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PubMed1995

Dental, visual, auditory and olfactory complications in Paget's disease of bone.

OBJECTIVE: To determine the prevalence of dental problems in Paget's patients and in a control population without Paget's disease. The relationship of localization of bony involvement of Paget's disease with the prevalence of dental, auditory, visual, and smell changes is examined. DESIGN: Cross-sectional national survey. PARTICIPANTS: Four hundred ninety-eight subjects with Paget's disease were generated randomly from the mailing list of the Paget Foundation. INTERVENTION: Each subject was sent a cover letter, two questionnaires, and a stamped, addressed return envelope. One questionnaire contained questions specific for the individual with Paget's disease. Subjects were asked to give the other questionnaire, which contained the same questions except for those asking about the specifics of Paget's disease, to an unaffected spouse or a similar aged friend. MEASUREMENTS: All subjects were asked about their age, gender, race, educational level, income, living situation, chronic medical conditions, self-rating of their general physical and dental health, the number of teeth present, and the presence of dental, auditory, visual, and olfactory problems. Paget's subjects were also asked to indicate which bones were affected. RESULTS: Paget's disease subjects assessed their oral health to be poorer than the controls. Paget's subjects were more likely to report pain when opening the mouth and were more likely to have had dental extractions. A significantly higher percentage of Paget's individuals with facial or maxillomandibular involvement reported having heart trouble. Paget's individuals with skull, facial or maxillo-mandibular involvement were more likely to report a change in their hearing, sight, and smell than Paget's subjects without involvement of the craniofacial complex. Dental problems were reported by 93% of those Paget's subjects with maxillomandibular involvement, compared with only 10% for those with skull involvement only or involvement at sites distant to the craniofacial complex. CONCLUSIONS: Patients with Paget's disease of bone involving facial or maxillo-mandibular parts of the skeleton have a higher prevalence of change in hearing, sight, smell, and dental problems. We also have found an association of heart disease in patients who have involvement of facial or maxillo-mandibular bones.

Adult↗

PubMed1998

Aborted implantable cardioverter defibrillator shock during facial electrosurgery.

A patient with a fourth-generation transvenous implantable cardioverter-defibrillator system nearly received an inappropriate defibrillation discharge while undergoing electrofulguration of keratotic facial skin lesions. The incident was confirmed by analyses of the implantable cardioverter-defibrillator's time/date stamped event log and stored electrogram record. Therapy was withheld by the noncommitted implantable cardioverter-defibrillator as the pulsed electrocautery was not continued beyond the charging period.

Aged↗

PubMed2005

Safe scanning, but frequent artifacts mimicking bradycardia and tachycardia during magnetic resonance imaging (MRI) in patients with an implantable loop recorder (ILR).

BACKGROUND: Patients with implantable devices are generally not permitted to undergo magnetic resonance imaging (MRI) because of potentially deleterious interactions. Little has been reported regarding the safety and effects of MRI scanning of patients with implantable loop recorders (ILRs). We evaluated the safety of scanning patients with ILRs and the output of the ILR after undergoing MRI. METHODS: Ten patients underwent 11 MRI scanning events. All patients had Reveal Plus (Medtronic, Minneapolis, MN) ILRs. Seven cranial, two lumbar-spine, one shoulder, and one knee MRI were performed. All of the MRIs were performed with the understanding that the patient had an ILR. In each patient, the ILR was cleared moments before the scan and the integrity of the signal and time date stamp were verified. The devices were reinterrogated immediately after MRI in 10 patients and two days post MR scanning in one patient. Each patient was questioned post MRI regarding any symptoms experienced during the scan. RESULTS: Both tachy and bradyarrhythmias appeared as artifacts as a result of ILR exposure to MRI. Post MRI, none of the ILRs showed diminished signal integrity, altered programmed parameters, diminished battery status, inability to communicate or be reprogrammed. No sensations of tugging or warmth at the implant site were noted. CONCLUSION: MRI was performed in ILR patients without harm to the patient or permanent damage to the ILR. MRI scanning of the Reveal appears safe. Artifact mimicking an arrhythmia was common, however, and must be excluded in any ILR patient undergoing MRI to avoid mistakenly attributing a syncopal episode, or palpitations to the artifacts produced from MRI exposure.

Artifacts↗

PubMed1998

Plato, Nightingale, and contemporary nursing.

PURPOSE: To explore the influence of Plato's ideal of leadership on Nightingale's vision for nursing. Nightingale left her imprint on nursing; greater understanding of Nightingale's legacy clarifies several contemporary problems in the field. ORGANIZING FRAMEWORK: Qualitative, historical research in which the great person framework is used to focus on Nightingale and Plato. Nightingale's familiarity with Plato, whose work she read in the original Greek, is established. SOURCES: Evidence for Platonic influence is uncovered in primary sources, then inductive reasoning and reflective analysis are used. FINDINGS: Nightingale's conception of nursing is akin to Plato's conception of public service. Platonic education aims to turn talented people into leading citizens who care for the good of the community. Modern nursing did not evolve from a craft guild tradition, as did medicine. This profound difference in the constitution of nursing is part of what distinguishes it. CONCLUSIONS: Reminiscent of Plato's "Republic," Nightingale's legacy leaves a guardian-like stamp on nursing. Although this legacy also leaves nursing with some ambiguities about technical training and hierarchical systems, it is an orientation to the general good that provides the basis for nursing's holism.

Education, Nursing↗

PubMedDate not supplied

Mothers' postpartum perceptions of spousal relationships.

The postpartum period is one of sexual adjustment for parents. A prospective study of a convenience sample of 194 women ascertained their perceptions of physical, social, and emotional aspects of spousal relationships at one, three, and six months postpartum. Attrition resulted in 131, 114, and 104 women remaining in the study at those time periods, respectively. Open-ended questions and rating scales were self-administered in the women's homes and returned in the stamped, addressed envelopes provided. Although perceptions of the spousal relationships changed little, sexual interest of the women declined over six months. The few women who responded to these questions felt positively about their mates' changed sexual interest in them. Of these women, the majority felt that breastfeeding did not affect their sexual enjoyment. At three and six months postpartum, the condom was the contraceptive method most frequently reported.

Breast Feeding↗

PubMedDate not supplied

Maternal-fetal attachment in twin pregnancies.

OBJECTIVE: To describe maternal attachment to twin fetuses and determine whether such attachment differs between the twins. DESIGN: A descriptive, correlational, nonexperimental design was used to collect data on a convenience sample of high-risk and low-risk women pregnant with twins. SETTING: Questionnaires were distributed or mailed by presidents of parents of multiples clubs to interested participants. Participants mailed the questionnaires back to the researcher via stamped return envelope. PARTICIPANTS: During a 14-month period, 214 eligible women from 41 states and the District of Columbia completed the survey instruments. MAIN OUTCOME MEASURE: The Prenatal Attachment Inventory. RESULTS: Pregnant women reported greater attachment to Twin B than to Twin A. CONCLUSION: Pregnant women may be more attached to Twin B (typically the nonpresenting fetus) because this twin may be easier to see and touch. While the mean attachment scores between twins differed, the size of the difference was small. Further study is needed to determine the predictive value and clinical significance of this finding for future mother-infant relationships.

Adolescent↗

PubMed2002

Quality of life in long term survivors of colorectal cancer.

OBJECTIVES: We aimed to determine the quality of life (QOL) for long term survivors of colorectal cancer. METHODS: Persons with colorectal cancer who had survived at least 5 yr from diagnosis were recruited from a local cancer registry to answer questions about general QOL and colon cancer-specific issues. Before the general survey, focus group interviews with long term survivors were conducted to select survey questions from a pool of general and cancer-specific QOL questionnaires. The survey included the Health Utilities Index, the Center for Epidemiological Studies Depression Scale, and questions from the Short Form 36 and Functional Assessment of Cancer Therapy-Colorectal Cancer. After permission was obtained from their primary physicians, long term survivors from the registry were mailed invitation letters, then telephoned. Those agreeing were mailed self-administered questionnaires with stamped return envelopes. RESULTS: Two hundred twenty-seven respondents (average age = 74 yr, 46% female) completed the survey. Survivors reported a relatively uniform and high QOL, irrespective of stage at diagnosis and time from diagnosis. Non-cancer related comorbid conditions and low income status had more influence on overall QOL than initial stage of colorectal cancer or time since diagnosis. Compared to age-matched populations, long term survivors reported higher overall QOL, but had higher rates of depression. Sixteen percent reported three or more bowel movements a day; 49% reported chronic recurrent diarrhea. CONCLUSIONS: Those who achieve long term remission from colorectal cancer may experience a relatively high QOL, although physical symptoms such as diarrhea and depressive symptoms remain a problem.

Aged↗

PubMed2005

Clinical risk factors associated with incidence and progression of periodontal conditions in pregnant women.

OBJECTIVES: Few large studies have investigated the progression of periodontal conditions during pregnancy in a comprehensive manner. This study aimed to identify clinical factors that were predictive of incidence/progression of periodontal measures in pregnant women adjusting for relevant predictors. MATERIAL AND METHODS: Periodontal examinations were conducted on 891 pregnant women prior to 26 weeks gestational age and within 48 h after delivery. Gingivitis/periodontitis incidence/progression (GPIP) was defined as four plus sites with 2+ mm increase in probing depth (PD) that resulted in PD of at least 4 mm at delivery. Multivariable models including relevant clinical variables and significant covariates were developed. RESULTS: While several clinical measures were significantly associated with the outcome, having >/=10% of sites with bleeding on probing (BOP) and four plus sites with PD >/=4 mm (PD4) were the best two predictors of GPIP (odds ratio (OR)=2.8, 95% confidence interval (CI)=1.8-4.2; OR=2.0, 95% CI=1.4-2.9, respectively), adjusting for maternal race, age, enrollment weight, smoking during pregnancy, marital status, food stamp eligibility, and private health insurance. Multivariable models assessed the impact of BOP on the PD4-GPIP relationship. PD4 was significant in the presence of BOP (low BOP OR=1.3, 95% CI=0.5-3.3; high BOP OR=3.0, 95% CI=2.2-4.3). CONCLUSIONS: Enrollment BOP and PD4 were significant predictors of PD in pregnant women, however; PD4 is only a predictor with BOP.

Adolescent↗

PubMed2006

Compliance and data reliability in sun exposure studies with diaries and personal, electronic UV dosimeters.

BACKGROUND/PURPOSE: Skin cancer risk estimations are based on sun exposure data. However, the reliability of collected data in personal ultraviolet (UV) dosimeters studies has not previously been validated. We aimed at investigating the data reliability and subject compliance in a study of sun exposure behaviour among 407 subjects (age range, 4-68 years) during 54 943 days based on time-stamped personal UV dosimeter readings and diary records. METHODS: By comparing diary records and UV dosimeter readings on a daily basis, we investigated subject compliance, total sun exposure record, reasons for non-responding along with rates of diary completing errors. Efforts to improve compliance were described. RESULTS: The subject compliance rate was median 93.5% (percent days where the diary was completed and the UV dosimeter was worn). The total sun exposure record rate was median 84.1% (percent of participation days with both UV dosimeter and diary records and where the UV dosimeter was worn). Children, adolescents and golfers had lower sun exposure record rates than the rest of the groups (P<0.05). No significant difference was found between males and females (P=0.15). The 17 non-responders were 10 children, three adolescents, one sun worshipper, two golfers and one gardener. Correctable diary completing mistakes were found in 3.1% of the days. Children made more completing mistakes than adults (P=0.001). The average estimated error rate was 3.3% and was higher for children (6.3%) and adolescents (3.6%) than the adult groups (2.4%). CONCLUSION: High subject compliance rate and data reliability were obtained because the investigators were service minded but persistent, offering dosimeter maintenance service within 24 h and scrutinized data for errors and mistakes.

Adolescent↗

PubMed2000

Practices of Maryland dentists: oral cancer prevention and early detection--baseline data from 1995.

OBJECTIVES: To investigate practices and opinions of general dentists in Maryland, USA, related to oral and pharyngeal cancer prevention and early detection. DESIGN AND METHODS: A pre-tested, 34-item questionnaire, cover letter and addressed, stamped envelope were mailed in the summer, 1995, to a simple random sample of 800 members and non-members of the American Dental Association practicing in Maryland. A reminder postcard was sent 3 weeks after initial mailing; a second complete mailing to all non-respondents 6 weeks after first mailing. RESULTS: Over 90% of dentists asked about patient's current use of tobacco but only 77% assessed patient's history of tobacco use and types and amounts used. Fewer (66%) asked about present use of alcohol. Ninety percent reported providing an oral cancer examination at the initial appointment for patients 40 years of age or older; only 6% provided the examination for edentulous patients and only 40% reported palpating lymph nodes of patients 80% or more of the time. CONCLUSIONS: Dentists' reporting on providing oral cancer examinations and taking appropriate health histories are disappointing. These results call for comprehensive educational interventions in terms of changes in dental curricula and as continuing education courses especially since most dentists were interested in continuing education courses on oral cancer prevention and early detection.

Adolescent↗

PubMed2006

Opinions and attitudes of the UK's GDPs and specialists in oral surgery, oral medicine and surgical dentistry on oral cancer screening.

OBJECTIVE: To survey two broad areas of oral cancer awareness and management of patients at risk of oral cancer by specialists in oral surgery, oral medicine, surgical dentistry and general dental practitioners (GDPs) in the UK. The first of these included knowledge and awareness of aetiological factors, changing patterns of disease, and screening/detection programmes including their effectiveness. The second included oral cancer detection methods, advice on avoidance of high-risk activity and self-examination, and referral pattern of GDPs. DESIGN AND METHOD: A pretested, 44-item questionnaire, a covering letter, a brief outline of the research protocol and return, stamped envelope were mailed in March 2003. A sample of 200 GDPs whose names were obtained from the General Dental Council's main list and 305 dental specialist names obtained from specialist's list in surgical dentistry, oral medicine and oral surgery were selected randomly. Information on oral cancer awareness and practice, screening practice and education was obtained. RESULTS: The response rate was 66.9%. The knowledge of the dental specialists was consistent with that in reports of current aetiological studies on oral cancer. However there were gaps in the GDP's knowledge and ascertainment of oral cancer risk factors. Over 70% of the dental specialists provided counselling advice on the risks of tobacco and alcohol habits compared with 41.2% of GDPs. More GDPs (52.4%) than specialists (35.4%) believed that oral cancer screening on a national basis would be effective in decreasing the mortality of oral cancer. Over 95% of all respondents used a visual examination for oral cancer screening and 89.9% of all respondents strongly believed that visual screening is effective in the early detection of oral cancer. CONCLUSION: The results showed that GDPs had knowledge gaps in their awareness of oral cancer risk factors and the application of preventive measures. Most dental health providers in the UK perform visual screening of the oral mucosa for their patients. Opinion was equivocal as to whether a nationally based screening programme similar to cervical cancer would be effective in improving the mortality and morbidity of oral cancer.

Adolescent↗

PubMed2001

Effects of surgical or banding castration on stress responses and behaviour of bulls.

OBJECTIVE: To compare the effects of surgical and latex banding methods of castration in 14- and 9-month-old bulls. DESIGN: Two randomised, controlled experiments. PROCEDURE: In Experiment 1, following administration of local anaesthetic, 14-month-old bulls were castrated by either surgical or banding methods, or left entire. Behavioural, plasma cortisol, plasma haptoglobin and bodyweight responses were recorded. A group of steers from the same mob was used as an additional comparison for bodyweight data. In Experiment 2, following administration of local anaesthetic, 9-month-old bulls were castrated by either surgical or banding methods and cortisol, haptoglobin and bodyweight responses were recorded. Entire bulls from the same group were used as an additional comparison for bodyweight data. RESULTS: In Experiment 1, surgical castrates exhibited more leg stamping and tail swishing than banded or entire animals in the hours after castration. Surgical castrates in both experiments also showed an increase in plasma haptoglobin, which resolved after 4 days. Plasma cortisol was generally not affected by castration. Surgical castrates grew more slowly than entire bulls, but faster than banded animals, in the 56 days after treatment. In Experiment 1, after 56 days, the bodyweights of surgical and banded castrates were not different from the bodyweights of the steers. Fourteen-month-old banded cattle developed persistent wounds above the latex band which remained for several weeks after scrotal dehiscence, but this did not occur in the 9-month-old animals. CONCLUSION: The banding procedure produced fewer acute effects, but a greater suppression of growth than surgical castration and induced prolonged wound formation in the older age group, suggesting that this procedure may not be as suitable for yearling cattle.

Age Factors↗

PubMed1979

Two non-reactive field experiments on stealing from a 'lost' letter.

Two non-reactive field experiments were conducted to study factors influencing stealing. The subjects were people in the streets of London who picked up a stamped, addressed, unsealed, apparently lost letter, containing a handwritten note and in most cases also a sum of money. Experiment 1 employed a 2 x 2 x 2 between-subjects factorial design, varying the amount of money (20p or 1 pound), the form of the money (cash or postal order) and the apparent victim (an old lady or a higher class male). Ten letters were dropped in each of the eight conditions, and a further 10 in each of two control (no money) conditions. Stealing was greatest with cash and the higher class male victim, but did not vary significantly with amount of money. In Expt 2, larger amounts of money were used, and the apparent victim in each case was the old lady. Twenty letters were dropped in each of three conditions, control (no money), 1 pound and 5 pounds in cash, and stealing did vary significantly with amount of money. In both experiments, younger people were more likely to steal, as were those who put the letter in pockets or handbags after picking it up.

Adult↗

PubMed1992

[Growth inhibitory activity of clinical isolates of Pseudomonas aeruginosa against Staphylococcus aureus (MRSA and MSSA)].

Anti staphylococcal activity by clinical isolates of Pseudomonas aeruginosa was tested by the reversed agar plate and the filter paper stamp methods. Almost 40% of Pseudomonas aeruginosa inhibited the growth of both Methicillin resistant Staphylococcus aureus (MRSA) and Methicillin sensitive Staphylococcus aureus (MSSA). Green pigment (Pyocyanin) produced strains showed a strong inhibitory effect against MRSA and MSSA respectively. But some other pigment (Yellow, Red) strains also showed anti staphylococcal activity. These data suggest the colonization of Pseudomonas aeruginosa with anti staphylococcal activity may not be eradicated by the anti pseudomonic antibiotics.

Antibiosis↗

PubMed2002

[Antimicrobial effects and efficacy on habitually hand-washing of strong acidic electrolyzed water--a comparative study of alcoholic antiseptics and soap and tap water].

The rate of bacterial elimination for the stamp method was compared with regular hand-washing (using soap and tap water), hygienic hand-washing (using alcoholic antiseptics), and hand-washing using strong acidic electrolyzed water (the SAEW method) in routine work. After routine work, the average number of bacteria remaining on the nurse's hands with using the SAEW-method, rubbing method and tap water method, were: 54 +/- 63, 89 +/- 190, 128 +/- 194 CFU/agar plate, respectively (n = 81). In this study. It was clarified that a much larger number of Bacillus sp. were detected for the rubbing method than for the other methods. After further nurse work, the most number of absorbed bacteria on a nurse's hands were counted after cleaning a patient's body. The rate of bacteria elimination for hand-washing with soap and tap water after taking care of a patient was insufficient, especially when before care was provided the number of bacteria on the nurse's hands were less than 100 CFU/agar plate. From these results, the following manual for sanitary hand washing is recommended: 1. At first, dirty hands should be cleaned and the number of bacteria should be reduced using soap and tap water or by scrubbing with disinfectants. 2. After the number of bacteria has been reduced, use the SAEW method routinely. 3. For care requiring a high level of cleanliness or if no tap water facilities are available, use the rubbing method. Finally, routine use of the SAEW method in ICU could be recommended with conventional disinfectants and soap and tap water on a case by case basis for less than adverse reactions, such as in the case of rough-hands or keeping a low level of bacteria on hands.

Anti-Infective Agents, Local↗

PubMed2004

[An outbreak of rubella among hospital personnel and measures taken against hospital infection--cost-benefits of the measure].

There is no nationwide outbreak of rubella after 1992 in Japan, but a local outbreak remains. Recently, some cases of congenital rubella syndrome (CRS) were reported after a local outbreak. An outbreak of rubella among hospital personnel occurred in our hospital located on Tanegashima Island on March and April 2003 after a visit of one rubella patient. Fifteen employees, including 7 clerks, 6 nurses, one doctor, and one radiologist, experienced rubella. A total of 259 employees in our hospital employees were examined for anti rubella hemagglutination inhibition (HI) tests with informed consent and recommended to take rubella vaccines. Sixty-seven employees (26%) among 257 examined for tests were found susceptible to rubella, and 53 employees were vaccinated. After vaccination, the outbreak was stamped out immediately. There was no rubella patient infected from employee. Nine among the 15 infected employees had declared to have a history of rubella or rubella vaccines before onsets, suggesting interviews are not reliable. There were many susceptible persons and rubella patients among elderly women and male personnel; therefore, measures are needed for elderly personnel as well as younger employees. In addition, adequate measures should be taken to prevent CRS, because many female personnel capable of pregnancy work in hospitals. The cost of the rubella HI tests and vaccination was approximately yen 200,000 (about dollar 1,600). The absence due to illness per one person was 6 days, and the wage per one day was about yen 12,000 (about dollar 100) on the average. The overall cost required in the outbreak was estimated to be approximate yen 1,400,000 (about dollar 12,000). Considering that an outbreak of rubella causes not only a large amount of expenditure but also loss of hospital income, the investment to prevent a rubella outbreak is quite valuable in the management of a hospital.

Adult↗

PubMedDate not supplied

Screening for the breast cancer gene (BRCA1) using a biochip system and molecular beacon probes immobilized on solid surfaces.

We describe the use of a biochip based on complementary metal oxide semiconductor (CMOS) technology for detection of specific genetic sequences using molecular beacons (MB) immobilized on solid surfaces as probes. The applicability of this miniature detection system for screening for the BRCA1 gene is evaluated using MB probes, designed especially for the BRCA1 gene. MB probes are immobilized on a zeta-probe membrane by biotin-streptavidin immobilization. Two immobilization strategies are investigated to obtain optimal assay sensitivity. The MB is immobilized by manual spotting on zeta-probe membrane surfaces with the use of a custom-made stamping system. The detection of the BRCA1 gene using an MB probe is successfully demonstrated and expands the use of the CMOS biochip for medical applications.

Adsorption↗

PubMedDate not supplied

Analysis of long range correlations due to coherent light scattering from in-vitro cell arrays using angle-resolved low coherence interferometry.

Angle-resolved low coherence interferometry (a/LCI) enables depth-resolved measurements of scattered light that can be used to recover subsurface structural information, such as the size of cell nuclei. Measurements of nuclear morphology, however, can be complicated by coherent scattering between adjacent cell nuclei. Previous studies have eliminated this component by applying a window filter to Fourier transformed angular data, based on the justification that the coherent scattering must necessarily occur over length scales greater than the cell size. To fully study this effect, results of experiments designed to test the validity of this approach are now presented. The a/LCI technique is used to examine light scattered by regular cell arrays, created using stamped adhesive micropatterned substrates. By varying the array spacing, it is demonstrated that cell-to-cell correlations have a predictable effect on light scattering distributions. These results are compared to image analysis of fluorescence micrographs of the cell array samples. The a/LCI results show that the impact of coherent scattering on nuclear morphology measurements can be eliminated through data filtering.

Algorithms↗