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Biomedical subjects

Roseann Mulligan

Publications and source records attributed to Roseann Mulligan.

9 recordsLinked to original sources
PubMed2006

Longitudinal evaluation of loss of attachment in HIV-infected women compared to HIV-uninfected women.

BACKGROUND: The Women's Interagency HIV Study (WIHS) is the largest, most detailed, controlled longitudinal collection of data to evaluate the influence of human immunodeficiency virus (HIV) disease and its therapies on the periodontium. METHODS: This report evaluates periodontal probing depth (PD), attachment loss (AL), and tooth loss from 584 HIV-seropositive and 151 HIV-seronegative women, recorded at 6-month intervals from 1995 to 2002. Using the random split-mouth method, PD and AL were recorded from four sites per tooth: mesial-buccal, buccal, distal-buccal, and lingual. Influence of viral load, CD4 count, race, smoking, drug use, low income, and level of education were evaluated. RESULTS: At baseline, AL was 1.6 versus 1.1 mm (P = 0.003) and PD was marginally deeper (2.1 versus 2.0 mm; P = 0.02) in HIV-seropositive versus HIV-seronegative women. Adjusted longitudinal analysis showed that HIV infection did not increase the mean PD (rate ratio [RR], 1.00; 95% confidence interval [CI], 0.96 to 1.04), worst PD (RR, 1.03; 95% CI, 0.98 to 1.09), mean AL (RR, 0.97; 95% CI, 0.96 to 1.02), worst AL (RR, 1.01; 95% CI, 0.94 to 1.07), or tooth loss (RR, 1.02; 95% CI, 1.0 to 1.05). CONCLUSIONS: CD4 count and viral load had no consistent effects on PD or AL. Among HIV-infected women, a 10-fold increase in viral load was associated with a marginal increase in tooth loss. The progression of periodontal disease measured by PD and AL did not significantly differ between HIV-infected and HIV-uninfected women. The HIV-seropositive women lost more teeth. Race, smoking, drug use, income, and education level did not influence the results for either group.

Adolescent↗
PubMed2006

The effect of an HIV/AIDS educational program on the knowledge, attitudes, and behaviors of dental professionals.

The Pacific AIDS Education and Training Center (PAETC) developed and tested over time a curriculum to meet the changed HIV/AIDS-related needs of dental health professionals. The objective of this study was to evaluate the HIV-related knowledge, attitudes/beliefs, and behaviors among the participants of a CE training course based on this curriculum, both before and six weeks after the completion of the course. The project recruited 106 participants who were dental health professionals over a ten and a half year period (1992-2003). The dental participants consisted of 79 percent dentists and 21 percent dental hygienists or dental assistants. The sample was 67 percent male, 33 percent female, 45 percent Caucasian, and 24 percent Asian. An adapted questionnaire was used before and after the training to assess the educational needs of the participants and evaluate the success of the program in meeting those needs. Approximately 81 percent of the participants completed both questionnaires. After the course, the participants significantly changed their knowledge, attitudes/beliefs, and behaviors (65 percent, 86 percent, 55 percent respectively, all at p=.0001). Overall, the educational program was successful in increasing and promoting the HIV/AIDS-related knowledge and attitudes/beliefs of the participants and enhancing their commitment to infection control and HIV risk screening behaviors.

Adult↗
PubMed2005

The effect of HAART on salivary microbiota in the Women's Interagency HIV Study (WIHS).

OBJECTIVE: Study the prevalence of potentially pathogenic microorganisms in saliva of HIV-positive women in the Women's Interagency HIV Study. STUDY DESIGN: 157 HIV-positive and 31 HIV-negative women were studied. At baseline and every 6 months over 4 years, information was collected on socioeconomic and educational status, oral and systemic health, including HIV markers and antiretroviral therapy, and frequency of professional oral care utilization. Bacterial and yeast pathogenic isolates from stimulated whole saliva were tentatively identified using standard methodologies. RESULTS: The prevalence of microorganisms in stimulated saliva of HIV-positive women was not significantly different from that of HIV-negative women. In HIV-positive women, highly active antiretroviral therapy (HAART) was independently and significantly associated with the presence of a variety of salivary bacterial species. HAART increased the risk for recovering Fusobacterium species (P < .001), enteric gram-negative rods (P < .05), Peptostreptococcus micros (P < .05), Campylobacter species (P < .0001), Eubacterium species (P < .001), and Tannerella forsythia (P < .01). In contrast, HAART led to decreased recovery rate of yeasts (Candida albicans and Candida dubliniensis) (P < .0001). CONCLUSION: The present findings suggest that the institution of HAART promotes an increasingly pathogenic salivary microbiota, at least temporarily. Similar findings have been reported for various nonoral microbial ecosystems.

Adolescent↗
PubMed2005

Osteoporosis: diagnostic testing, interpretation, and correlations with oral health--implications for dentistry.

Osteoporosis affects over 10 million Americans, including over 2 million men. Dentistry is in a position to work alongside medicine to assist the population in preventing and coping with this condition. This article provides an overview of osteoporosis, including its causes, assessment, prevention, and treatment. Various pharmacologic agents are reviewed, including bisphosphonates, selective estrogen receptor modulators, calcitonin, anabolic agents, and fluoride. The article also discusses the dentist's role in prevention, risk assessment, diagnosis, nutrition counseling, and evaluating the impact of the disease and its treatment on dental management and treatment planning. As dental implants become more in demand, the prognosis for and potential complications of implant therapy in patients with osteoporosis are a matter of intense interest.

Aged↗
PubMed2004

Baseline characteristics of participants in the oral health component of the Women's Interagency HIV Study.

OBJECTIVES: This study described baseline sociodemographic and oral health characteristics of a subset of HIV sero-positive and sero-negative women who participated in the oral health component of the Women's Interagency HIV Study (WIHS). METHODS: In 1995-96, 584 HIV sero-positive and 151 sero-negative women from five WIHS core sites were enrolled in the oral study. Data on oral mucosa, salivary glands, dentition and periodontium, along with demographics, socioeconomics, and behavioral characteristics, were used to characterize this population. RESULTS: Mean (SD) age was 37 (8) years for HIV sero-positive and 36 (8) years for sero-negative women; 27% of sero-positive women had CD4 counts < or =200 and 34% had viral loads >50,000 copies/ml. Sero-positive and sero-negative women were similar demographically, as well as on plaque index, gingival bleeding, linear gingival banding, and numbers of DMF teeth and surfaces, but sero-positive women had more abnormal gingival papilla (P = 0.004) and fewer teeth (P = 0.01). Among sero-positive women, those with <200 CD4 counts had more DMF teeth (P = 0.007), and the number of DMF surfaces increased with decreasing CD4 counts (P = 0.04). Sero-positive women who fit the Center for Disease Control (CDC) AIDS criteria were also more likely to have more DMF teeth (P = 0.004), DMF surfaces (P = 0.003), and decayed and/or filled (DF) root surfaces (P = 0.0002) compared to sero-positive women without AIDS. CONCLUSIONS: Dental and periodontal variables showed little difference between HIV sero-positive and sero-negative women. Among sero-positive women, there were significant differences in coronal and root caries by AIDS diagnostic criteria, but no periodontal indicators by either AIDS diagnostic criteria or CD4 status, were observed.

Adolescent↗
PubMed2003

A 4-year longitudinal evaluation of xerostomia and salivary gland hypofunction in the Women's Interagency HIV Study participants.

OBJECTIVES: Our purpose was to conduct a longitudinal investigation of xerostomia and salivary gland hypofunction in a national cohort of HIV-positive and at-risk HIV-negative participants in the Women's Interagency HIV Study. Study design. Data included responses to a dry mouth questionnaire, clinical evaluations of major salivary glands, and unstimulated and chewing-stimulated whole salivary flow rates. Repeated measures regression models were used to determine factors associated with xerostomia and salivary gland hypofunction. RESULTS: Significant univariate associations were found between HIV status and reports of "too little saliva" (P <.0001), < or = 0.1 mL/min, unstimulated saliva (P =.01), and lack of saliva upon palpation of parotid (P =.02) and submandibular/sublingual salivary glands (P =.03). Adjusted odds of reports of "too little saliva" were significantly higher for HIV-positive participants (odds ratio [OR] = 2.44; 95% CI, 1.49 - 3.97; P =.0004) than for HIV-negative participants. Among HIV-positive women, adjusted odds of reports of "too little saliva" and of < or = 0.7 mL/min chewing-stimulated saliva were significantly higher for those with CD4 < 200 (OR = 1.58; 95% CI, 1.07-2.34; P =.022; and OR = 1.53; 95% CI, 1.05-2.23; P =.027, respectively) and for those with CD4 200-500 (OR = 1.47; 95%CI, 1.07-2.02; P = 0.016; and OR = 1.37; 95% CI, 1.01-2.31; P =.001, respectively) than for those with CD4 > 500. Also, adjusted odds of < or = 0.1mL/min unstimulated saliva and < or = 0.7 mL/min chewing-stimulated saliva were significantly higher in women on highly active antiretroviral therapy (HAART) (OR = 1.25; 95% CI, 1.05 - 1.50; P =.014) than in women not on HAART (OR = 1.34; 95% CI, 1.01 - 1.79; P =.044). CONCLUSIONS: HIV-positive women are at a significantly higher risk for xerostomia and salivary gland hypofunction than HIV-negative women, and low CD4 cell counts and HAART use are significant risk factors for these conditions.

Adult↗
PubMed2003

Teledentistry in rural California: a USC initiative.

Dentistry, in a synergistic combination with telecommunications technology and the Internet, has yielded a relatively new and exciting field that has endless potential. "Teledentistry" emerges from the fusion of dental practice and technology and can take on two forms--real-time consultation and "store and forward." The first entity to put teledentistry into practice was the Army, which, in 1994, successfully undertook consultations between dentists and service personnel located more than 100 miles apart. Since then, various institutions and organizations in the United States and farther afield have practiced teledentistry, with varying degrees of success. The Children's Hospital Los Angeles Teledentistry Project, being run in association with the University of Southern California's Mobile Dental Clinic, seeks to increase and enhance the quality of oral health care that is provided to children living in remote rural areas of California, areas often severely underserved by dental health providers. The project has three phases: Phase I involves the establishment and organization of the teledentistry network; Phase II will introduce technologies to provide orthodontic consultation and treatment; and Phase III will expand the network and provide increased specialty care into further areas of California and beyond, providing services to more children in desperate need of dental health care.

California↗
PubMed2002

The three phases of Eve: exploring the common and unique findings in oral and systemic health of differently aging women.

Given that, collectively, women are the longer-lived of the human species, it is fitting that we examine the impact and correlations of aging on systemic and oral health with women as the paradigm. Aging, however, is not a homogeneous process. Its influences are as diverse as the subgroups of people affected. To exemplify the differing manifestations and progressiveness of aging, this article highlights the profiles of three differently aging women: an independent dweller in the community, a participant in an assisted living program, and a resident of a skilled nursing home. How aging has affected their lives commonly and uniquely is addressed, as are medical and oral health issues that transcend functional capability, and evolving research in preventive strategies focusing on successful aging.

Activities of Daily Living↗