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Biomedical subjects

L Hillman

Publications and source records attributed to L Hillman.

At least 19 recordsLinked to original sources
PubMed2006

CASP and CONSORT.

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Anti-Infective Agents, Local↗
PubMed2000

Retinal imaging techniques in diabetes.

Diabetic retinopathy is progressive, and detection early is essential for the prevention of blindness. Doppler flowmetry, retinal photography, scanning laser ophthalmoscopy, and retinal oximetry measurements may identify proliferative disease early. Drawbacks of these methods include lack of compliance, failure to refer, and failure to identify disease early. As a result, diabetic retinopathy is a leading cause of blindness. Our retinal oximeter measures the blood oxygen saturation in the large vessels of the retina near the optic disc. Retinal vessel oxygen saturations measured with our instrument are sensitive indicators of blood loss and hypoxia in swine. We are generating scientific data that suggests that retinal vessel oxygen saturations may be used to identify retinal hypoxia prior to changes in retinal vessel architecture. We expect to study humans within the next two years, and a clinically useful eye oximeter should be available in the near future.

Animals↗
PubMed1999

Changing trends in South Wales fluoride prescription dispensing (1993-7).

OBJECTIVE: To observe patterns of fluoride preparation dispensing by primary care practitioners in a health authority. DESIGN: Observational study. SETTING: The Prescription Pricing Agency of the Welsh Health Common Services Authority (WHCSA). SUBJECTS: Individuals who had exchanged a prescription for a fluoride preparation at a pharmacy in Bro Taf Health Authority in the six months from 1 January 1997 to 30 June 1997. METHOD: Information from each prescription including a fluoride preparation, passed to WHCSA from pharmacists during the study, was entered onto a database, including the prescriber's postcode and profession, the recipient's postcode and product information. Numbers of dental prescriptions were correlated to local levels of NHS primary dental care provision and caries prevalence data. Comparisons were made with a similar study undertaken in 1993. RESULTS: 415 dentists' prescriptions were dispensed within the area, of which 38.8% originated from five dentists. At least one prescription had been made by 89 of the 253 local primary dental care providers (35%). Within the area monitored in both 1993 and 1997, dental prescribing rates had almost halved. Of the 122 doctors' prescriptions that were dispensed over the six-month period, 98 were mouthwash preparations for adult patients and four were for children. CONCLUSION: NHS provision of fluoride supplementation was low and remained related to prescribing patterns of individuals rather than to evidence on local variations in dental caries prevalence.

Adult↗
PubMed1999

Views of parents and head teachers on the school dental screening service in a north of England city.

OBJECTIVE: The study was designed to explore parents' and head teachers' understanding of and attitudes to the process, objectives and perceived outcomes of a school dental screening. BASIC RESEARCH DESIGN: Qualitative methods were used as a source for questionnaire development and questionnaires were subsequently used to test the strength of agreement with the qualitative findings. PARTICIPANTS: Head teachers and parents of a sample of 5- and 10-year-old children attending primary schools in Sunderland. RESULTS: Questionnaire responses from 83 (79%) of the head teachers and 934 (82%) parents of 5- and 10-year-old children showed that the exercise was well accepted by the majority. Gaps were identified in many aspects of communication between the Community Dental Service, schools and parents. CONCLUSIONS: It is recommended that, taking into account the views of all involved, the objectives of the exercise should be clearly defined and then clearly communicated. Evaluation should follow, measuring the extent to which the defined objectives are met. In this way the process will make a more positive and relevant contribution to oral health and the provision of primary dental care.

Adult↗
PubMed1996

Decreased bone mineralization in children with phenylketonuria under treatment.

Children with phenylketonuria (PKU) obtain a great deal of their protein and mineral intakes from synthetic elemental formulae devoid of phenylalanine. To assess the effect of such diets and/or the disease on bone mineralization, children with PKU were compared to normal children for many parameters of mineral homeostasis and bone mineralization. A total of 11 children with PKU of mean age 10.9 +/- 4.2 years were compared to a large group of normal control children mean age 11.4 +/- 4.2, and an age and sex matched subset (n = 11). Children with PKU had lower serum calcium (9.1 +/- 0.9 vs 10.4 +/- 1.9 mg/dl P < 0.01) amd magnesium (1.67 +/- 1.4 vs 2.07 +/- 0.16 mg/ dl, P < 0.001) but normal values for phosphorus, zinc, and copper. The percentage tubular reabsorption of phosphorus was increased in PKU (93 +/- 3% vs 88 +/- 6%, P < 0.05) suggesting a lower phosphorus intake and/or absorption. Serum 25-hydroxyvitamin D, parathyroid hormone and 1,25 dihydroxyvitamin D were similar in PKU and control children. Serum albumin and lean body mass by dual energy X-ray absorption were not different suggesting that protein intake was adequate. In the 11 pairs, a decreased bone mineral density was seen for the lumbar spine (0.61 +/- 0.15 vs 0.72 +/- 0.24 P < 0.05), and lower extremities (1.56 +/- 0.30 vs 1.87 +/- 0.56 P < 0.05) by paired t-test. Compared to the total controls and the paired controls, decreases were seen in markers of bone formation; bone alkaline phosphatase, (72 +/- 30 vs 126 +/- 43 P < 0.001), osteocalcin (10.7 +/- 3.4 vs 13.1 +/- 2.0 P < 0.05) and procollagen type I carboxyterminal propeptide. No differences were seen in the bone resorption markers tartrate resistant acid phosphatase and urine Ca/Cr. The changes noted could not be related after age correction to serum phenylalanine levels, protein intake, or mineral intakes. It is unclear whether deficits in bone mineralization relate to the disease process itself or its treatment.

Adolescent↗
PubMed1994

Vitamin D metabolism and bone mineralization in children with juvenile rheumatoid arthritis.

OBJECTIVE: To examine bone mineralization and bone mineral content in a cross-sectional population of children with juvenile rheumatoid arthritis (JRA). METHODS: Bone mineral content was measured by single-photon absorptiometry in 44 children with JRA and 37 control children. Serum concentrations of minerals, vitamin D, parathyroid hormone, osteocalcin, bone alkaline phosphatase, and tartrate-resistant acid phosphatase, and urinary concentrations of minerals, were determined. RESULTS: Bone mineral content was decreased in children with JRA. Significantly lower concentrations of osteocalcin (7.4 +/- 3.4 vs 12.5 +/- 2.5 micrograms/L) and bone alkaline phosphatase (78.8 +/- 36.4 vs 123.0 +/- 46.0 IU/L) suggested reduced bone formation; lower levels of tartrate-resistant acid phosphatase (10.3 +/- 4.1 vs 14.4 +/- 5.8 IU/L) and a lower urinary calcium/creatinine ratio (0.07 +/- 0.06 vs 0.12 +/- 0.09) suggested decreased bone resorption. The serum calcium concentration was significantly lower (9.3 +/- 1.0 vs 10.0 +/- 0.4 mg/dl), as was the parathyroid hormone concentration (19.8 +/- 8.6 vs 26.7 +/- 9.3 ng/L); 1,25-dihydroxyvitamin D values (30.1 +/- 10.5 vs 30.4 +/- 9.3 pg/ml) were normal. CONCLUSION: These data suggest that decreased mineralization in JRA is related to low bone turnover; parathyroid hormone and 1,25-dihydroxyvitamin D levels may be inappropriately normal for the decreased serum calcium concentration in children with JRA.

Adolescent↗
PubMed1993

Bone metabolism in children with asthma treated with inhaled beclomethasone dipropionate.

Previous studies have shown that inhaled corticosteroids can affect bone metabolism in adults. A study to assess the effect of inhaled beclomethasone, 300 to 800 micrograms/day for at least 6 months (mean 25 months), was therefore undertaken in children. In part 1 of the study, 18 children with asthma, aged 4 to 17 years (mean 10.1 years), were compared with an age- and sex-matched group of children with asthma not treated with corticosteroids. In part 2, eight more pairs were compared. Comparisons were also made with 61 healthy children. Bone mineral density measured by radiographic absorptiometry, and bone mineral content measured by single-photon absorptiometry and by dual-energy x-ray absorptiometry, showed no significant differences. Serum levels of calcium, magnesium, zinc, total alkaline phosphatase, bone specific alkaline phosphatase, parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D also showed no differences. The activity of tartrate-resistant acid phosphatase, a marker of bone resorption, was significantly lower in the beclomethasone group than in both the asthma control and the normal control groups, but urine calcium excretion did not differ. Patients with asthma had lower serum osteocalcin and higher serum copper levels than control subjects without asthma, but treatment with beclomethasone did not affect these values. We conclude that inhaled beclomethasone (up to 800 micrograms/day) does not reduce bone mineralization or increase bone resorption. Effects on bone formation were difficult to assess because asthma per se caused a significant reduction in osteocalcin, a sensitive marker of bone formation.

Acid Phosphatase↗
PubMed1993

Evaluation of two iron-fortified, milk-based formulas during infancy.

OBJECTIVE: Compare milk-based, iron-fortified formulas containing 7.4 and 12.7 mg/L iron and breast-feeding during the first year of life. DESIGN: Partially randomized, double-blind trial: non-breast-fed infants randomly assigned to receive one of two coded formulas, identical except for iron content; infants discontinuing breast-feeding between 1 and 8 weeks of age randomly assigned to a formula late-start group. SETTING: Five general community pediatric practices in Missouri, Indiana, Illinois, and Pennsylvania. PARTICIPANTS: Sample of 347 healthy, term infants, enrolled within 1 week after birth; 172 included in statistical analyses. OUTCOME MEASURES: Length, weight, and indicators of formula intolerance recorded at clinic visits; formula consumption, bowel movements, stool consistency, and other tolerance indicators recorded by parents on daily and weekly report forms; hemoglobin, hematocrit, and serum ferritin, iron zinc, and copper measured at 6 and 12 months. RESULTS: No significant differences between formula-fed groups in growth, attrition, formula consumption, bowel movements, hematocrit, hemoglobin level, and serum iron, zinc, and copper levels (P > .05); first 6-month weight and length changes of the breast-fed group significantly less than in both formula-fed groups (P < .008); serum ferritin level of the formula-fed, high-iron group significantly higher than that of the low-iron and breast-fed groups (P < .008), although all groups' values were normal; no apparent differences between formula groups in formula tolerance and stool characteristics but data were not analyzed statistically. CONCLUSIONS: Milk-based formulas containing either 7.4 or 12.7 mg/L iron support normal growth and iron status of healthy, term, normally fed infants during the first year and both are well tolerated and accepted.

Copper↗
PubMed1992

The management of craniofacial pain in a pain relief unit.

This paper reports the results of 34 craniofacial pain sufferers who were treated at the Dudley Pain Relief Unit over a 1-year period. Most of the patients were referred by their general medical practitioners. They were adults representing all age groups, with a female-male ratio of 4:1. The average history of pain was 5.5 years. Neuralgic pain (as distinct from temporomandibular joint dysfunction syndrome, migrainous disorders, and pain of iatrogenic origin) was most frequently seen. Oral drug therapy, local injection of corticosteroids and analgesics, peripheral neurolysis, magnetotherapy, hypnotherapy, and acupuncture were the lines of management available. By the end of this study period, pain had been relieved or eliminated in 30 of the patients (88%).

Adult↗
PubMed1990

Operation Himalaya!

Primary health care is more than a luxury for many of the world's poorest countries. The charity, Action Health 2000, is attempting to develop dental services in, among other places, the northern provinces of India. Linda Hillman answered their advertisement and found herself among the people of the 'God King'.

Australia↗
PubMed1989

The management of craniofacial pain in a pain relief unit.

Craniofacial pain can be one of the more intractable problems that presents to the GDP. One management route can be referral to a specialist pain relief unit, where the facilities and expertise will be available for diagnosis, counselling, drug management and invasive therapy. In this article the authors describe the results achieved at one such unit, over a one-year period, for a group of 34 craniofacial pain sufferers. At the end of the year 30 patients reported total or partial relief from their pain.

Adult↗