PubMed Health⌕ Search

Biomedical subjects

M Wise

Publications and source records attributed to M Wise.

At least 19 recordsLinked to original sources
PubMed2003

Study group funding.

Explore the source record for details and available documents.

Education, Dental, Continuing↗
PubMed2001

Fit of implant-supported fixed prostheses fabricated on master casts made from a dental stone and a dental plaster.

STATEMENT OF PROBLEM: The impression and cast on which an implant-supported fixed prosthesis is fabricated must accurately reproduce the intraoral relations. PURPOSE: The fit of fixed prostheses fabricated on master casts poured in a conventional die stone and in an ultra-low-expansion plaster was investigated in vitro. MATERIAL AND METHODS: An impression was made of patient replicas with inter-implant abutment distances of 50 and 35 mm. Ten master casts were poured in a conventional die stone (Velmix, Kerr) and 10 in an ultra-low-expansion plaster (Gnathostone, Zeus). A simulated plaster fixed prosthesis was fabricated on each master cast and then returned in a random order to the appropriate patient replica. The fixed prostheses were screwed into place on one abutment with a torque of 10 Ncm. Vertical discrepancies were measured at the other abutment by an operator blinded to the cast on which the fixed prosthesis was fabricated. A 2-way analysis of variance was performed for distance and materials, and significant differences were identified with regression analysis. RESULTS: For the 50-mm inter-abutment distance, die stone master casts produced a mean vertical discrepancy of 80 microm (SD 32.50 microm). Plaster master casts produced a mean vertical discrepancy of 42.8 microm (SD 12.17 microm). The means were significantly different (P=.01). For the 35-mm inter-abutment distance, the mean vertical discrepancy produced from the die stone and plaster master casts was 84.33 microm (SD 49.9 microm) and 0 microm (SD 0), respectively. The means were significantly different (P<.001). A significant difference was found between the mean vertical seating discrepancies of fixed prostheses produced from plaster casts with inter-abutment differences of 50 mm and plaster casts with inter-abutment distances of 35 mm (P=.003). No significant differences were found between mean vertical seating discrepancies for fixed prostheses fabricated on die stone casts. CONCLUSION: In this in vitro study, master casts poured in an ultra-low-expansion plaster limited to a maximum inter-abutment dimension of 35 mm were more accurate than casts with 50-mm inter-abutment spans or those poured in a conventional die stone.

Analysis of Variance↗
PubMed2001

Accuracy of administrative and trauma registry databases.

OBJECTIVE: Accurate data are needed to evaluate clinical outcomes, therapeutic modalities, and quality of care in trauma. Administrative data, usually used for billing, and trauma registries, have been used to perform these functions. This study compares data for trauma patients from administrative and trauma registry databases at a Level I trauma center. METHODS: Data from patients injured in 1998 were obtained from both the trauma registry and administrative database. These International Classification of Diseases, Ninth Revision, Clinical Modification codes signify an admitting diagnosis of trauma. Patients from each database were "matched" by admission date, medical record number, age, and name. The two matched data sets were compared for accuracy in recording data. Chi-square analysis was used to compare groups. RESULTS: There were 2,702 patients found in both databases. One hundred eighteen patients with significant trauma were recorded in the trauma registry, but not in the administrative database. Comparison of recorded data for "matched" patients is as follows. The underreporting of mechanism of injury, diagnoses, diagnostic interventions, surgical procedures, and complications was rampant throughout the administrative database. Statistical significance was seen in the comparison between the trauma registry and the administrative database with motor vehicle collisions (458 vs. 391), abdominal injuries (346 vs. 293), orthopedic injuries (1,243 vs. 1,101), and thoracic injuries (486 vs. 397). Diagnostic interventions such as diagnostic peritoneal lavage, head computed tomographic scans, and abdominal computed tomographic scans were all grossly underrecorded, with only 40%, 12%, and 9% captured by the administrative database, respectively. Analysis of surgical procedures revealed these same trends, with statistical significance seen in abdominal and orthopedic procedures. Complications such as acute respiratory distress syndrome and deep venous thrombosis showed statistically significant differences. Mortality was underreported in the administrative database, with 14 deaths omitted. CONCLUSION: This study shows that administrative data have copious omissions of specific injuries, diagnostic and therapeutic interventions, as well as complications. The trauma registry recorded more of the diagnoses, diagnostics, procedures, and outcomes in the care of trauma patients. Trauma registries may be more useful than administrative databases in assessing quality of care and diagnostic and therapeutic interventions.

Adult↗
PubMed2001

CHESS: ten years of research and development in consumer health informatics for broad populations, including the underserved.

This paper reviews the research and development around a consumer health informatics system CHESS (The Comprehensive Health Enhancement Support System) developed and tested by the Center for Health Systems Research and Analysis at the University of Wisconsin. The review will place particular emphasis on what has been found with regard to the acceptance and use of such systems by high risk and underserved groups.

Aged↗
PubMed2000

Chandra X-Ray Observations of the Hydra A Cluster: An Interaction between the Radio Source and the X-Ray-emitting Gas.

We present Chandra X-ray observations of the Hydra A cluster of galaxies, and we report the discovery of structure in the central 80 kpc of the cluster's X-ray-emitting gas. The most remarkable structures are depressions in the X-ray surface brightness, approximately 25-35 kpc in diameter, that are coincident with Hydra A's radio lobes. The depressions are nearly devoid of X-ray-emitting gas, and there is no evidence for shock-heated gas surrounding the radio lobes. We suggest that the gas within the surface brightness depressions was displaced as the radio lobes expanded subsonically, leaving cavities in the hot atmosphere. The gas temperature declines from 4 keV at 70 kpc to 3 keV in the inner 20 kpc of the brightest cluster galaxy (BCG), and the cooling time of the gas is approximately 600 Myr in the inner 10 kpc. These properties are consistent with the presence of an approximately 34 M middle dot in circle yr-1 cooling flow within a 70 kpc radius. Bright X-ray emission is present in the BCG surrounding a recently accreted disk of nebular emission and young stars. The star formation rate is commensurate with the cooling rate of the hot gas within the volume of the disk, although the sink for the material that may be cooling at larger radii remains elusive. A bright, unresolved X-ray source is present in the BCG's nucleus, coincident with the radio core. Its X-ray spectrum is consistent with a power law absorbed by a foreground NH approximately 4x1022 cm-2 column of hydrogen. This column is roughly consistent with the hydrogen column seen in absorption toward the less, similar24 pc diameter VLBA radio source. Apart from the point source, no evidence for excess X-ray absorption above the Galactic column is found.

Journal Article↗
PubMed2000

Practice parameters for the evaluation of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine.

Chronic insomnia is the most common sleep complaint which health care practitioners must confront. Most insomnia patients are not, however, seen by sleep physicians but rather by a variety of primary care physicians. There is little agreement concerning methods for effective assessment and subsequent differential diagnosis of this pervasive problem. The most common basis for diagnosis and subsequent treatment has been the practitioner's clinical impression from an unstructured interview. No systematic, evidence-based guidelines for diagnosis exist for chronic insomnia. This practice parameter paper presents recommendations for the evaluation of chronic insomnia based on the evidence in the accompanying review paper. We recommend use of these parameters by the sleep community, but even more importantly, hope the large number of primary care physicians providing this care can benefit from their use. Conclusions reached in these practice parameters include the following recommendations for the evaluation of chronic insomnia. Since the complaint of insomnia is so widespread and since patients may overlook the impact of poor sleep quality on daily functioning, the health care practitioner should screen for a history of sleep difficulty. This evaluation should include a sleep history focused on common sleep disorders to identify primary and secondary insomnias. Polysomnography, and the Multiple Sleep Latency Test (MSLT) should not be routinely used to screen or diagnose patients with insomnia complaints. However, the complaint of insomnia does not preclude the appropriate use of these tests for diagnosis of specific sleep disorders such as obstructive sleep apnea, periodic limb movement disorder, and narcolepsy that may be present in patients with insomnia. There is insufficient evidence to suggest whether portable sleep studies, actigraphy, or other alternative assessment measures including static charge beds are effective in the evaluation of insomnia complaints. Instruments such as sleep logs, self-administered questionnaires, symptom checklist, or psychological screening tests may be of benefit to discriminate insomnia patients from normals, but these instruments have not been shown to differentiate subtypes of insomnia complaints.

Chronic Disease↗
PubMed2000

Backbone dipoles generate positive potentials in all proteins: origins and implications of the effect.

Asymmetry in packing the peptide amide dipole results in larger positive than negative regions in proteins of all folding motifs. The average side chain potential in 305 proteins is 109 +/- 30 mV (2. 5 +/- 0.7 kcal/mol/e). Because the backbone has zero net charge, the non-zero potential is unexpected. The larger oxygen at the negative and smaller proton at the positive end of the amide dipole yield positive potentials because: 1) at allowed phi and psi angles residues come off the backbone into the positive end of their own amide dipole, avoiding the large oxygen; and 2) amide dipoles with their carbonyl oxygen surface exposed and amine proton buried make the protein interior more positive. Twice as many amides have their oxygens exposed than their amine protons. The distribution of acidic and basic residues shows the importance of the bias toward positive backbone potentials. Thirty percent of the Asp, Glu, Lys, and Arg are buried. Sixty percent of buried residues are acids, only 40% bases. The positive backbone potential stabilizes ionization of 20% of the acids by >3 pH units (-4.1 kcal/mol). Only 6.5% of the bases are equivalently stabilized by negative regions. The backbone stabilizes bound anions such as phosphates and rarely stabilizes bound cations.

Amides↗
PubMed2000

Controversy in the treatment of adult long ileocolic intussusception: case report.

Adult intussusception is an unusual cause of intestinal obstruction. In contrast to children, intussusception in adults is usually due to an identifiable cause. We present a case of an 81-year-old female who was diagnosed with a long intussusception on CT scan of the abdomen. Because of the likelihood of neoplasia, a right hemicolectomy was undertaken, after which the patient recovered well. The correct treatment of adult intussusception is not unanimously agreed upon. We present a case of long intussusception in which partial reduction of viable small bowel before the resection was done by applying gentle traction. This provided sufficient small bowel mesentery length, preventing any damage to superior mesenteric vessels and avoiding unnecessary excision of healthy bowel.

Adenoma, Villous↗
PubMed1999

Practice parameters for the nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine.

Insomnia is the most common sleep complaint reported to physicians. Treatment has traditionally involved medication. Behavioral approaches have been available for decades, but lack of physician awareness and training, difficulty in obtaining reimbursements, and questions about efficacy have limited their use. These practice parameters review the current evidence with regards to a variety of nonpharmacologic treatments for insomnia. Using a companion paper which provides a background review, the available literature was analyzed. The evidence was graded by previously reported criteria of the American Academy of Sleep Medicine with references to American Psychological Association criteria. Treatments considered include: stimulus control, progressive muscle relaxation, paradoxical intention, biofeedback, sleep restriction, multicomponent cognitive behavioral therapy, sleep hygiene education, imagery training, and cognitive therapy. Improved experimental design has significantly advanced the process of evaluation of nonpharmacologic treatments for insomnia using guidelines outlined by the American Psychological Association (APA). Recommendations for individual therapies using the American Academy of Sleep Medicine recommendation levels for each are: Stimulus Control (Standard); Progressive Muscle Relaxation, Paradoxical Intention, and Biofeedback (Guidelines); Sleep Restriction, and Multicomponent Cognitive Behavioral Therapy (Options); Sleep Hygiene Education, Imagery Training, and Cognitive Therapy had insufficient evidence to be recommended as a single therapy. Optimal duration of therapy, who should perform the treatments, long term outcomes and safety concerns, and the effect of treatment on quality of life are questions in need of future research.

Academic Medical Centers↗
PubMed1999

Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine.

These are the first clinical guidelines published for the treatment of Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD) providing evidence-based practice parameters. They were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. The guidelines provide recommendations for the practice of sleep medicine in North America regarding the treatment of RLS and PLMD. Recommendations are based on the accompanying comprehensive review of the medical literature regarding treatment of RLS and PLMD which was developed by a task force commissioned by the American Academy of Sleep Medicine. Recommendations are identified as standards, guidelines, or options, based on the strength of evidence from published studies that meet criteria for inclusion. Dopaminergic agents are the best studied and most successful agents for treatment of RLS and PLMD. Specific recommendations are also given for the use of opioid, benzodiazepine, anticonvulsant, and adrenergic medications, and for iron supplementation. In general, pharmacological treatment should be limited to individuals who meet diagnostic criteria and especially who experience insomnia and/or excessive sleepiness that is thought to occur secondary to RLS or PLMD. Individuals treated with medication should be followed by a physician and monitored for clinical response and adverse effects. It would be desirable for future investigations to employ multicenter clinical trials, with expanded numbers of subjects using double-blind, placebo-controlled designs, and an assessment of long-term response, side effects, and impact of treatment on quality of life. Evaluation of special groups such as children, pregnant women, and the elderly is warranted.

Academic Medical Centers↗
PubMed1999

Practice parameters for the use of light therapy in the treatment of sleep disorders. Standards of Practice Committee, American Academy of Sleep Medicine.

These clinical guidelines were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. The guidelines provide recommendations for the practice of sleep medicine in North America regarding the use of light therapy for treatment of various sleep disorders. This paper is based on a series of articles in the Journal of Biological Rhythms and also includes evidence tables from an updated Medline review covering the period January 1994 to December 1997. Evidence is presented by grade and level. Recommendations are identified as standards, guidelines, or options. Recommendations are provided for delayed sleep phase syndrome (DSPS), advanced sleep phase syndrome (ASPS), non-24-hour sleep-wake syndrome, jet lag, shift work, dementia, and sleep complaints in the healthy elderly. Light therapy appears generally safe if used within recommended intensity and time limits. Light therapy can be useful in treatment of DSPS and ASPS. Benefits of light therapy are less clear and treatment is an option in jet lag, shift work, and non-24-hour sleep-wake syndrome in some blind patients.

Humans↗