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Biomedical subjects

S P Klein

Publications and source records attributed to S P Klein.

14 recordsLinked to original sources
PubMed1990

A case study in contesting the conventional wisdom: school-based fluoride mouthrinse programs in the USA.

This paper presents the events surrounding the dissemination of the results of a major preventive dentistry demonstration program designed and conducted to provide evidence of the effectiveness and actual costs of a combination of commonly used preventive procedures. It then reviews the controversy provoked when the results of that program were counter to the conventional wisdom of the day, prevailing national policy, and public health practice. An analysis of possible reasons for this reaction follows. The paper concludes with some observations about how such a situation might be approached to minimize similar controversy in the future.

Child↗
PubMed1988

Tolerance to morphine analgesia from brief exposure to a palatable solution.

The onset of tolerance to morphine analgesia was studied in 34 female Wistar rats immediately after they drank a dextrose-saccharin cocktail or tap water for 6 or 24 hours. Tail flick tests conducted at the end of the drinking period showed no analgesia in cocktail or water groups. Morphine (3.5 mg/kg) was then injected subcutaneously, and after 20 min another series of tail flick tests was conducted. Morphine produced strong analgesia in rats that drank water, but only partial analgesia in rats that drank the cocktail. This reduction in morphine analgesia did not differ in comparisons between 6-hour and 24-hour cocktail groups. The results were interpreted as indicating that ingestion of the cocktail produced tolerance for morphine in the test of analgesia, and that such factors as novelty of flavor stimulation or stress from repeated testing were unlikely to yield the attenuation of analgesia that was observed. It was concluded that processes that produce tolerance become active in less than 6 hours.

Animals↗
PubMed1985

Operation of the National Preventive Dentistry Demonstration Program.

Operation of large-scale, multiple-site demonstration programs is an infrequent activity, one for which most investigators have had little previous experience. The success of a demonstration program, however, often rests on operational aspects. Following the completion of a major demonstration, the writers discuss the design of their program, the problems they encountered in its operation, and the aspects they would change in future demonstrations.

Audiovisual Aids↗
PubMed1985

The cost and effectiveness of school-based preventive dental care.

The National Preventive Dentistry Demonstration Program assessed the cost and effectiveness of various types and combinations of school-based preventive dental care procedures. The program involved 20,052 first, second, and fifth graders from five fluoridated and five nonfluoridated communities. These children were examined at baseline and assigned to one of six treatment regimens. Four years later, 9,566 members of this group were examined again. Analyses of their dental examination data showed that dental health lessons, brushing and flossing, fluoride tablets and mouthrinsing, and professionally applied topical fluorides were not effective in reducing a substantial amount of dental decay, even when all of these procedures were used together. Occlusal sealants prevented one to two carious surfaces in four years. Children who were especially susceptible to decay did not benefit appreciably more from any of the preventive measures than did children in general. Annual direct per capita costs were $23 for sealant or fluoride prophy/gel applications and $3.29 for fluoride mouthrinsing. Communal water fluoridation was reaffirmed as the most cost-effective means of reducing tooth decay in children.

Child↗
PubMed1984

Indications for sealant use in a community-based preventive dentistry program.

Dental caries is a disease that recently has undergone, and may still be undergoing, dramatic changes in distribution of incidence and prevalence. The most recent epidemiologic data available have been reviewed in this paper to illustrate that caries is becoming a disease primarily of pits and fissures, with less differentiation than previously acknowledged between fluoridated and fluoride-deficient areas. The present distribution of caries suggests that prevention may be accomplished more effectively through targeted sealant programs than through currently popular mass preventive programs. Existing information can be used to identify logical target groups for sealant programs, and age specific tooth eruption and caries attack information can be used to design delivery methods. Although the adoption of targeted sealant programs represents a departure from the traditional mass approach to prevention in dental programs, the present-day caries distribution requires that the initiation of such programs be given serious consideration. At the very least program administrators are encouraged to invoke the planning-implementation-evaluation process. Current programs should be evaluated carefully in view of today's disease patterns and the clinical significance of the results achieved. The content, design, and timing of future community-based programs should reflect individualized community diagnosis and the application of new epidemiologic data as well as a careful evaluation of the results achieved by current preventive procedures.

Adolescent↗
PubMed1983

Two-dimensional echocardiographic detection and diagnostic features of tricuspid papillary fibroelastoma.

Cardiac papillary fibroelastomas are rare and benign primary tumors in the cardiac valves or occasionally the mural endocardium. Before 1977, these tumors were diagnosed exclusively at postmortem examination. Over the last few years, a handful of cases have been diagnosed in vivo by echocardiography. In this report, we describe the first tricuspid valve papillary fibroelastoma detected by echocardiography in an adult. Clinical and echocardiographic features are discussed.

Echocardiography↗
PubMed1980

Reactive hypoglycemia and A-cell ('pancreatic') glucagon deficiency in the adult.

Serum glucose, A-cell (IRGA) and total glucagon (IRGT), insulin, growth hormone, cortisol, triiodothyronine, and thyroxine values were measured in the fasting state and in response to oral glucose, intravenously administered arginine, and a meal of pan-broiled ground beef in 31 symptomatic patients and 11 normal subjects. Twenty-four patients and 11 control subjects had normal glucose tolerance (group 1); seven patients had reactive hypoglycemia (group 2). Under all conditions, serum IRGA value was significantly lower in group 2 than in group 1. Glucose, arginine, or meat increased serum IRGT levels. This response did not differ significantly in the two groups, nor did the secretion of the other measured hormones. We conclude that A-cell insufficiency can contribute to reactive hypoglycemia in the adult.

Adolescent↗
PubMed1980

The hemispheric specialization for linguistic and non-linguistic tactile stimuli in third grade children.

Thirty third-grade children were given two dichaptically presented tests of hemispheric specialization. Specialization for linguistic stimuli was measured by a letters task and specialization for spatial stimulus was measured by a nonsense shapes task. The results showed a significant right hemisphere processing advantage for tactually presented spatial stimuli. There was no significant processing advantage for either hemisphere with tactually presented linguistic stimuli. The right hemisphere specialization for tactually presented spatial stimuli was present for both boys and girls. Thus there was no evidence of sexual bimorphism in the neurological organization of third grade children for spatial processing.

Child↗