Animals↗
PubMed1992

Drug use and AIDS risks in a soup kitchen population.

Untreated substance users remain beyond the reach of most acquired immune deficiency syndrome (AIDS) prevention efforts. In an effort to describe the risk behavior and attitudes of this population, the authors conducted interviews with 148 drug users in an urban soup kitchen. The study focused on subjects' risk-taking and risk-reduction behavior related to injection drug use, perceived changes in risk behavior, perceived risk for contracting AIDS, and socioeconomic and attitudinal correlates of injecting and sharing needles. Study findings underscore the need for community-based AIDS prevention strategies to intervene with high-risk populations beyond the reach of drug treatment and AIDS prevention programs.

AIDS Serodiagnosis↗
PubMed1991

An objective, noninvasive method for the diagnosis of temporomandibular joint disorders.

An objective, noninvasive method for the diagnosis and monitoring of pathology referable to the temporomandibular joint is presented. A computerized temporomandibular joint analyzer was developed to obtain data from the patient's temporomandibular joint area to provide an objective record of clinical symptoms and signs. This data, used in conjunction with a complete history and physical examination, aids in the diagnosis and decision-making process for therapy. Fifty patients with temporomandibular complaints were evaluated. Diagnoses made using the temporomandibular joint analyzer in conjunction with complete histories and physical examinations were confirmed in 81% of the patients by further examinations with x-ray studies, computed tomography scans, magnetic resonance imaging, and arthroscopy. Patients' progress during treatment was monitored using the temporomandibular joint analyzer. Results of the temporomandibular joint analyzer were compatible with patient's progress as reported subjectively and with clinical evaluation in 97% of the cases. The temporomandibular joint analyzer can be used to reduce time and expense as well as to minimize the discomfort involved in the evaluation of temporomandibular joint disorders.

Adolescent↗
PubMed1990

Endoscopic localization of the squamocolumnar junction before cervical cone biopsy in 284 patients.

A preoperative examination of the endocervical canal was performed in 284 patients scheduled for excisional cone biopsy because of abnormal cervical cytology and unsatisfactory colposcopy. The information obtained regarding the depth of the new squamocolumnar junction (SCJ) was used to tailor the length of the cone specimen in an attempt to remove the entire transformation zone (TZ), and was associated with a low rate of incomplete disease excision. An analysis of the data generated by this study indicates that the position of the new SCJ is influenced by age, menopausal status, and the use of estrogen-containing medication.

Adult↗
PubMed1990

Unsatisfactory colposcopy and the response to orally administered oestrogen: a randomized double blind placebo controlled trial.

Thirty-six women with dyskaryotic cervical smears and unsatisfactory colposcopy were randomly allocated to receive either 30 micrograms ethinyl oestradiol or placebo daily by mouth for 10 days. Thirty-four women were available for review (17 women in each of the two groups), full colposcopic inspection of the transformation zone was possible in a significantly greater proportion of the oestrogen treated group (70% versus 23%, P less than 0.01). As most diagnostic conizations are currently performed on the basis of unsatisfactory colposcopy, the use of oestrogen medication followed by colposcopic reassessment should permit a reduction in the number of patients subject to operation.

Adult↗
PubMed1990

Suitability of teachers as oral health educators.

In view of the vast number of people to whom dental services are not accessible, the WHO has proposed the use of lay persons as health educators. This study investigated the suitability of teachers in Gazankulu to fulfil this role. Two hundred and twenty-two teachers from the district of Letaba provided the study population. Oral health status was measured and a structured questionnaire was administered which probed areas such as knowledge, attitudes, reported behaviour, motivation and interest. The mean DMFT was 4,7 with an M component of 3,6 while 28 per cent of subjects were free from caries. The majority of subjects expressed an adequate knowledge of causes of decay, frequency of brushing, dental visits and fluoride. In terms of oral health status and knowledge the teachers appear to be suitable as oral health educators. With regard to utilisation of services, their self-assessment, attitudes, motivation and interest, several contradictions exist, which raise some doubt about their suitability. This however, can be minimised by adequate training and does not preclude the utilisation of teachers as oral health educators, especially in the context of the social reality in Gazankulu.

Adult↗
PubMed1990

Aerotitis: cause, prevention, and treatment.

Aerotitis, an acute inflammation of the middle ear caused by the difference in air pressure between the airplane cabin and the middle-ear space, is becoming more common in the United States as our society becomes increasingly mobile. We describe a case in which a 33-year-old woman with a resolving upper respiratory tract infection and mildly blocked eustachian tubes flew on a business trip. During ascent, her ears became blocked. This blockage was partially alleviated by a Valsalva's maneuver. On descent, however, her ears became severely blocked, she experienced intense pain, and her tympanic membranes ruptured. She became nauseated and vomited. Her hearing became significantly diminished and she experienced vertigo. On landing, she was taken to a local emergency room and treated with penicillin and antivertiginous medication. Subsequent otologic evaluation revealed severe permanent sensorineural hearing loss. The vestibular symptoms lasted several months. She now requires hearing aids on a permanent basis. Suggestions are presented for prevention and treatment of aerotitis.

Adult↗
PubMed1990

Microcolpohysteroscopic tailoring of cervical conization.

The ideal cone biopsy should have its apex just above the transformation zone to ensure removal of all abnormal squamous and metaplastic epithelium in the endocervix, with only minimal normal glandular tissue included. The microhysteroscope has been shown to be useful in identifying the upper limit of the transformation zone within the canal, and this distance from the external os can be measured. However, this technique has not been evaluated to determine whether it can tailor cone length to this predetermined measurement. We report an observational analysis of 176 consecutive conizations in patients with colposcopically proved extension of abnormal epithelium high into the cervical canal. In 162 cases, the distance of the transformation zone from the external os could be measured with the microhysteroscope and its endocervicometer, permitting an attempt to tailor the cone length to this measurement plus a safety margin of 5 mm. There was good correlation between the intended cone length and the excised cone length, with 85% of the excised cones falling within 5 mm above or below the intended measurement. In 153 instances (94.4%), the excised cones had clear endocervical margins. Thus, tailoring of the cone length to the hysteroscopically determined measurement is feasible, thereby increasing the chances of complete excision while limiting cone size to the required minimum.

Adult↗