Biomedical subjects

Al M Best

Publications and source records attributed to Al M Best.

28 records · Page 2Linked to original sources

PubMed2003

The crisis in orthodontic education: goals and perceptions.

A crisis in orthodontic education exists today because of a shortage of qualified people seeking to pursue careers in academic orthodontics; 35% of orthodontic graduate programs in the United States report having at least 1 vacant faculty position. Previous studies have identified several factors that contribute to the current shortage. The purpose of this study was to quantify and compare real and perceived differences in income, workload, and other qualitative characteristics between academic and private practice orthodontists. Orthodontic faculty, private practitioners, and residents were surveyed, and their answers were compared statistically. Faculty annual income was less than one half that of private practitioners matched by experience and geography. Faculty reported working an average of 25% more hours per week, and income per hour for full-time faculty was less than one third that of their private-practice colleagues. In addition, faculty perceived that they experienced more stress, encountered more bureaucracy, received less respect, and had a more difficult time achieving board certification than did private practitioners. Despite these findings, both faculty and private practitioners reported high levels of satisfaction in their respective jobs. Orthodontic residents were better attuned to the differences between academics and private practice than were faculty or private practitioners themselves. Residents perceived that it would take an average of 67% longer to pay off their educational debt in a faculty position than in private practice. It is in the best interest of orthodontics to resolve the crisis in education if it is to maintain its well-respected status among dental and medical specialties.

Adult↗

PubMed2003

Genome-wide detection of LOH in prostate cancer using human SNP microarray technology.

Loss of heterozygosity (LOH) of chromosomal regions is crucial in tumor progression. In this study we assessed the potential of the Affymetrix GeneChip HuSNP mapping assay for detecting genome-wide LOH in prostate tumors. We analyzed two human prostate cell lines, P69SV40Tag (P69) and its tumorigenic subline, M12, and 11 prostate cancer cases. The M12 cells showed LOH in chromosomes 3p12.1-p22.1, 11q22.1-q24.2, 19p13.12, and 19q13.42. All of the prostate cases with informative single-nucleotide polymorphism (SNP) markers showed LOH in 1p31.2, 10q11.21, 12p13.1, 16q23.1-q23.2, 17p13.3, 17q21.31, and 21q21.2. Additionally, a high percentage of cases showed LOH at 6p25.1-p25.3 (75%), 8p22-p23.2, and 10q22.1 (70%). Several tumor suppressor genes (TSGs) have been mapped in these loci. These results demonstrate that the HuSNP mapping assay can serve as an alternative to comparative genomic hybridization for assessing genome-wide LOH and can identify chromosomal regions harboring candidate TSGs implicated in prostate cancer.

Adult↗

PubMed2003

The residents' viewpoint of the matching process, factors influencing their program selection, and satisfaction with the results.

PURPOSE: The purpose of this study was to determine the factors considered by oral and maxillofacial surgery residents in selecting residency programs, to estimate the level of their satisfaction with the selection and matching processes, and to analyze the relationship between these factors and overall satisfaction with their match. MATERIALS AND METHODS: A questionnaire was sent to 675 residents listed as members of the American Association of Oral and Maxillofacial Surgeons, and 208 responded to the survey. Of these residents, 56.7% were in an MD integrated program, 30.3% were in a 4-year certificate program, 10.6% were in an MD optional program, and 2.4% were in a combined PhD program. RESULTS: There were no differences between the program types and the number of resident applications or the number of interviews. Residents in the MD integrated programs had significantly higher board scores than both the MD optional residents and the 4-year certificate residents. The most important factors that residents considered when making their match list were as follows: good relationships between residents, good relationships between residents and attendings, training in orthognathic surgery, training in implant surgery, and training in dentoalveolar surgery. When residents were asked whether they were satisfied with the program in which they were currently enrolled, MD integrated residents were significantly more satisfied than were those residents in the MD optional and 4-year certificate program. Additional predictors of residence satisfaction were satisfied with the results of the match process, accuracy of the program in representing itself during the interview process, and less importance placed on orthognathic surgery training. Although generally satisfied, 25% would want to go to a different program if they could go through the match again. CONCLUSIONS: The majority of residents seem to be satisfied with the program in which they matched. Among the important factors determining satisfaction are the degree of honesty during the interview process, good relations among residents and between residents and attending doctors, the scope of clinical training, and the didactic/academic content of the program.

Analysis of Variance↗

PubMed2003

Effects of animal-assisted therapy on patients' anxiety, fear, and depression before ECT.

OBJECTIVE: To determine whether animal-assisted therapy (AAT) is associated with reductions in fear, anxiety, and depression in psychiatric patients before electroconvulsive therapy (ECT). MATERIALS AND METHODS: Before their scheduled ECT treatment, 35 patients were assigned on alternate days to the treatment condition, consisting of a 15-minute AAT session, and the standard (comparison) condition, consisting of 15 minutes with magazines. Visual analogue scales were used to measure anxiety, fear, and depression before and after treatment and standard conditions. RESULTS: The effect of AAT on fear was significant in both the mixed-model, repeated-measures analysis of covariance (ANCOVA) (p = 0.0006) and the secondary analysis (p = 0.0050), which covaried out all of the demographic conditions (gender, race, marital status, pet ownership, age), condition order, and the pretest rating. The effect of AAT on anxiety approached significance in the ANCOVA (p = 0.0982), but in the secondary analysis, the effect was not significant (p = 0.6498). The AAT effect on depression was not significant in ANCOVA (p = 0.7665) or in the secondary analysis (p = 0.9394). A least squares mean analysis showed that AAT reduced fear by 37% and anxiety by 18%. There was no demonstrated effect of AAT on depression. CONCLUSIONS: Animal-assisted therapy may have a useful role in psychiatric and medical therapies in which the therapeutic procedure is inherently fear-inducing or has a negative societal perception.

Adult↗

PubMed2003

Prostaglandin E2-mediated regulation of immunoglobulin G2 via interferon gamma.

BACKGROUND: Patients with localized aggressive periodontitis (LAgP) produce elevated levels of IgG2 both in vivo and in vitro. Responses to the periodontitis-associated pathogens Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis are dominated by IgG2, and these IgG2 responses are associated with reduced extent and severity of disease. Little is known about regulation of the IgG2 subclass, although prostaglandin E2 (PGE2) (a mediator known to polarize responses toward Th-2) and interferon (IFN)-gamma (a Th-1 mediator) both promote IgG2 production. This unusual relationship prompted the hypothesis that, in certain circumstances, PGE2 enhances rather than inhibits IFN-gamma production. METHODS: To test this hypothesis, indomethacin (IND)-treated peripheral blood mononuclear cell (PBL) cultures from healthy volunteers were stimulated with pokeweed mitogen (PWM), and the cultures were manipulated by adding PGE2, rIFN-gamma, rIL-Ialpha, rIL-1beta, rIL-6, or rIL-12. Production of IgG1, IgG2, IFN-gamma, and PGE2 was monitored by enzyme-linked immunosorbent assay. RESULTS: Indomethacin treatment inhibited IgG1 and IgG2 production, and PGE2 restored both immunoglobulins in PWM-stimulated cultures. Remarkably, addition of IFN-gamma also restored IND-suppressed IgG2 but not IgG1. In contrast, addition of rIL (interleukin)-1alpha, rIL-1beta, rIL-6, or rIL-12 did not restore IgG2 responses. Furthermore, IND suppressed IFN-gamma production and PGE2 increased IFN-gamma levels. Kinetic studies indicate that PGE2 production occurred on the first day of culture, followed by IFN-gamma two days later. CONCLUSIONS: These findings support the concept that in certain circumstances, PGE2 production can lead to increased IFN-gamma and that this IFN-gamma selectively promotes IgG2 responses. These data suggest that the elevated PGE2 observed in LAgP patients may contribute to increased IFN-gamma production and help explain elevated IgG2 responses.

Adult↗

PubMed2002

Public recognition of specialty designations.

PURPOSE: Although there is no supporting evidence, there is a perception that the public is unfamiliar with what an oral and maxillofacial surgeon does. The purpose of this study was to evaluate the knowledge of persons about the type of treatment rendered by 12 different specialties and to determine if such unfamiliarity is true only for oral and maxillofacial surgery or whether it occurs with other specialties. PATIENTS AND METHODS: Two groups of patients, one in a dental setting (n = 101) and one in a general medical office setting (n = 157), were asked to match a list of 12 different specialists with list of 15 brief treatment options. Data related to level of education, gender, and age were also collected. Logistic regression was used to assess the relationship between correct identification of individual specialties and the demographic variables. RESULTS: Subjects in both settings correctly matched an average of 72% of the specialists. The most commonly identified specialist in both groups was the gastroenterologist (90%), and the least recognized was the nephrologist in the dental setting (44%), and the otolaryngologist in the medical setting (53%). The oral and maxillofacial surgeon had an identification rate of 77%. Older and better-educated respondents correctly recognized the greatest number of specialists. CONCLUSIONS: The results of this study show that name recognition is not a problem faced only by oral and maxillofacial surgeons. It also shows that efforts directed at improving this situation should be aimed at the younger and less-educated population.

Adolescent↗

PubMed2002

Monocyte differentiation in localized juvenile periodontitis is skewed toward the dendritic cell phenotype.

Several lines of evidence indicate that the monocytes of subjects with localized juvenile periodontitis (LJP) are functionally distinct from cells of age- and race-matched nonperiodontitis (NP) subjects. Among the abnormalities are the propensity to secrete large amounts of prostaglandin E(2) and the induction of immunoglobulin G2 (IgG2) antibodies. The experiments described here were performed to further characterize the LJP monocytes and to determine if these cells mature differently than NP monocytes. When adherent monocytes from LJP subjects were cultured in the presence of human serum, both macrophages and cells with the morphology of immature monocyte-derived dendritic cells (MDDC) were observed. Within 4 days the prevalence of the immature MDDC was approximately twofold higher in LJP cultures than in NP cultures. In addition to their dendritic morphology, these cells were CD11c(+) and CD14(-) or CD14(low) and stimulated potent autologous mixed leukocyte reactions, consistent with differentiation to the MDDC phenotype. Like LJP monocytes, cultures of MDDC generated with interleukin-4 and granulocyte-macrophage colony-stimulating factor selectively induced IgG2 in cultures of pokeweed mitogen-stimulated NP leukocytes. Together, these data suggest that the monocytes of LJP subjects have a propensity to differentiate into MDDC and that this differentiation may be related to the high levels of IgG2 that are observed in the sera of LJP subjects. As high levels of circulating IgG2 are correlated with less severe disease, the propensity of LJP monocytes to differentiate into MDDC may have important implications for both the host response against oral pathogens and the progression of LJP.

Aggressive Periodontitis↗

PubMedDate not supplied

Effects of weight reduction interventions by community pharmacists.

OBJECTIVE: To compare a meal replacement (MR) program with a conventional reduced-calorie diet (RCD) for weight management using the pharmacy as the setting and the pharmacist as the point of contact for dietary advice. DESIGN: Randomized, controlled, open-label trial. SETTING: Travis Pharmacy in Shenandoah, Iowa. PATIENTS: Ninety-five patients from southwestern iowa and southeastern Nebraska were enrolled, of whom 88 were considered eligible for comparison (by continuing through week 2 of the study). INTERVENTION: Patients were randomized to an MR plan or a traditional RCD plan. Patients were followed for a 3-month period of active weight loss and a 10-week period of weight maintenance. Patients returned every 3 weeks for follow-up with the pharmacist, for a total of 13 visits. MAIN OUTCOME MEASURE: Weight changes. RESULTS: During the active weight loss phase, the MR (n = 45) and RCD (n = 43) groups lost a significant amount of weight, although no significant difference was found between the groups (mean +/- standard error = 4.90 +/- 0.30 kg MR versus 4.30 +/- 0.30 kg RCD; P = .16). In the weight maintenance phase, the MR group lost 0.70 +/- 0.40 kg and the RCD group lost 0.90 +/- 0.40 kg (P = .60). Significant improvements were observed in waist circumference, systolic and diastolic blood pressure, and triglyceride levels. No significant changes were seen in high-density lipoprotein cholesterol or low-density lipoprotein cholesterol levels in either group. CONCLUSION: Successful weight management can be achieved in a pharmacy setting. Both MR and RCD programs were effective.

Adult↗

PubMedDate not supplied

Effect of submucosal midazolam on behavior and physiologic response when combined with oral chloral hydrate and nitrous oxide sedation.

PURPOSE: This study was designed to examine the efficacy and safety of submucosal (SM) midazolam and oral chloral hydrate (CH) when used for pediatric conscious sedation in a clinical dental environment. METHODS: Twenty children ages 32 to 63 months participated in this institutionally approved study. Selection criteria included good health (ASA I), 2 to 5 years of age, uncooperative behavior, and the need for multiple restorative visits. In a double-blind crossover design, patients were randomly assigned to receive either oral CH (50 mg/kg) and SM midazolam (0.2 mg/kg), or oral CH (50 mg/kg) and SM saline placebo on their first sedation visit. On the second sedation visit, the patient received the opposite drug regimen than the first visit. Nitrous oxide (50%) was used during each sedation visit. Behavior response was rated as quiet (Q), crying (C), movement (M), or struggling (S) every 2.5 minutes through 40 minutes of operative procedures. Sedations were monitored using a capnograph, pulse oximeter, an automated blood pressure cuff, and precordial stethoscope. Respiratory rate (RR), heart rate (HR), and blood pressure (BP) were evaluated for each procedure. Data was analyzed using ANOVA and multinomial repeated-measures logistic regression. RESULTS: Analysis showed a significant difference in behavior during sedation across drug regimen (chi-square = 55.6, df = 3, P < .0001). Patients given SM midazolam in addition to oral CH showed increased Q rating and decreased C, M, and S ratings. RR, BP, and HR for both groups remained within the normal values for 2- to 5-year-olds. CONCLUSIONS: SM midazolam improved the quality of sedation without compromising safety. Quiet behavior was increased and struggling behavior was decreased. In addition, mean HR, RR, and BP analysis did not deviate from the norm for this age group.

Anesthesia, Dental↗

PubMedDate not supplied

Rural versus urban analysis of dental procedures provided to Virginia Medicaid recipients.

PURPOSE: The purpose of this study was to report the distribution of procedures provided to Virginia Medicaid children by 3 types of dental providers in rural and urban areas. METHODS: Medicaid claims filed for dental patients less than 21 years old were obtained and analyzed for fiscal years 1994-1995. Dental providers were categorized according to their practice type: (1) general practice (GP); (2) pediatric (PD); and (3) public health (PH) dentists. Each type of practice was categorized as practicing in a metropolitan, urban, rural, or completely rural location and evaluated for percentages of preventive, diagnostic, and corrective services provided. RESULTS: Rural areas had a higher percentage of significant providers than did metropolitan or urban areas. General dentists performed more diagnostic and preventive but fewer corrective procedures than pediatric dentists. Pediatric dentists and general dentists in completely rural areas performed more corrective procedures than their counterparts in metropolitan or urban areas. CONCLUSIONS: General, pediatric, and public health dentists in metropolitan and urban areas perform slightly more diagnostic services and fewer corrective services than practitioners in more rural areas.

Adolescent↗