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Biomedical subjects

N A Miller

Publications and source records attributed to N A Miller.

34 records · Page 2Linked to original sources
PubMed1991

Antibody to Coxsackie B virus in diagnosing postviral fatigue syndrome.

OBJECTIVE: To study the association between coxsackie B virus infection and the postviral fatigue syndrome and to assess the immunological abnormalities associated with the syndrome. DESIGN: Case-control study of patients with the postviral fatigue syndrome referred by local general practitioners over one year. SETTING: General practitioner referrals in Dunbartonshire, Scotland. PATIENTS: 254 Patients referred with the postviral fatigue syndrome (exhaustion, myalgia, and other symptoms referable to postviral fatigue syndrome of fairly recent onset--that is, several months) and age and sex matched controls obtained from same general practitioner; 11 patients were rejected because of wrong diagnoses, resolution of symptoms, and refusal to participate, leaving 243 patients and matched controls. MAIN OUTCOME MEASURES: Detailed questionnaire (patients and controls) and clinical examination (patients) and blind analysis of blood sample at entry and after six months for determination of coxsackie B virus IgM and IgG antibodies and other variables (including lymphocyte protein synthesis, lymphocyte subsets, and immune complexes). RESULTS: Percentage positive rates for coxsackie B virus IgM at entry were 24.4% for patients and 22.6% for controls and for coxsackie B virus IgG 56.2% and 55.3% respectively; there were no significant differences between different categories of patients according to clinical likelihood of the syndrome nor any predictive value in a fourfold rise or fall in the coxsackie B virus IgG titre in patients between entry and review at six months. The rates of positive antibody test results in patients and controls showed a strong seasonal variation. Of the numerous immunological tests performed, only a few detected significant abnormalities; in particular the mean value for immune complex concentration was much higher in 35 patients and 35 controls compared with the normal range and mean value for total IgM was also raised in 227 patients and 35 controls compared with the normal range. CONCLUSIONS: Serological tests available for detecting coxsackie B virus antibodies do not help diagnose the postviral fatigue syndrome. Percentage positive rates of the antibodies in patients simply reflect the background in the population as probably do the raised concentrations of total IgM and immune complexes.

Adult↗
PubMed1991

An analysis of the community periodontal index of treatment needs. Studies on adults in France. V. Presentation of CPITN data in cross-tabulations.

A total of 1005 subjects were examined using the CPITN and DFT indices. CPITN data were modified in their presentation in order to be suitable for cross-tabulation. Two different methods were considered. One, described previously by Roland et al. (1984), classified subjects according to the combination of their highest CPITN score and the mean of the highest scores of every nonedentulous sextant. The other consisted of multiplying the above mentioned mean by the individual's highest CPITN score. A critical analysis of the methodology showed that the two number system developed by Roland et al. (1984) was impractical. The new method provides a linear array of values from 0 to 16. Very little overlapping of values was observed, which means that a relatively precise periodontal condition is characterised by each value. With this transformation the CPITN can be used as an index that quantifies periodontal conditions instead of treatment needs.

Adult↗
PubMed1991

Analysis of the Community Periodontal Index of Treatment Needs--study on adults in France. IV. The significance of gingival recession.

A total of 1005 persons were examined using the CPITN criteria which were recorded for every tooth. All the teeth were also measured on both their buccal and lingual aspects to assess the amount of gingival recession. The combination of pocket depth and gingival recession was computed using a specially written program: 93.8 per cent of the teeth had 1 mm or less gingival recession; 82.5 per cent of the teeth with gingival recession did not present pockets; 26.6 per cent of all subjects had at least one tooth with gingival recession of 2 mm or more but only 9.9 per cent had at least one tooth with 2 mm or more gingival recession and a periodontal pocket.

Adolescent↗
PubMed1990

An analysis of the Community Periodontal Index of Treatment Needs. Studies on adults in France. III--Partial examinations versus full-mouth examinations.

1005 persons were examined using the Community Periodontal Index of Treatment Needs. Presence or absence of every clinical sign was registered for each tooth. A specially written program computed CPITN values corresponding to full mouth or partial examinations. Results compare the prevalence and treatment needs obtained through either full mouth or partial examinations. Cross tabulation analysis of the number of cases detected by full mouth and partial examinations shows differences in detection rates of 23.5 per cent for deep pockets, 17.6 per cent for moderate pockets, 13.4 per cent for calculus, 3.2 per cent for bleeding and 53.0 per cent for health. When determining treatment needs using the partial examination procedure approximations of the number of subjects needing hygiene education and scaling are acceptable but the evaluation of the number of individuals needing complex therapy is greatly underestimated. The CPITN is most accurate using full mouth examinations.

Adolescent↗
PubMed1990

[Effect of a sanguinarine mouthwash on children with and without upper extremity motor handicap].

A survey was done at the Center of Child Readaptation at Flavigny (Meurthe-et-Moselle) to determine the effect of a mouth rinse containing 0.03% sanguinaria extract, on the plaque accumulation and gingivitis of 30 children 8 to 17 years old. 13 children had a motricity handicap of their superior members and 17 did not. All subjects rinsed their mouths twice with 15 ml of solution each time. The mouth rinses were performed in the morning and in the evening during three weeks. The children were photographed and examined using the P1I and GI indices on days 0, 7, 14, 21 and 35. No statistical significant difference was observed at any moment between children with or without handicapped upper limbs. After 3 weeks of treatment the Plaque Index had decreased 47.3% and Gingival Index 55.6%.

Adolescent↗
PubMed1990

[Evaluation of time needed to treat periodontal conditions classified according to the C.P.I.T.N. index].

A questionnaire was sent to 623 members of the "French Society of Periodontology" with a view to assessing the time necessary to provide instructions concerning hygiene, carry out root planing, surgery on 3.5 to 5.5 mm pockets, surgery on pockets of 6 mm or more, and to ensure maintenance. 282 responses were received from the practitioners and were computer analysed. The time required for instructions concerning hygiene was estimated to be approximately 15 mn. This information was usually repeated 4 times. It was determined that scaling and root planing require an average of 29.19 mn per sextant. The surgical interventions for 3.5 to 5.5 mm and 6 mm or more pockets are estimated to last an average of 77.03 and 107.36 mn respectively. Finally, the assessment of the time necessary for maintenance of the whole mouth was 30 to 60 mn, with an average of 45.11 mn. A quarterly check-up was recommended by 48.9% of the practitioners. The treatment of complex cases requires much more time, and maintenance is indispensable in order to avoid relapse. A plaque control programme undertaken sufficiently early might avoid long treatment stages.

Dental Scaling↗
PubMed1986

Paget's disease of the nipple: a ten year review including clinical, pathological, and immunohistochemical findings.

Thirty-five women with biopsy-proven Paget's disease of the nipple were treated over a 10 year period at the Breast Cancer Unit, Guy's Hospital. Twenty-four (69%) patients had Paget's disease without a palpable mass in the breast; eleven (31%) presented with a palpable mass and Paget's disease of the nipple. Definitive treatment consisted of modified radical mastectomy in 32 patients, radiotherapy only in 2, and one patient had no definitive treatment. All 11 patients with Paget's disease and an associated lump proved to have invasive ductal carcinoma; five also had associated positive axillary nodes. Nine of the 23 patients with nipple changes only, treated by mastectomy, also had invasive carcinoma; three of these had positive axillary nodes. The remaining 14 patients with nipple changes only were found to have in situ ductal carcinoma, which was extensive in the majority of cases. In 13 cases, histological sections of the nipple were examined by immunohistochemical staining which showed that the Paget's cells expressed a keratin phenotype that was specifically characteristic of simple epithelial cells as seen in glandular epithelium. This was quite unrelated to the normal keratin phenotype of the surrounding skin keratinocytes. Clinical, pathological, and immunohistochemical data suggest a mammary origin of the abnormal cells in Paget's disease of the nipple. Mastectomy appears to be the treatment of choice.

Adult↗
PubMed1982

Sutureless gingival grafting. A simplified procedure.

Suturing a gingival graft is often the most time-consuming stage of the grafting procedure, especially in regions of difficult access. Previously, it has been suggested that a combination of adhesive cellophane and cyanoacrylate may be used to immobilize the graft without suturing. The technique presented here attempts to simplify further sutureless grafting with the following modifications: - Bandage tape is used instead of adhesive cellophane. - The tape is not placed on the teeth but on the attached gingiva on either side of the graft site. - The use of cyanoacrylate is discarded. The success of the procedure depends on complete haemostasis as any moisture will prevent the tape from adhering to the gingiva. Inherent advantages of sutureless grafting accomplished with the use of bandage tape are: - The graft lies flat on the recipient site and is kept under slight pressure by the tape. - Minimal blood clot is present between the graft and the recipient site. - The "wick" effect of the sutures is eliminated. - The chairside time is greatly reduced. - A shorter appointment and no sutures to remove imply less discomfort for the patient. The technique is contraindicated should the patient present an allergic background to bandage tape.

Bandages↗
PubMedDate not supplied

In situ duct carcinoma of the breast: clinical and histopathologic factors and association with recurrent carcinoma.

There has been a recent increase in the diagnosis of in situ duct carcinoma of the breast (DCIS) as a result of mammographic screening. DCIS is heterogeneous in appearance and likely in prognosis. There is no generally accepted model to predict progression to invasive carcinoma. We investigated the prognostic effect of clinical presentation and pathologic factors for women diagnosed with primary DCIS. A cohort of 124 patients was accrued between 1979 and 1994 and was followed to 1997; 78 had DCIS detected mammographically, and 88 underwent lumpectomy alone. In this article, we provide details about characteristics affecting the choice of primary therapeutic modality, and we examine the effects of factors on progression for the two patient subgroups. Presentation with bloody nipple discharge was associated with a significant increase in DCIS recurrence (p=0.07). The pattern of duct distribution was important: DCIS in which the involved ducts were more widely separated had a significantly greater recurrence of DCIS than when the involved ducts were more concentrated (p=0.08 for mammographically detected DCIS, p=0.07 for patients who underwent lumpectomy alone). For mammographically detected DCIS, younger patients had more DCIS recurrence (p=0.07). We found considerable heterogeneity in nuclear grade; 50% of patients exhibited more than one grade. Nuclear grade, necrosis, and architecture were not significantly associated with either recurrence of DCIS or development of invasive carcinoma. Longer follow-up will allow further evaluation of the prognostic relevance of the factors assessed.

Adult↗
PubMedDate not supplied

Female clients in substance abuse treatment.

This paper reviews recent research on sex differences in the nature of alcohol and drug problems, use of treatment services, and the role of treatment and extratreatment factors in influencing these problems. Although patterns of use are different for men and women, responses to traditional treatment programs have not been different. Research suggests that programs providing ancillary services designed to meet the particular needs of women, such as child care, and those involving other family members and significant others hold the greatest promise for women with drug and alcohol problems.

Alcoholism↗