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Biomedical subjects

C Mason

Publications and source records attributed to C Mason.

At least 55 records · Page 3Linked to original sources
PubMed2000

A retrospective study of unerupted maxillary incisors associated with supernumerary teeth.

We retrospectively reviewed the clinical records and radiographs of 100 patients who had had supernumerary teeth removed. Their mean (SD) age was 9 years 3 months (2). The 100 patients had a total of 127 unerupted maxillary incisors associated with supernumerary teeth. The supernumerary tooth was removed without exposure of the permanent tooth more often among the 79 younger children (aged 10 years or less) (SND=3.52, P<0.01), and when the incisors were less mature (Cvek classification 1, 2, and 3) (SND=5.27, P<0.01). Of these incisors with immature roots that were treated conservatively, 60 (72%) erupted and 24 (28%) required further operation. Of the mature incisors treated conservatively, 10 (63%) required further operation. In this study, almost three-quarters of immature incisors erupted spontaneously after removal of the associated supernumerary teeth. Over half of the mature teeth required further operation. Mature teeth should be exposed with or without bonding at the time of removal of the supernumerary teeth.

Adolescent↗
PubMed1999

Developmental regulation of spine motility in the mammalian central nervous system.

The function of dendritic spines, postsynaptic sites of excitatory input in the mammalian central nervous system (CNS), is still not well understood. Although changes in spine morphology may mediate synaptic plasticity, the extent of basal spine motility and its regulation and function remains controversial. We investigated spine motility in three principal neurons of the mouse CNS: cerebellar Purkinje cells, and cortical and hippocampal pyramidal neurons. Motility was assayed with time-lapse imaging by using two-photon microscopy of green fluorescent protein-labeled neurons in acute and cultured slices. In all three cell types, dendritic protrusions (filopodia and spines) were highly dynamic, exhibiting a diversity of morphological rearrangements over short (<1-min) time courses. The incidence of spine motility declined during postnatal maturation, but dynamic changes were still apparent in many spines in late-postnatal neurons. Although blockade or induction of neuronal activity did not affect spine motility, disruption of actin polymerization did. We hypothesize that this basal motility of dendritic protrusions is intrinsic to the neuron and underlies the heightened plasticity found in developing CNS.

Animals↗
PubMed1999

Feasibility of implementing health promotion interventions to improve health-related quality of life.

Survivors of childhood cancer are a growing and vulnerable population. Cure rates for pediatric cancers now exceed 60% and, by the year 2000, an estimated 1 of every 1,000 young adults will be a cancer survivor. Because this population is at increased risk for late medical and neoplastic complications that impact adversely on health-related quality of life, it is important to investigate methods to promote risk reduction by motivating survivors to practice health-promoting behaviors. With this background, we initiated a prospective, randomized, controlled feasibility study in which survivors attending a long-term follow-up clinic were randomized to receive standard care or standard care plus an educational intervention. Our objectives were to determine if the intervention would improve the survivors' knowledge about their cancer treatment and risks of late effects and increase their practice of health-protective behaviors. Since July 1995, 272 of 318 families (86%) approached about the study agreed to participate. Of these, 266 are evaluable for assessment of baseline knowledge and health behaviors. Demographic features, baseline knowledge, health perceptions and health behaviors did not differ among randomized groups. Assessment of the intervention's efficacy at changing health behaviors of survivors randomized to the intervention group will be available when the 1-year follow-up evaluations are completed for the study cohort. Our preliminary experience with this pilot study supports the feasibility of educational intervention research in a specialty clinic dedicated to monitoring long-term childhood cancer survivors. Int. J. Cancer Suppl. 12:138-142, 1999.

Adolescent↗
PubMed1999

A nasopalatine cyst in an 8-year-old child.

The nasopalatine cyst (NPC) was first described in 1914 and it is considered the most common non-odontogenic cyst. Most studies show a higher incidence of NPC among males than females, with a male/female ratio of 1.7:1. The majority of the cases described in people in their fifth decade involve Afro-Caribbeans, while those in their sixth decade are mainly caucasians. These cysts are normally asymptomatic, unless they are infected. The most commonly reported clinical symptom is swelling in the anterior part of the palate. The treatment of choice is enucleation. Even though it has been stated that NPCs may occur at any age no reports have been made on children less than 9 years old. Some reports support a predisposition in young Afro-Caribbeans, where NPCs appear to be more aggressive, larger and symptomatic. We present a case of a NPC in an 8-year-old caucasian female.

Child↗
PubMed1999

Guide to practice or 'load of rubbish'? The influence of care plans on nursing practice in five clinical areas in Northern Ireland.

A nursing care plan is a written, structured plan of action for patient care. There is strong evidence that care plans are viewed negatively by nurses and poorly implemented, with little evidence to suggest that they have any positive effect on quality of care or patient outcomes. The project reported in this paper aimed to investigate how nursing care plans were being used in five clinical areas, and to assess their influence on nursing practice. An exploratory, predominantly qualitative research design was selected utilizing participant observation, focus groups and diaries. In four of the five clinical areas, the 'activities of daily living' section of care plans had no apparent positive influence on nursing practice which was driven by other factors and sources of information. Care plans in the remaining ward were clinically led and locally owned, and in this setting they operated as an important guide to practice. It is concluded that a reinvention of the nursing care plan is needed without the constraint of a nursing model as its necessary foundation. New and imaginative plans of action for patient care should be encouraged, developed at ward level and tailored to the demands of the clinical area. These should contain a minimum of documentation and integrate with nursing practice.

Adult↗
PubMed1999

Health professionals' perspectives on service delivery in two Northern Ireland communities.

This research builds on the findings of an ethnographic study of health inequalities in two small, rural communities in Northern Ireland. Through further analysis of existing data, this second study aimed to explore health professionals' perspectives on issues of service delivery relevant to government policy on primary care. Anthropological fieldwork was conducted for two consecutive 4-month periods during 1995 and 1996 in one predominantly Catholic and one predominantly Protestant town. To preserve confidentiality, the locations have been given the pseudonyms, respectively, of Ballymacross and Hunterstown. Research tools included fieldwork journals and a fieldwork diary, meetings with key informants, tape-recorded interviews, group discussions, participant observation and use of secondary material such as census data, local newspapers and community health profiles. Interviews with 15 health workers revealed that there was not a coherent approach to achieving health gain, little collaborative enterprise and minimal interaction between the different professional groups. The National Health Service (NHS)-employed primary care professionals, more than local community workers, appeared to be demoralized, exhausted and suspicious of the business-orientated health service. In this respect, the primary care-led NHS appeared not to be working. It is concluded that a shared health agenda should be developed by NHS-employed primary care professionals and local community workers to create a health-inducing environment at community level. This needs to be complemented by the establishment of formal mechanisms for inter-agency working at local, professional and government levels.

Community Participation↗
PubMed1998

Requirement of Ras-GTP-Raf complexes for activation of Raf-1 by protein kinase C.

Receptor tyrosine kinase-mediated activation of the Raf-1 protein kinase is coupled to the small guanosine triphosphate (GTP)-binding protein Ras. By contrast, protein kinase C (PKC)-mediated activation of Raf-1 is thought to be Ras independent. Nevertheless, stimulation of PKC in COS cells led to activation of Ras and formation of Ras-Raf-1 complexes containing active Raf-1. Raf-1 mutations that prevent its association with Ras blocked activation of Raf-1 by PKC. However, the activation of Raf-1 by PKC was not blocked by dominant negative Ras, indicating that PKC activates Ras by a mechanism distinct from that initiated by activation of receptor tyrosine kinases.

Animals↗
PubMed1998

Consensual partnering in Australia: a review and 1991 census profile.

"This paper is the first part of a two-part examination of consensual partnering in Australia. It reviews the Australian literature on consensual partnering, summarizing evidence of its proliferation since the mid-1960s and also the findings of investigations into its nature and the personal attributes that predispose some people more than others to adopt it. It then discusses the shortcomings of Australian census data as a source for studying consensual unions, before using data from the 1991 Census to present the first elements in a comprehensive profile of the cohabiting population. These cover the basic demography of consensual partnering: the ages, marital statuses and family type distributions of those involved."

Age Distribution↗
PubMed1998

Emergency treatment of orodental injuries: a review.

There has been an increase in the incidence of injuries to the incisor teeth in the primary and permanent dentitions over the last decade; one study reported that roughly 35% of 9-year-old children will have damaged their teeth in some way. Much has been written about dental injuries, and there may be confusion about the appropriate emergency treatment for different types. Classification and understanding of the types of injury are essential before diagnosis and treatment can be undertaken. Although dental injuries can occur singly, they more usually involve a combination of injuries to a tooth and its supporting structures. Prompt, accurate diagnosis and appropriate emergency treatment as outlined in this paper will greatly improve the prognosis for many dentoalveolar injuries. The aim must be to ensure that the third of the population of preteenage children who damage their teeth are not resigned to loss of an incisor in later life because of inaccurate diagnosis and poor treatment of the emergency condition.

Child↗
PubMed1998

Group psychotherapy for women molested in childhood: psychological and somatic symptoms and medical visits.

Molested women who completed a series of 16 weekly group psychotherapy sessions conducted by social workers improved substantially regarding various aspects of psychological functioning, including self-image, coping techniques, relationship issues, and mothering. In addition, there was significant improvement in all psychological symptom scales and all global indices of symptomatic distress measured by the SCL-90-R. Furthermore, the improvement was present immediately after therapy and, with the exception of the hostility score, persisted 1 year later. Although the somatization score was reduced, the number of visits for physical symptoms did not change. The patients studied manifested characteristics typical of previously surveyed women with a history of childhood abuse, including a frequent history of major surgery (Drossman et al., 1996; Longstreth & Wolde-Tsadik, 1993; Springs & Friedrich, 1992) and, in some, a previous problem with alcohol (Springs & Friedrich, 1992; Walker et al., 1995) or drugs (Longstreth & Wolde-Tsadik, 1993; Miller & McCluskey-Fawcett, 1993; Springs & Friedrich, 1992). Also, nearly one half of the subjects had irritable bowel syndrome, the prototypical functional bowel disorder (Drossman et al., 1995; Longstreth & Wolde-Tsadik, 1993; Scarinci et al., 1994; Walker et al., 1995). Most of their baseline SCL-90-R scores were > 1 SD above the nonpatient norms. A problem inherent in assessing the long-term benefit of this study and other group psychotherapy studies is the tendency for some patients to continue similar or different forms of therapy after completing the group sessions. More than one half of patients received subsequent therapy that could have influenced their status at 1-year follow-up. However, most of the symptom dimensions and all global indices were similar 1 year posttherapy in the women who did not receive more treatment as compared to results in the women who did. Patients who received additional therapy had higher somatization scores before, immediately after, and 1 year posttherapy; scores in the other group increased 1 year posttherapy. Although the indications for subsequent therapy were not surveyed, there was an association between additional psychological care seeking and somatization. Furthermore, improvement in psychological status reflected by the phobic-anxiety score immediately posttherapy may have contributed to the decision of some patients to seek subsequent therapy. In the group without additional treatment, the loss of some of the initial somatization improvement at 1 year may have contributed to the lack of reduction in medical care visits in the combined groups. We speculate that provision of additional therapy to more patients might have had a long-term effect on somatization and reduced medical visits. We obtained complete psychological data and nearly complete medical-visit data on our patients, and our survey included 1-year follow-up. Our survey did not meet rigorous methodological standards for an outcome study, however. We surveyed only a small number of patients and did not collect similar data on an untreated control group. It was not possible to distinguish health care visits for organic versus functional disorders, but such a distinction may be artificial, because psychological factors may influence health care seeking for "organic" illness. Because our measurements came from a subset of our patients who were willing to complete the survey questionnaires, we do not know how generalizable the findings are. There is increasing awareness among health care professionals that childhood sexual abuse is common and that it may have serious and long-term psychological and medical sequelae. Our data suggest that group psychotherapy by social workers for women victims may have long-lasting psychological and somatic symptom benefits. Reduction in health care usage was not found, and this outcome may require the identification and treatment of patients who need additi

Adult↗
PubMed1997

Platelet serotonin measures in adolescents with conduct disorder.

Dysregulation of serotonergic function has been associated with aggression in several studies involving children, adolescents, and adults. This study investigated the relationship of platelet serotonergic measures to conduct disorder type, severity of aggression, and social skills impairment. Standardized assessments of diagnosis, aggression, impulsivity, and social skills were obtained from 43 male adolescents (ages 13-17) incarcerated at an involuntary residential treatment facility for juvenile offenders. Blood samples were collected and assayed for whole blood serotonin (5-HT) and platelet [3H]-paroxetine-labeled 5-HT-transporter binding. Whole blood 5-HT was higher in adolescents with conduct disorder, childhood type than in subjects with conduct disorder, adolescent type. Whole blood 5-HT was positively correlated with violence rating of the current offense and total offense points, and staff ratings of social skills impairment. Our findings are consistent with a relationship between 5-HT dysregulation and aggressive behavior in incarcerated adolescent boys with conduct disorder, particularly of childhood onset.

Adolescent↗
PubMed1997

The molecular epidemiology of HIV-1 among male sex workers in northern Thailand.

Male commercial sex workers (CSWs) in northern Thailand are at high risk for HIV-1 infection and may be exposed to multiple subtypes of HIV-1 through sexual contact with men and women from Thailand, other Asian nations, and the West. We studied 103 male Thai nationals working in gay bars and clubs in Chiang Mai city who participated in the 1994 sentinel surveillance of the Thai Ministry of Public Health using HIV serologic testing, DNA polymerase chain reaction methods, molecular cloning, differential colony hybridization, nucleotide sequencing, and a third hypervariable region (V3) peptide enzyme-linked immunoabsorbent assay to differentiate subjects infected with HIV-1 subtypes B, E, both, or neither. The majority (58%) reported heterosexual orientation, and 35 (34%) were married. Seventeen (16.5%) were HIV infected: 16 (94%) of 17 had HIV-1 subtype E; 1 had HIV-1 subtype B. Two subjects had dually reactive results by molecular techniques but colony hybridization sequencing revealed only HIV-1 subtype E. HIV-1 subtype E appears to be the predominant clade among male CSWs in northern Thailand. This may have important implications for the global kinetics of the HIV epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Liquid sterilization versus high level disinfection in the urologic office.

OBJECTIVES: Systems are available for liquid sterilization (LS) and high level disinfection (HLD) of flexible cystoscopes. Guidelines from the Association of Operating Room Nurses and the Association for Professionals in Infection Control and Epidemiology recommend HLD for urologic endoscopic equipment. We examine these methods emphasizing costs, performance of procedure, and maintenance. METHODS: The process of LS using the Steris System 1 Processor (SSP1) was studied from June 1993 to June 1994. The Voluntary Hospital Association (VHA) Plus Glutaraldehyde HLD system was evaluated from July 1994 to July 1995. Costs are those incurred by the Ochsner Department of Urology over these same periods. RESULTS: Purchase of the SSP1 system proved costly: $16,200 for purchase; $8645 for accessories, service contract, and training seminars; and $5800 for unit installation. Two gallons of glutaraldehyde including the disinfection container cost $15.60. Since government regulation requires less than 0.2 ppm airborne glutaraldehyde concentration, some facilities may need to install ventilation systems. There were no clinical differences between the two systems. Yearly operating expenses in our department for SSP1 was $6037 compared to $445 for HLD. Mean length of time to process was 35 minutes per use for SSP1 and 20 minutes for HLD. Repair of seven cystoscopes during the SSP1 period cost $11,500. No repairs were required for the cystoscopes used during the HLD period. CONCLUSIONS: Outpatient flexible cystoscopy was performed an average of 988 times per year during the study period. Major cost savings were incurred with institution of the HLD system and no endoscope repairs were necessary. There were no clinical differences between the two systems.

Costs and Cost Analysis↗
PubMed1997

Early management of dental pain in children and adolescents.

OBJECTIVES: There is little information regarding the initial management of dental pain in children and adolescents. The present study investigated the early management of 155 children and adolescents with dental pain prior to definitive treatment in the Eastman Dental Institute and Hospital for Oral Health Care Sciences, London, UK. METHOD: Prior to the child being examined by a qualified dentist in the casualty department, the accompanying parents or guardians were requested to complete a self-administered questionnaire regarding the duration and severity of pain, presence of swelling, professional advice sought and medication taken. RESULTS: Of the attending children, 83% were in pain, 20% having been in pain for over 1 month. Most parents sought professional health care advice, particularly from a dentist; however, 15% initially obtained advice from a medical practitioner and 5% from a pharmacist. Simple analgesics were taken by 74% of patients; however, these rarely produced complete pain relief. Of concern, 10 children were inappropriately given aspirin, three of whom had taken the aspirin on the advice of a pharmacist. Sixty-seven children received systemic antibiotic therapy; however, 31% of these patients did not have any local swelling. CONCLUSION: It is evident that children and adolescents often receive inappropriate initial treatment for dental pain and may thus suffer unnecessary symptoms for several weeks. There is thus a need to educate healthcare workers more appropriately on aspects of the management of oral pain and to promote oral health care and hence reduce the incidence of caries in children.

Adolescent↗
PubMed1997

Role of myelin basic protein and proteolipid protein genes in multiple sclerosis: single strand conformation polymorphism analysis of the human sequences.

Susceptibility to multiple sclerosis (MS) is widely held to have a strong genetic component. While the identities of genes conferring susceptibility are currently unknown, possible candidates include those genes coding for proteins which function in central nervous system (CNS) myelin. Two such genes are the human myelin basic protein (MBP) and proteolipid protein (PLP) genes, whose products make up approximately 80% of the total protein in CNS myelin. The association of a variable number tandem repeat (VNTR) 5' to the human MBP gene with MS has been the subject of conflicting reports. Here we test the hypothesis that mutations in the human MBP and PLP genes might be associated with MS by examining the entire expressed sequence of both genes by single strand conformation polymorphism (SSCP) analysis, using a panel of 71 MS patients and 71 controls. We have also re-examined the VNTR region in patients and controls. Three base changes were found in the human PLP gene and nine base changes in the human MBP gene; these were essentially equally distributed between patients and controls. No preferential distribution of various alleles of the VNTR between patients and controls was found. Although intronic and regulatory regions have not been examined, it would appear unlikely that mutations in these genes coding for the two major CNS myelin proteins contribute significantly to genetic susceptibility to MS.

Adult↗
PubMed1997

Case-control study of neuroleptic malignant syndrome.

OBJECTIVE: The authors performed a case-control study of neuroleptic malignant syndrome to identify potential risk factors. METHOD: Twenty-five patients with neuroleptic malignant syndrome were matched with 50 comparison subjects on age, sex, primary psychiatric diagnosis, and time of admission to the hospital. The records of all subjects were reviewed independently by two researchers for information on postulated risk factors. Exploratory direct comparisons of the two groups were followed by a conditional logistic regression analysis. RESULTS: Patients with neuroleptic malignant syndrome were more likely to be agitated or dehydrated before the development of neuroleptic malignant syndrome, often needed restraint or seclusion, and received larger doses of neuroleptics soon after hospitalization. Previous treatment with ECT increased vulnerability. CONCLUSIONS: The prevalence of neuroleptic malignant syndrome may be reduced by avoiding large doses of neuroleptics over short periods in the management of acute psychosis and by paying adequate attention to the patient's hydration and electrolyte status.

Adult↗
PubMed1996

Ethical considerations in the management of asylum seekers on hunger strike.

Hunger strikes have confronted physicians with complex ethical dilemmas throughout history. Asylum seekers under threat of forced repatriation have emerged as a new category of hunger strikers, posing novel challenges for management. The management of 3 Cambodian asylum seekers on hunger strike admitted to a hospital in Sydney, New South Wales, Australia, posted important ethical dilemmas for the physicians and mental health experts involved in their care. Several factors confounded the task of assessment and decision making, including language and cultural barriers, the patients' past exposure to persecution by authorities, and the complexities of the legal procedures being pursued. Different rules appeared to govern the actions of the hunger strikers, the medical team, and the immigration authorities, creating a ¿malignant triangle¿ of mounting confrontation. Recent recommendations for the management of asylum-seeking hunger strikers include the appointment of an external physician of confidence and the writing of a confidential advance directive specifying the hunger striker's wishes about resuscitation in the event of collapse. In addition, we consider the value of constituting an ad hoc ethics committee to advise the responsible physician on points of conflict in managing the hunger strike. The advantages and limitations of these proposals in relation to the particular cultural, historical, and contextual issues relevant to asylum seekers are examined herein.

Advance Directives↗