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P Andreou

Publications and source records attributed to P Andreou.

18 recordsLinked to original sources

The analysis of 51 genes in DSM-IV combined type attention deficit hyperactivity disorder: association signals in DRD4, DAT1 and 16 other genes.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, starting in early childhood and persisting into adulthood in the majority of cases. Family and twin studies have demonstrated the importance of genetic factors and candidate gene association studies have identified several loci that exert small but significant effects on ADHD. To provide further clarification of reported associations and identify novel associated genes, we examined 1,038 single-nucleotide polymorphisms (SNPs) spanning 51 candidate genes involved in the regulation of neurotransmitter pathways, particularly dopamine, norepinephrine and serotonin pathways, in addition to circadian rhythm genes. Analysis used within family tests of association in a sample of 776 DSM-IV ADHD combined type cases ascertained for the International Multi-centre ADHD Gene project. We found nominal significance with one or more SNPs in 18 genes, including the two most replicated findings in the literature: DRD4 and DAT1. Gene-wide tests, adjusted for the number of SNPs analysed in each gene, identified associations with TPH2, ARRB2, SYP, DAT1, ADRB2, HES1, MAOA and PNMT. Further studies will be needed to confirm or refute the observed associations and their generalisability to other samples.

Adolescent↗

Quality of life in thalassemia.

Morbidity and mortality related to thalassemia have been reduced significantly with modern medical treatment, and quality of life (QOL) should now be considered an important index of effective health care. An assessment of QOL differs from other forms of medical assessment in that it focuses on the individuals' own views of their well-being and assesses other aspects of life, giving a more holistic view of well-being. There is very little published work on evaluation of QOL in thalassemia. A suitable tool should be reproducible, sensitive to the major features of the condition that affect patients' lives, and applicable in the range of different cultural, age, and social settings. Such an instrument would be valuable in evaluating new forms of treatment and in comparing health outcomes between different clinics. Two instruments have been assessed, one derived from the WHOQOL-100 questionnaire, and one designed specifically for thalassemia, which assesses psychosocial and clinical burden, as they affect adult patients, parents, and children. Further studies are required to develop and assess such tools for use in thalassemia. Another approach is to seek patients' own views of their routine treatment and the extent to which medical treatment affects QOL. Results from patient questionnaires in the United Kingdom and Cyprus are consistent in finding problems with organization of transfusions, insufficient options with chelation therapy, and poor communication. Practical measures could be taken to address these issues.

Adolescent↗

Bone marrow mobilized with granulocyte colony-stimulating factor in related allogeneic transplant recipients: a study of 29 patients.

We studied whether a short course of granulocyte colony-stimulating factor (G-CSF) administered to normal donors immediately before bone marrow (BM) harvest would shorten time to neutrophil and platelet engraftment in matched related allogeneic BM recipients. Twenty-nine normal donors received 4 consecutive daily subcutaneous injections of G-CSF (median dose, 12.1 microg/kg per day; range, 9.6-15.7 microg/kg per day) immediately before BM harvest. Donors tolerated G-CSF well, with only mild myalgias and arthralgias, and BM was easy to aspirate. The BM harvest contained a median of 5.3 x 10(8) white blood cells (WBCs)/kg (range, 3.1-11.1 x 10(8) WBCs/kg) and 2.5 x 10(6) CD34+ cells per kg (range, 1.5-7.3 x 10(6) CD34+ cells per kg). Median times to neutrophil (18 days [range, 11-30 days] versus 22 days [range, 16-36 days]; P = .05) and platelet (22 days [range, 15-55 days] versus 27 days [range, 18-46 days]; P = .04) engraftment were statistically shorter than those of historical control subjects whose donors had not received G-CSF before BM harvest. However, secondary engraftment-dependent outcomes including red blood cell and platelet transfusions, febrile days, days on antibiotics, days from transplant to hospital discharge, and days in hospital during the first 60 days after transplant were not statistically different from historical control subjects. We conclude that G-CSF administered to normal donors immediately before harvest facilitates BM aspiration, increases the WBC content of the harvest, and hastens neutrophil and platelet engraftment compared with historical control subjects.

Adolescent↗

Effect of distance on the power density from two light guides.

PURPOSE: This study determined the effect of distance on the power density from standard and Turbo light guides (Demetron/Kerr, Danbury, Connecticut). MATERIALS AND METHODS: Power density was measured from 0 to 10 mm away from the tip of standard 8-mm curved light guides and 13/8-mm Turbo curved light guides. To determine the effect of distance on power density, a polynomial regression line was fitted. The Kolmogorov-Smirnov (K-S) statistic and the Wilcoxon rank sum (WR) tests were used to determine if there was a difference in the rate at which the power density decreased for the standard and Turbo light guides as the distance from the tip increased. Photographs of the light dispersion from each tip were also taken. RESULTS: At 0 mm, the mean (+/- SD) power density from the two standard light guides was 743 +/- 6.1 mW/cm2 and from the four Turbo light guides was 1128 +/- 22.1 mW/cm2. As the distance from the tip of the light-guide tip increased, the power density decreased, but the rate of decrease was greater from the Turbo light guides than from the standard light guides. At 6 mm the power density from the standard light guides fell to 372 mW/cm2 (50% of the original value) and the power density from the Turbo light guides fell to 263 mW/cm2 (23% of the original value). Both the K-S statistic and the WR sum test indicated that the distribution of light intensities was significantly different from the two light guides (WR p-value = .0246, K-S p-value < .0001). The two estimated polynomials intersected at 3.66 mm, and the 95% prediction intervals intersected at about 2.8 and 4.8 mm. Therefore, beyond 5 mm away from the tip of the light guide, the standard light guides gave higher power density readings than the Turbo light guides. Photographs showed that the light dispersed at a wider angle from the Turbo light guides than from the standard light guide. CLINICAL SIGNIFICANCE: The design of the light guide of a light curing unit affects light dispersion, power density, and ultimately the dentist's ability to properly cure composite. For these reasons, manufacturers should report the power density at the tip of the light guide and 6 mm from the tip of the light guide, since significant differences exist between light guide designs.

Dental Cavity Preparation↗

A rare Behr.

Explore the source record for details and available documents.

Anisocoria↗

Interchangeability of semiadjustable articulators after 2 to 7 years of use.

PURPOSE: The purpose of this study was to test the interchangeability of articulators that had been in use from 2 to 7 years and compare these results with the interchangeability of the same articulators 1 year earlier. MATERIALS AND METHODS: Forty-six Whip Mix model #2240 articulators (Whip Mix Corporation, Louisville, KY) that were in clinical use from 2 to 7 years were checked for interchangeability using the Whip Mix #2245 check system. The horizontal tolerance of the check system was 94 microm. Articulators were also evaluated in the vertical dimension at 4 predetermined locations around the check system cylinders using 26-microm-thick shimstock. Vertical discrepancies between the cylinders were recorded as the thickness of 0, 1, 2, or more than 2 pieces of shimstock. Interchangeability results were compared with those determined 1 year previously using the same evaluation methods using the Exact McNemar's Test of Agreement (alpha = 0.05). RESULTS: Using the Whip Mix 2245 check system, 35 (76%) articulators were interchangeable after 2 to 7 years of use. This compares to 38 (83%) that were interchangeable upon evaluation 1 year earlier. The decrease in interchangeability was not significant (p =.4531). Forty-three (94%) of the articulators had vertical discrepancies of 52 microm or less at the initial evaluation. One year later, 45 (98%) of the articulators had vertical discrepancies of 52 microm or less. After 1 year, there were significant differences in the amount of vertical space between the cylinders only at the right side (p =.014). CONCLUSION: The Whip Mix model #2240 articulator can remain interchangeable during clinical use for 7 years, but should be routinely checked for calibration.

Calibration↗

Trends in the prevalence and treatment of hypertension in Halifax County from 1985 to 1995.

BACKGROUND: The objective of this study was to document changes in the prevalence and treatment of hypertension in Halifax County from 1985 to 1995 in an effort to observe, at the population level, the consequences of the availability of new antihypertensive medications. METHODS: The study population comprised a random sample of Halifax County residents, aged 25-64 years, who responded to the 1985 and 1995 surveys of the Halifax County MONICA Project and residents who responded to the Nova Scotia Health Survey conducted in 1995. Data from the two 1995 surveys were pooled. Information on hypertension awareness and use of medication were obtained through questionnaires, and blood pressure was measured according to a standard protocol, using phase I and V of Korotkoff sounds as respective markers for systolic and diastolic pressures. Uncontrolled hypertension was defined as a systolic pressure of 140 mm Hg or greater and a diastolic pressure of 90 mm Hg or greater. Changes in the prevalence of hypertension, prescribing trends and medication costs were examined, and the association between the type of antihypertensive treatment and characteristics of the respondents with self-reported hypertension was investigated by multivariate logistic regression. RESULTS: Of the 917 people interviewed in 1985 and the 1338 in 1995, 274 (29.9%) and 356 (26.6%), respectively, reported a history of hypertension. When age was controlled for, the proportion of respondents reporting hypertension did not differ between survey years or between men and women. The proportion of treated respondents who had uncontrolled hypertension increased between 1985 and 1995, from 32.6% to 57.4% among men and from 38.0% to 42.6% among women. An increase was seen in the use of calcium-channel blockers (from 2.1% to 19.7%) and angiotensin-converting-enzyme inhibitors (from 5.2% to 25.4%); the proportion of patients receiving combination therapy or diuretics decreased (from 39.6% to 15.6% and from 31.3% to 17.2% respectively). These changes were associated with an increase in the average daily cost of medication from $0.48 to $0.85 per patient. INTERPRETATION: The shift to new antihypertensive drugs was not associated with improved blood pressure control, but it was associated with an increase in average medication costs per patient. Uncontrolled hypertension remains a public health problem.

Adult↗

Prevalence of risk factors for cardiovascular disease in Canadians 55 to 74 years of age: results from the Canadian Heart Health Surveys, 1986-1992.

BACKGROUND: By 2016, the proportion of Canadians older than 65 years of age will increase to 16%, and there will be an increase in the absolute number of cases of cardiovascular disease in older Canadians. The Canadian Heart Health Surveys database provides information about this population upon which health policy related to cardiovascular disease can be based. This paper presents for the first time population-based data on the risk factors for cardiovascular disease in older Canadians. METHODS: Canadians from all 10 provinces participated in surveys of cardiovascular risk factors; health insurance registries were used as sampling frames. In each province, probability samples of 2200 adults 18 to 74 years old not living in institutions, on reserves or in military camps were asked to participate in interviews and to undergo testing at clinics for major risk factors for cardiovascular disease. RESULTS: A total of 2739 men (response rate 70%) and 2617 women (response rate 66%) aged 55 to 74 years participated in the survey and also provided follow-up clinical measurements at the clinic. Overall, 52% of participants were hypertensive, 26% had isolated systolic hypertension, and 30% had a total blood cholesterol level of 6.2 mmol/L or greater. Rates of current smoking were lower in women than men (17% v. 22%). Overall, 87% of men and 78% of women who were current smokers smoked at least 10 cigarettes per day. Only slightly more than half of participants exercised at least once a week for at least 15 minutes, and almost half had a body mass index of 27 or greater. In only 4% was no major risk factor for cardiovascular disease detected. INTERPRETATION: Significant numbers of older Canadians have one or more major risk factors for cardiovascular disease. Many of these risk factors are amenable to modification.

Aged↗

Knowledge and awareness of risk factors for cardiovascular disease among Canadians 55 to 74 years of age: results from the Canadian Heart Health Surveys, 1986-1992.

BACKGROUND: Cardiovascular disease is the leading cause of death and disability in older people, who account for an increasing proportion of Canada's population. Knowledge and awareness of risk factors is essential for changes in behaviour, yet little is known about these issues in older people. The Canadian Heart Health Surveys database provides a unique resource to examine knowledge and awareness of cardiovascular risk factors in older Canadians. METHODS: This descriptive cross-sectional study used data from the Canadian provinces' Heart Health Surveys, for the years 1986 to 1992. Sampling within each province consisted of stratified, 2-stage, replicated probability samples; 4976 people 55 to 74 years of age were included in the present analysis. Knowledge and awareness of cardiovascular risk factors was determined from the survey question "Can you tell me what are the major causes of heart disease or heart problems?" Blood pressure was measured during a home visit; anthropometric and blood measurements were obtained during a clinic visit. Cardiovascular health status was determined by self-reporting. RESULTS: Smoking and stress or worry were mentioned as major causes of heart disease by the greatest proportion of participants (41% and 44% respectively); hypertension was mentioned by only 16%. Men and women did not differ in their awareness of high blood cholesterol (cited by 23% of participants), smoking (41%), excess weight (30%) or lack of exercise (28%) as causes of heart disease. A greater proportion of women than men were aware of hypertension (19% v. 12%) and heredity (31% v. 17%) as major causes of heart disease. Awareness of risk factors was consistently lower in the older age group (65-74 v. 55-64 years). Among women, there was greater awareness of the respective risk factors as causes of heart disease among those who were smokers (60% v. 35% of nonsmokers), those who had a body mass index (BMI) of 25 or greater (38% v. 24% of those with a BMI less than 25) and those who were hypertensive (22% v. 17% of those without hypertension). Those who had experienced a heart attack had greater awareness of the major causes of heart disease than those who had not; this pattern was stronger among women than among men. Of those in whom elevated cholesterol level was identified during the course of the study, 62% of men and 67% of women were unaware of their cholesterol status. Of those in whom high blood pressure was diagnosed, 43% of men and 33% of women were unaware of their hypertensive status. INTERPRETATION: Awareness of the major causes of cardiovascular disease is low among older Canadians, especially among men and in those 65 to 74 years of age.

Aged↗

Clinical and economic analysis of allogeneic peripheral blood progenitor cell transplants: a Canadian perspective.

Allogeneic peripheral blood progenitor cell (PBPC) transplants are an alternative to BMT, although G-CSF mobilization dose, timing of pheresis and risk of GVHD are not well defined. We compared harvest characteristics, donor and recipient outcomes and costs of two PBPC transplant strategies with historical controls who received BMT. Twenty donors mobilized with four daily s.c. G-CSF doses (5 microg/kg/day) (group 1) and 20 mobilized with 10 microg/kg/day G-CSF (group 2) were compared with 20 BM controls (group 3). G-CSF and phereses were well tolerated. Four of 40 PBPC donors required femoral catheter placement. At least 2.5 x 10(6) CD34+/kg recipient weight were collected with two phereses in 19/20 donors (group 1) and 18/20 donors (group 2). Time to neutrophil (18 vs 20 vs 22 days, P = 0.02) and platelet (21 vs 24 vs 27 days, P = 0.005) engraftment was shorter in the PBPC groups (group 2 vs group 1 vs group 3) but secondary engraftment outcomes were not different. The incidence of grade 2-4 aGVHD was higher in the low-dose G-CSF group (group 1) but there was no difference in cGVHD, 100-day or 1-year survival. The mean PBPC transplant cost (group 1) at first hospital discharge was less than BM (group 3) ($34,643 vs $37,354) but the mean overall cost for both groups was similar at 100 days ($46,334 vs $46,083). Allogeneic PBPC transplant with short course, low-dose G-CSF mobilization is safe, feasible and cost equivalent to allogeneic BMT.

Bone Marrow Transplantation↗

A methodological assessment of diurnal variability of peak flow as a basis for comparing different inhaled steroid formulations.

BACKGROUND: A "survival" model offers certain ethical and practical advantages over alternative experimental designs if used to compare antiasthmatic inhaled steroid formulations. The model requires an objective daily measure of therapeutic effect (e.g., peak expiratory flow rate, which may be expressed as the lower of two daily measurements (LPF) or as diurnal variability (DVPF). The relative efficiency of these two measures is unknown. OBJECTIVE: This study was conducted to determine the relative efficiency of LPF and DVPF. METHODS: We analyzed data from a placebo-controlled comparison of an active inhaled formulation of budesonide versus an inactive oral formulation. The primary outcome measure in this design is the number of days from the time the test treatments start until a statistically significant deterioration occurs from an optimal asthma control value established at baseline. RESULTS: DVPF proved less sensitive than LPF; that is, fewer patients relapsed during the 8-week trial period: 32 versus 41, respectively. Also, the median interval until relapse was longer: 24 versus 9 days. With LPF, inhaled budesonide proved more effective than placebo or oral budesonide (p = 0.03), whereas DVPF failed to discriminate among the test treatments (p = 0.38). LPF correlated with all three symptom indices (p > or = 0.003) and two of three spirometric indices measured concomitantly (p < or = 0.04). DVPF did not correlate with any index (p > or = 0.10). CONCLUSION: In this experimental model, LPF proved more sensitive and valid than DVPF as an indicator of differences in antiasthmatic potency between two inhaled steroid formulations.

Administration, Inhalation↗

A histopathological study of the appendix at autopsy and after surgical resection.

In a study of 101 autopsy appendices and over 3000 surgically resected appendices the range of histopathological features seen in each group is described. Fibrosis and faecoliths were more common in the older autopsy group than in the younger surgically resected group. The high incidence of fibrosis in the autopsy group suggests that this is an age-related change, although some may be due to previous inflammation. The low incidence of faecoliths in the surgically resected group does not support the hypothesis that they are a major cause of appendicitis.

Adolescent↗

Interchangeability of two semiadjustable articulators.

PURPOSE: Interchangeability between articulators allows mounted casts to be transferred accurately from one articulator to another. The purpose of this study was to evaluate the interchangeability of 109 new, unused interchangeable articulators in the centric position. MATERIALS AND METHODS: The interchangeability of 38 unused Whip Mix model #2240 and 71 unused model #3040 semiadjustable articulators was evaluated using the Whip Mix #2245 check system as the standard. Vertical discrepancies between the check system cylinders were also measured. RESULTS: Within the standard for interchangeability established by the Whip Mix #2245 check system (< 94 microns horizontal discrepancy), 101 (93%) of 109 articulators were interchangeable (34 were model #2240 and 67 were model #3040). Overall, the amount of vertical space between the check system cylinders was < or = 52 microns in 99.4% of the model #2240 articulators and 99.7% of the #3040 articulators. CONCLUSION: New, unused Whip Mix model #2240 and #3040 articulators are potentially interchangeable in the centric position.

Calibration↗

Sexual health knowledge of students at a high school in Nova Scotia.

PURPOSE: In the context of a community development project related to adolescent sexual health, this study was carried out at Amherst Regional High School (ARHS) in Amherst, Nova Scotia, to assess students' sexual health knowledge, gender differences in knowledge, and associations between knowledge and sexual behaviours. METHODS: A 29-item scale assessed knowledge in five areas of sexual health. Gender differences in correct responses to questions were compared. Overall knowledge scores were compared by gender, grade, and sexual activity, and tested for association with sexual behaviours. RESULTS: Of 796 students, 80% participated. Sexual health knowledge scores were highest for sexually active females. Higher score was associated with oral contraceptive use and later sexual debut. Knowledge was highest for HIV/AIDS. Students were insufficiently aware of their right to patient confidentiality. CONCLUSIONS: ARHS students lack knowledge in some sexual health areas. School programs should consider these findings, and work to improve school-based sexual health education.

Adolescent↗