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Biomedical subjects

B Rolfe

Publications and source records attributed to B Rolfe.

At least 19 recordsLinked to original sources
PubMed2006

Modification of the home environment for the reduction of injuries.

BACKGROUND: Injury in the home is extremely common, accounting for around a third of all injuries. The majority of injuries of children under five and people aged 75 and over, occur at home. Multifactorial injury prevention interventions have been shown to reduce injuries in the home. However, few studies have focused specifically on the impact of physical adaptations to the home environment and the effectiveness of such interventions needs to be ascertained. OBJECTIVES: To review the evidence for the effect on injuries of modification of the home environment with a primary focus on interventions to reduce physical hazards. SEARCH STRATEGY: We searched The Cochrane Library, MEDLINE, EMBASE, National Research Register and other specialised databases. We also scanned conference proceedings and reference lists. In addition, we contacted experts and trialists in the field. The searches were not restricted by language or publication status. The searches were last updated in December 2004. SELECTION CRITERIA: Randomised controlled trials. DATA COLLECTION AND ANALYSIS: All abstracts were screened by two authors for relevance, outcome and design. Two authors independently assessed methodological quality and extracted data from each eligible study. MAIN RESULTS: We found 18 published and one unpublished trials. Trials were not sufficiently similar to allow pooling of data by statistical analyses, so this review takes a narrative form. Studies were divided into three groups based on the primary population sample; children (five studies), older people (14 studies) and the general population/mixed age group (no studies). None of the studies focusing on children demonstrated a reduction in injuries that might have been due to environmental adaptation in the home; one study reported a reduction in injuries and in hazards but the two could not be linked. Of the 14 included studies in older people, none demonstrated a reduction in injuries due to hazard reduction, although two demonstrated a reduction in falls that could be due to hazard reduction. AUTHORS' CONCLUSIONS: There is insufficient evidence to determine the effects of interventions to modify environmental home hazards. Further interventions to reduce hazards in the home should be evaluated by adequately designed randomised controlled trials measuring injury outcomes. Recruitment of large study samples to measure effect must be a major consideration for future trials.

Accidents, Home↗
PubMed2003

Modification of the home environment for the reduction of injuries.

BACKGROUND: Injury in the home is extremely common, accounting for around a third of all injuries. The majority of injuries of children under five and people aged 75 and over occur at home. Multi-factorial injury prevention interventions have been shown to reduce injuries in the home. However, few studies have focussed specifically on the impact of physical adaptations to the home environment and the effectiveness of such intervention needs to be ascertained. OBJECTIVES: To review the evidence for the effect on injuries of modification of the home environment with a primary focus on interventions to reduce physical hazards. SEARCH STRATEGY: We searched the following databases: APId, ASSIA, British Nursing Index, CINAHL, Cochrane Library databases, Dissertation Abstracts, EMBASE, HealthSTAR, ICONDA, ISI Science (and Social Science) Citation Index, MEDLINE, National Research Register, PREMEDLINE, SIGLE and Urbadisk. Conference proceedings and reference lists were scanned. Experts in the field and trialists were contacted. Searches were not restricted to English language. Handsearching of relevant journals was not conducted. SELECTION CRITERIA: Randomised controlled trials, non-randomised controlled trials, controlled before-and-after studies and interrupted time series studies. DATA COLLECTION AND ANALYSIS: All abstracts were screened by two reviewers for relevance, outcome and design. Two reviewers independently evaluated methodological quality and extracted data from each eligible study. MAIN RESULTS: We found 28 published trials and one unpublished study. Trials were not sufficiently similar to allow for the combination of data by statistical analyses, so this review takes a narrative form. Studies were divided into three groups based on the primary population sample: children, older people and the general population. None of the 11 childhood studies demonstrated a reduction in injuries that might have been due to environmental adaptation in the home. One study reported a reduction in injuries and in hazards but the two could not be linked. The majority of studies used hazard reduction as the outcome. Of the 15 studies in older people, none demonstrated a reduction in injuries due to hazard reduction, although two demonstrated a reduction in falls that could be due to hazard reduction. In the mixed age group there were two trials; neither demonstrated an effect on injuries. REVIEWER'S CONCLUSIONS: There is insufficient evidence to determine the effects of interventions to modify environmental home hazards. Further interventions to reduce hazards in the home should be evaluated by adequately designed randomised controlled trials measuring injury outcomes. Recruitment of large study samples to measure effect may be a major consideration for future trials.

Accidents, Home↗
PubMed2001

The relationship between Index of Complexity, Outcome and Need, and patients' perceptions of malocclusion: a study in general dental practice.

AIM: To examine the relationship between the Index of Complexity, Outcome and Need (ICON) and the subjective opinions of patients attending for routine dental care. MATERIALS AND METHODS: This study was undertaken at two general dental practices in Cardiff and Bedford. 50 patients aged between 11-14 years and 50 patients aged 30-40 years presenting for routine dental treatment were selected in each. The subjects were assessed objectively using the ICON guidelines by two examiners trained and calibrated in the use of this index. The scores were recorded directly from the patient. Subjective assessments were obtained from the patients by means of a questionnaire consisting of four simple questions addressing aesthetics, function, speech and treatment need using a five point Likert scale. RESULTS: The mean ICON scores for the different genders and age groups participating in this study were; 11-14 year old males 58.4 (SE 3.17); 11-14 year old females 51.8 (SE 3.51); 30-40 year old males 51.2 (SE 2.70); 30-40 year old females 45.3 (SE 2.56). There were statistically significant differences in ICON scores between the younger and older groups (P = 0.024) and females and males (P = 0.04). Adult patients were more likely to reject treatment than younger patients. Analysis of the professional scores in relation to subjective assessments, using the Spearman rank correlation coefficient, for 11-14 and 30-40 year olds, and for the male and female genders, revealed that the ICON has a significant correlation with patients' perceptions of aesthetics, function, speech and treatment need (r2 = 0.01 to 0.28). The only exceptions were patients' perceptions of speech in the 30-40 year old group, and function in the female gender, which did not show a statistically significant correlation to the professional assessments. CONCLUSION: In this study, the ICON was found to correlate with patients' opinions of aesthetics, function, speech and treatment need. The strength of association, however, was low. It can be concluded that the ICON alone is not necessarily a suitable predictor for appearance, function, speech or treatment need for those individuals attending general dental practice for routine dental care. In combination with a simple question to assess the patients desire for treatment, the shared decision for any particular individual to enter the treatment process can be determined.

Adolescent↗
PubMed2001

A 2-center comparison of orthodontist's perceptions of orthodontic treatment difficulty.

The aim of this study was to determine which factors correlate with easy and difficult treatments and to assess the use of the Index of Complexity, Outcome & Need (ICON) as an indicator for treatment difficulty. The study was conducted at 2 centers using a retrospective cross-sectional questionnaire-based design. The participants were specialist orthodontic practitioners in Dresden, Germany and Cardiff, UK. Sixteen specialist orthodontists participated. Each supplied 10 completed cases--5 they regarded as being easy and 5 as being difficult. The specialist orthodontists completed a questionnaire and stated up to 5 reasons why they considered the case easy or difficult. Two examiners were calibrated in the use of the ICON. Logistic regression analysis using a forward conditional systematic model with complexity of case (ie, easy or difficult) as the dependent variable demonstrated statistical significance of the following patient-related factors: pretreatment ICON score, number of appointments, and age. Chi-squared testing demonstrated statistical significance of the following factors: cooperation, extent of overbite, presence of dysfunction, extent of overjet, anchorage, angulation of teeth, presence of crossbite, center-line shift, nonextraction treatment, age at start of treatment, compliance during the course of treatment, oral hygiene level. This study indicates that the main distinguishing factors between easy and difficult cases appear to be pretreatment age, number of appointments, and pretreatment ICON score. However, the odds ratios were not sufficiently high for these factors to be strong predictors of difficulty.

Age Factors↗
PubMed2001

Orthodontic treatment standards in a public group practice in Sweden.

The aim was to assess the orthodontic treatment service provided by 6 orthodontists in a group practice in Malmö. One hundred cases were randomly selected from the model store. The Index of Complexity, Outcome and Need (ICON) was used to assess the need, complexity of the problem, outcome, the degree of improvement and whether the completed case was acceptable or not. The reliability of the examiner using the ICON was assessed using Root Mean Square. Logistic regression analysis was employed to explore the variables related to acceptability of the finish and duration of treatment. The younger the patient at the start of treatment the lower initial ICON score, with short treatment duration were associated with an acceptable finish. Three out of 100 cases were deemed as not requiring orthodontic treatment and 36 cases were classified as very difficult to treat. Nevertheless, 71 cases out of the 100 exhibited acceptable finishes with 27 indicating substantial or great improvement. 6 cases finished treatment with ICON scores greater than 43 indicating need for orthodontic treatment. The treatment on average took 22 months. An objective appraisal of the quality of orthodontic care in a group practice in Malmö has been undertaken. Seventy-one cases were completed with acceptable occlusions. The Index of Complexity, Outcome and Need appears to be a valuable tool to assess the multiple facets of orthodontic provision.

Adolescent↗
PubMed1993

Anomalies associated with vertebral malformations.

A review of 218 patients with congenital vertebral anomalies demonstrates that 61% of patients had associated abnormalities affecting seven systems. The type of vertebral anomaly did not predict the location or type of associated abnormality. The site of vertebral anomaly did correlate with the occurrence of some associated diagnoses. The most common abnormalities associated with vertebral malformation were cranial nerve palsy, radial hypoplasia, club feet, dislocated hip, Sprengel's deformity, imperforate anus, hemifacial microsomia, and renal and cardiac anomalies. Comprehensive evaluation of patients with vertebral anomalies will be enhanced by knowledge of the type and frequency of associated anomalies.

Abnormalities, Multiple↗
PubMed1993

Osteogenic melanoma. A rare variant of malignant melanoma.

Osteogenic melanoma is a rare variant of malignant melanoma; only eight cases have been reported. To characterize this unusual neoplasm further, we present four new cases. Two patients were men and two were women (average age, 56 years; range, 47-78 years). All tumors arose from acral lentiginous melanomas. Three were subungual finger lesions and one was on the sole of the foot. All four had been previously diagnosed as or were suspected to have been primary osseous lesions. The vertical growth components were high-grade, amelanotic sarcomatoid malignancies with abundant osteoid matrix. Two tumors also had chondroblastic differentiation. Cells with epithelioid features, including prominent eosinophilic nucleoli, were discernible in every tumor. Regional lymph node metastases in two cases retained osteocartilaginous differentiation, whereas metastatic cells in another case were purely epithelioid. Tumor cells in every case were immunoreactive for S-100 protein and vimentin, and non-reactive for cytokeratin. Two tumors also expressed HMB-45. Melanosomes were identified ultrastructurally in every tumor. Follow-up information was available on every patient. Three developed regional lymph node metastases and are currently alive and well after 14, 39, and 101 months. The fourth patient died of metastatic uterine carcinoma 20 months postoperatively. The differential diagnosis of osteogenic melanoma includes osteosarcoma as well as atypical fibro-osseous proliferations. Clinico-pathologic features that support a diagnosis of osteogenic melanoma include junctional activity, absence of primary bony involvement, regional nodal metastases, immunoreactivity for S-100 protein and/or HMB-45, lack of cytokeratin reactivity, and ultrastructural identification of melanosomes.

Aged↗
PubMed1990

Mixed gonococcal and mycobacterial sepsis of the wrist.

Mycobacterial infections of the hand and wrist are rare. Concurrent infection of a joint by more than one organism is also unusual. A 25-year-old man developed wrist sepsis caused by Neisseria gonorrhoeae and Mycobacterium avium intracellularis. The infection was successfully treated by wrist drainage, carpal debridement, and intravenous antibiotics. Secondary carpal reconstruction was accomplished by delayed bone grafting and internal fixation to preserve radiocarpal motion.

Adult↗
PubMed1989

Genetically-restricted effector molecules released by human lymphocytes in response to early pregnancy factor.

The binding of early pregnancy factor (EPF) to lymphocytes stimulates the release of soluble effector molecules. Studies in mice have shown that it is these factors rather than EPF as such which are inhibitory in the T cell-dependent reactions, the adoptive transfer of contact sensitivity and the rosette inhibition test. Two factors have been identified: mEPF-S1 (Mr approximately 15,000) is major histocompatibility complex (MHC)-restricted while mEPF-S2 (Mr approximately 55,000) is restricted to a locus (or loci) outside the MHC. In the present paper, evidence is presented which shows that EPF also induces the release of soluble mediators from human lymphocytes. With the rosette inhibition test two factors have been detected, both of similar size and genetic restriction to those described previously in the mouse. One factor, designated hEPF-S1 (Mr 14-18,000), is human lymphocyte antigen (HLA)-restricted and the other, hEPF-S2 (Mr 50-60,000), appears to be restricted to a locus (or loci) outside the HLA complex.

Chaperonin 10↗
PubMed1989

Assessing fibular length using bimalleolar angular measurements.

Shortening of the fibula after fracture is common and often difficult to appreciate. Loss of lateral malleolar anatomy causes significant biomechanical changes in the ankle and correlates with poor clinical results. We studied angular measurements of distal fibular length to serve as a guide for assessing fibular reduction after ankle fracture. Mortise view X-rays of 50 normal ankles from 25 healthy volunteers were obtained. The average talocrural angle measured 78.5 degrees. However, individual variation was high with values ranging from 75 to 86 degrees. Comparing contralateral ankles demonstrated an average difference of 1.3 degrees (range 0 to 4 degrees). A new, simpler bimalleolar angle was devised which compares the long axis of the fibula with a line drawn between the tips of the malleoli. The average bimalleolar angle measured 77.8 degrees (range 72 to 86 degrees). The contralateral difference averaged 1.2 degrees (range 0 to 3 degrees). This angle was simpler to use and more reproducible. Angular measurements were tolerant of usual radiographic techniques. Internal or external rotation of the ankle up to 5 degrees caused an insignificant change in the angular measurements. One degree change in the talocrural or bimalleolar angle was found to correspond with a 1 mm change in fibular length for the average ankle, calculated radiographically and confirmed in a cadaver study. Abnormal fibular shortening is detected with an angular difference between injured and contralateral sides of 3.0 degrees using the talocrural angle or 2.5 degrees using the bimalleolar angle (95% confidence limits). Thus, a 2.5 to 3.0 degrees contralateral difference should serve as a minimum value required to direct a change in therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[3H] diazepam binding to human granulocytes.

[3H]-diazepam binds to sites on human granulocyte membranes, with little or no binding to platelets or lymphocytes. These [3H]-diazepam binding sites are of the peripheral type, being strongly inhibited by R05-4864 (Ki = 6.23nM) but only weakly by clonazepam (Ki = 14 microM). Binding of [3H] diazepam at 0 degree is saturable, specific and stereoselective. Scatchard analysis indicates a single class of sites with Bmax of 109 +/- 17f moles per mg of protein and KD of 3.07 +/- 0.53nM. Hill plots of saturation experiments gave straight lines with a mean Hill coefficient of 1.03 +/- 0.014. Binding is time dependent and reversible and it varies linearly with granulocyte protein concentration over the range 0.025-0.300 mg of protein.

Benzodiazepines↗
PubMed1984

Modified rosette inhibition test with mouse lymphocytes for detection of early pregnancy factor in human pregnancy serum.

The rosette inhibition test has been modified so that early pregnancy factor (EPF) in human pregnancy serum can be detected with mouse lymphocytes. Interference with the assay, which would result from incubation of lymphocytes with heterologous serum proteins, is prevented by the introduction of an ion exchange chromatography step. This provides a simple and rapid method for separating EPF from interfering serum proteins. Human pregnancy and non-pregnancy sera were assayed for EPF with human lymphocytes and results compared with those obtained with DEAE-Sephacel fractions of the same sera tested with mouse lymphocytes. The 2 systems showed good agreement but the mouse assay gave greater differentiation between positive and negative results. When monoclonal anti-T cell antibodies, Hu Ly-m1 and anti-Ly-1.1, were substituted for anti-lymphocyte sera in the human and mouse assay systems respectively, similar results were obtained. The mouse assay system has several advantages over the human assay, including stability of the anti-mouse lymphocyte serum and the ready availability of mouse lymphocytes. Moreover the modified method may be applied not only to the assay of human EPF, but also to the assay of EPF from other species. This would be of value if several species were being studied in 1 laboratory, or if sufficient quantities of lymphocytes from a particular species were not available.

Animals↗
PubMed1982

Rosette inhibition test: a multicentre investigation of early pregnancy factor in humans.

The rosette inhibition test for the detection of early pregnancy factor is described in detail. The extended methodology presented here represents the cumulative experience of three independent laboratories. Special reference is made to the effect on the assay of varying the conditions of rosette formation between lymphocytes and sheep red blood cells. Antilymphocyte sera prepared for use in the rosette inhibition test fell into three categories: (i) with no rosette inhibiting activity, (ii) with rosette inhibiting activity which is not affected by the presence of EPF, and (iii) rosette inhibiting activity which is significantly increased in the presence of EPF. To date, this third reaction has been found to be a specific indication of the presence in serum of early pregnancy factor.

Animals↗
PubMed1979

Galactose-1 phosphate uridyl transferase deficiency in the western grey kangaroo (Macropus fuliginosus; marsupialia): a model system for gene therapy studies.

The western grey kangaroo (Macropus fuliginosus) was found to be deficient for galactose-1 phosphate uridyl transferase (GPUT). This species could be used therefore for studies of gene therapy techniques. An improved GPUT assay procedure was developed. It was found that phage particles injected intravenously remain in the blood of kangaroos until the particles are removed by the reticuloendothelial system or, if this system is overloaded, the particles are inactivated by the immune system four days later. No effective transgenosis was detected of the bacterial gal operon contained in the phage used.

Animals↗
PubMed1977

An early pregnancy factor detected in human serum by the rosette inhibition test.

Modification of maternal lymphocyte activity has been demonstrated early in pregnancy by the rosette inhibition test. Normal human lymphocytes showed a similar depression of activity after incubation in serum from pregnant women, indicating that the response was caused by a serum factor. This early pregnancy factor has been differentiated from other substances which appear later in pregnancy and which may also be involved in the suppression of the maternal response. The results of this investigation suggest that the early pregnancy factor may be necessary for the continued viability of the early embryo.

Antilymphocyte Serum↗