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Biomedical subjects

Rachel L Badovinac

Publications and source records attributed to Rachel L Badovinac.

4 recordsLinked to original sources

Folic acid-containing supplement consumption during pregnancy and risk for oral clefts: a meta-analysis.

BACKGROUND: There is equivocal evidence in the published literature that folic acid supplementation during pregnancy may protect against the common congenital anomalies cleft lip with or without cleft palate (CLP) and cleft palate alone (CP). We undertook this meta-analysis to test the hypothesis that nonsyndromic oral cleft birth prevalences are different for those whose mothers took folic acid-containing supplements and for those whose mothers did not. METHODS: Human studies published in English were identified through MEDLINE, bibliography reviews, and contacting experts in the field. Within strata of prospective and case-control studies, CLP, CP, and all clefts, respectively, were analyzed using either a fixed or random effects model, as appropriate. We assessed for publication bias using Begg and Mazumdar's rank correlation and Egger's regression-based tests. RESULTS: Five prospective studies were analyzed, yielding combined relative risks of 0.51 (95% CI: 0.32, 0.95) for CLP, 1.19 (95% CI: 0.43, 3.28) for CP, and 0.55 (95% CI: 0.32, 0.95) for all clefts. Twelve case-control studies were assessed, which resulted in combined relative risks of 0.77 (95% CI: 0.65, 0.90) for CLP, 0.80 (95% CI: 0.69, 0.93) for CP, and 0.78 (95% CI: 0.71, 0.85) for all clefts. CONCLUSIONS: In aggregate, our results support the hypothesis of a protective effect of folic acid-containing supplement intake during pregnancy on the risk for oral clefts, although this conclusion is tempered by the potential for bias and uncontrolled confounding.

Cleft Lip↗

Risk assessment criteria applied to a screening exam: implications for improving the efficiency of a sealant program.

OBJECTIVES: The present study aimed to determine the ability of first-grade screening exam findings to predict carious lesions in permanent first molars by fourth grade. The ability to identify high-risk children would be useful in the rational allocation of limited public health resources, such as the application of sealants. METHODS: Screening exams were performed on 204 children in 1st grade and 4th grade. Analyses were conducted at both the child- and molar- levels. Cross-tabulations were used to identify the threshold dmfs + DMFS in first grade that had the highest sensitivity and highest negative predictive value for discriminating between children with and without permanent caries (1) in the entire population and (2) in subpopulations defined by race/ethnicity, gender, and language spoken at home. This threshold then was entered into logistic regression models. RESULTS: On the child and molar level, the study determined that dmfs + DMFS > 0 had the highest sensitivity (child: 69.4%, molar: 74.7%) and negative predictive value (child: 87.8%, molar: 94.4%). Using this test criterion, univariate logistic regression of the child-level data revealed an odds ratio of 2.72 (p = 0.012) for presence of permanent tooth caries experience. Controlling for gender, grade, race/ethnicity, and language spoken at home, the odds ratio increased slightly to 2.76 (p = 0.012). CONCLUSIONS: There is a relationship between carious lesion experience in 1st grade and carious lesion incidence in the first permanent molars by 4th grade. Using the dmfs + DMFS > 0 criterion may help public health providers determine which children should receive sealants when resources do not allow the delivery of sealants to all children.

Age Factors↗

The effect of aspirin intake on bleeding on probing in patients with gingivitis.

BACKGROUND: Bleeding indices are used as a screen for periodontal disease activity, a measure of disease prevalence, and a measure of effectiveness in clinical trials. Bleeding on probing (BOP) is widely interpreted as a sign of disease activity whereas its absence is interpreted as both a sign and predictor of health. Aspirin use has become increasingly common in the prevention of cerebrovascular and cardiovascular diseases. Because of its anti-platelet activity, aspirin is a non-disease factor that has the potential to affect the appearance of BOP. The hypothesis being tested is that short-term aspirin use in doses of 81 mg and 325 mg will increase the number of bleeding sites in a population with gingivitis. METHODS: Fifty-four subjects were screened initially, those subjects with 20% to 30% whole mouth BOP were randomly assigned to one of three arms: placebo group, 81 mg aspirin group, or 325 mg aspirin group. Before and after exposure to the respective regimens, clinical parameters were measured on all the teeth: the plaque index was recorded at four sites per tooth, and probing depth and BOP were evaluated at six sites per tooth using an automated pressure-sensitive probe. RESULTS: The data obtained in this clinical trial were analyzed utilizing a linear regression analysis to control for confounding variables. The primary measure of interest was BOP in patients clinically demonstrating naturally occurring gingivitis. The results of this study indicate that while controlling for age, gender, and plaque, "low dose" 81 mg and "regular dose" 325 mg of aspirin demonstrated a statistically significant 5.30 (P = 0.001) and 4.13 (P = 0.010) increase from baseline, respectively, in percent BOP. CONCLUSION: Failure to consider the effects of aspirin on BOP could impair proper diagnosis and treatment planning for clinicians and introduce a significant confounding variable in research situations.

Adult↗

Tutoring in a problem-based curriculum: expert versus nonexpert.

Many studies have examined whether being an "expert" influences the success of a tutor in a problem-based learning curriculum. There are, however, no established standards by which to determine expertise. The purpose of this study was to examine whether students evaluate expert and nonexpert tutors comparably and to determine whether setting different standards to determine expertise influences the outcome of the above findings. Tutor evaluations, consisting of eight Likert-type questions completed by first-, second-, and third-year dental students, were analyzed. Tutors were ranked by the authorswithin three different categories of expertise based on the highest educational degree they had attained, familiarity with the specific subject matter, and previous problem-based learning (PBL) experience. Linear regression analyses were then performed between each category and student evaluation results. A statistically significant difference was found in the way students evaluated experts, but only when expertise was defined by the tutor's previous tutorial experience. The findings of this study underscore the importance of the retention of dental faculty with PBL experience in a PBL-based curriculum.

Analysis of Variance↗