Biomedical subjects

C McGrath

Publications and source records attributed to C McGrath.

At least 19 recordsLinked to original sources

PubMed2003

Changes in life quality following third molar surgery--the immediate postoperative period.

OBJECTIVES: This study describes patients' perceptions of changes in oral health related quality of life (OHQOL) in the early postoperative period following third molar surgery. METHODS: One hundred patients were enrolled in a prospective cohort study of the surgical removal of lower third molars under local anaesthetic. Two specific oral health related quality of life measures, OHIP-14 and OHQoLUK, were administered to the study group prior to surgery. Standardized surgical and analgesic protocols were followed. Patients kept a diary of changes in life quality each postoperative day (POD) for 7 days, completing both OHIP-14 and OHQoLUK daily. RESULTS: Both oral health related quality of life measures identified a significant deterioration in quality of life on POD1 (P<0.01) and this remained evident on POD2 (P<0.01), POD3 (P<0.01), POD4 (P<0.01) and POD5 (P<0.05). By POD6 and POD7 there was no significant difference in quality of life compared with preoperative status (P>0.05). Deterioration in life quality over the study period was associated with postoperative clinical findings (P<0.05): swelling and trismus. CONCLUSION: The study concludes that there is a significant deterioration in oral health related quality of life in the immediate postoperative period following third molar surgery; particularly during the first five days. This is associated with postoperative clinical findings. This has implication for patients deciding on third molar surgery and informed consent.

Attitude to Health↗

PubMed2003

An evaluation of the oral health quality of life (OHQoL) instrument in a Brazilian population.

OBJECTIVES: To translate and evaluate the performance of a Brazilian Portuguese version of the United Kingdom Oral Health related Quality of Life instrument, OHQoLUK, in assessing the impact of oral health on quality of life among a Brazilian adult population. DESIGN: Following forward-backwards translation the 16-item OHQoLUK measure was administered to adults utilising municipal dental health services in Araraquara, São Paulo, Brazil. The instrument's psychometric properties, validity and reliability, were assessed. RESULTS: The response rate was 72% (323/450). OHQoLUK scores were associated with self-reported oral health status including number of teeth present (p < 0.001), denture status (p < 0.01) and self-reported dental attendance pattern; time (p < 0.05) and reason for last dental visit (p < 0.001), supporting the construct validity of the measure. In addition, OHQoLUK scores were associated with self-ratings of oral health (p < 0.0001) and perceived need for dental treatment (p < 0.001), supporting it's criterion validity. Internal reliability was high: Cronbach's alpha = 0.96, while the agreement for each of the 16 OHQoLUK items (Kappa values) ranged from 0.57 to 0.87. CONCLUSION: The Brazilian Portuguese version of OHQoLUK measure of oral health related quality of life performed well, exhibiting good validity (face, construct and criterion) and reliability (internal and external). This confirms the sound psychometric properties of the OHQoLUK measure and the applicability of the Portuguese version among a Brazilian population.

Adolescent↗

PubMed2002

Population based norming of the UK oral health related quality of life measure (OHQoL-UK).

OBJECTIVES: The aims of this study were to establish normative age-gender values for the UK oral health related quality of life measure (OHQoL-UK) in Britain and to provide a local reference for its interpretation. In addition, to identify key factors associated with oral health related quality of life in the UK. MATERIALS AND METHODS: A national survey conducted with the assistance of the Office for National Statistics involving a random probability sample of 2,718 households. Participants were interviewed about their oral health status. The impact of oral health on quality of life was measured using the 16 item OHQoL-UK measure. RESULTS: The response rate was 68% (1,838/2,718). The majority (75%, 1,378/1,838) perceived their oral health as affecting their life quality and did so across a wide range of domains. Age-gender norm values are presented. Variations in OHQoL-UK scores were apparent in relation to socio-demographics: age (P<0.05), social class (P<0.01), and self-reported oral health status: number of teeth possessed (P<0.01). CONCLUSIONS: The impact of oral health on the life quality of Britons was substantial, in both positive and negative ways and associated with socio-demographic and oral health (self-reported) factors. National norm values presented should provide a reference source for meaningful interpretation of similar data and local studies.

Adolescent↗

PubMed2002

Physiognomy and teeth: an ethnographic study among young and middle-aged Hong Kong adults.

OBJECTIVES: To determine knowledge and beliefs about traditional physiognomy (judging an individual's character from their facial appearance) concerning teeth among young (17-26) and middle-aged (35-44) Hong Kong adults. METHODS: In a cross sectional ethnographical telephone survey, 400 adults were interviewed about 16 traditional physiognomy concerning teeth (in consultation with a Feng Shui specialist). RESULTS: Most completed the interview (93%, 373). Over half the study group (63%, 234) claimed they had heard of aspects of physiognomy concerning teeth, and a quarter (24%, 88) believed in such ideologies. Variations in knowledge and beliefs were apparent among people of different age (P < 0.01), gender (P < 0.05), educational attainment (P < 0.01), economic status (P < 0.01), place of birth (P < 0.01) and religion (P < 0.01). Their knowledge and belief in aspects of physiognomy concerning teeth was also associated with reported use of dental services (P < 0.01). CONCLUSION: Among young and middle-aged adults in Hong Kong, knowledge and beliefs concerning traditional physiognomy regarding teeth is strong, and socio-demographic variations exist in these perceptions. These findings have implications for all those involved in the delivery of dental care in multicultural societies and in raising cultural awareness about traditional health beliefs.

Adolescent↗

PubMed2002

Magnetically quantized continuum distorted waves.

A new derivation of continuum distorted-wave theory is presented. It is generalized to magnetically quantized continuum distorted waves. The context is analytic continuation of hydrogenic-state wave functions from below to above threshold, using parabolic coordinates and quantum numbers including m the magnetic quantum number. This continuation applies to excitation, charge transfer, ionization, and double and hybrid events for both light- and heavy-particle collisions. It is applied to the calculation of double-differential cross sections for the single ionization of the hydrogen atom and for a hydrogen molecule by a proton for electrons ejected in the forward direction at a collision energy of 50 keV and 100 keV respectively.

Journal Article↗

PubMed2002

Severe tooth loss among UK adults--who goes for oral rehabilitation?

A random probability sample of 2667 United Kingdom (UK) addresses was selected in a multistage sampling process. Participants were interviewed about their oral health status--number of teeth possessed and denture status. In addition information was collected about their socio-demographic characteristics (age, gender, social class and income level) and dental service factors--type of service used and difficulty accessing national health service (NHS) care. The response rate was 70%. Six percent (107) claimed they had less than 20 teeth but did not use a denture. Variations in this practice were apparent in relation to a number of socio-demographic factors: age (P < 0.05), gender (P < 0.01) and social class (P < 0.001) but not service related factors. In regression analysis, social class, gender and age emerged as important predictors of this practice. For example, those from lower social classes were approximately half as likely to use dentures despite experiencing considerable tooth loss (OR=0.53, 95% CI 0.34, 0.83), having controlling for other factors. More than one in 20, in Britain claim they have experienced considerable tooth loss but are without resource to a denture. Socio-demographic factors rather than service related factors are associated with this practice, particularly social class.

Adolescent↗

PubMed2002

A randomised, double blind, placebo-controlled study to determine the efficacy of immune modulation therapy in the treatment of patients suffering from peripheral arterial occlusive disease with intermittent claudication.

OBJECTIVES: this study examined the effect of immune modulation therapy (IMT) on claudication distances. MATERIALS AND METHODS: a double-blind placebo controlled trial was performed on patients with disabling intermittent claudication with randomisation stratified for short and long distance IC. For IMT, following exposure to UV light, oxidisation and 42.5 degrees C, 10 ml of citrated autologous blood was administered by intra-muscular injection. One course consisted of 6 injections in 3-weeks followed by 3-weeks rest. Patients received 2, 3 or 4 courses depending on response. The primary end-point was the number of responders (>50% increase in initial claudication distance (ICD)) in each group. Secondary end-points included percentage changes in ICD and change in quality of life. RESULTS: at week 24, there were more responders in the IMT group (20/31, 65%) compared to placebo (16/39, 41%) (p=0.06). In the subgroup of short distance claudicants this difference reached significance (IMT 17/26, 65%) (Placebo 12/33, 36%) (p=0.04). The median increase in ICD was significantly greater in the IMT group (81%) compared to placebo (44%, p=0.04). These results were supported by quality of life measurements. CONCLUSIONS; IMT is a safe and apparently effective treatment for patients with short distance claudication.

Aged↗

PubMed2002

Patient-centred outcome measures in oral medicine: are they valid and reliable?

The present study evaluates the performance of patient-centred outcome measures in the oral medicine setting in patients with oral lichen planus. The study included 48 patients with a histologically confirmed diagnosis of oral lichen planus who completed a questionnaire incorporating two patient-centred outcome measures: the 16-item UK Oral Health Related Quality Of Life Measure (OHQOL-UK) and 14-item Oral Health Impact Profile (OHIP-14). They subsequently underwent an oral examination and rated the pain they experienced on a visual analogue scale (VAS). The impact of oral health on their life quality was considerable with physical, social and psychological consequences. Both OHQOL-UK (P<0.01) and OHIP-14 scores (P<0.01) were associated with clinical findings; demonstrating criterion validity. Patient rating of pain experienced (on a VAS) correlated with OHQOL-UK scores (P<0.01) and OHIP-14 (P<0.01); demonstrating construct validity. The mean inter-item correlation for OHQOL-UK was 0.93 and was 0.90 for OHIP-14; demonstrating high internal consistency reliability. Our results suggest both OHQOL-UK and OHIP-14, patient-centred outcome measures perform well in patients with oral lichen planus, demonstrating validity and reliability. This implies patient-centred outcome measures may be utilized in both oral medicine and oral and maxillofacial surgery to assess patient needs and opinions.

Adult↗

PubMed2002

A study of the comparative efficacy of three common analgesics in the control of pain after third molar surgery under local anaesthesia.

BACKGROUND: The aim of this study was to evaluate the comparative efficacy of three commonly used analgesics (Panadeine, Diflunisal and Etodolac) in the control of pain after third molar surgery under local anaesthesia. METHODS: A randomized control study. Outcome of primary efficacy was judged by overall assessment of the area under the curve of graphs for pain intensity, measured from serial visual analogue scales over a 24-hour period. Other measures of efficacy included the number (per cent) of patients who took 'additional' analgesics and the incidence of adverse effects occurring in each treatment group over the study period. RESULTS: The three drugs were effective in the control of post-operative pain (p<0.01). Variations in pain intensity and the use of additional medication between the treatment groups were observed over the study period. The Diflunisal group experienced less pain than the Panadeine or Etodolac group (p<0.01). Furthermore, a lesser number of those in the Diflunisal group used additional medication compared to the other two groups (p<0.01). The incidence of side effects from all three drugs was low. CONCLUSION: Diflunisal is superior in the control of pain following third molar surgery under local anaesthesia than either Panadeine or Etodolac, and has few side effects.

Acetaminophen↗

PubMed2002

Are single mothers in Britain failing to monitor their oral health?

OBJECTIVES: This study was designed to identify association between self reported dental attendance patterns and family structure in the UK. DESIGN: A national study involving 666 women with dependent children. SETTING: Home interviews were undertaken exploring time and reason for last dental visit. In addition, numerous sociodemographic and service related characteristics were collected. RESULTS: Bivariate analysis identified that family structure was associated with respondents' self reported dental attendance patterns: marital status (p<0.01), number of children (p<0.05), and age of children (p<0.05). When the combined effects of age, family structure, income, educational attainment, working status, and service factors (difficulty obtaining a NHS dentist and time taken to get an appointment) on dental attendance were explored, family structure emerged as a very important predicator of service use. Notably, young (age 16-34) single mothers and those with more than two children were less likely to have attended the dentist within the past year for reasons other than a dental emergency compared with older (age 35 or more), mothers from a two parent family and those with one or two children. CONCLUSION: Family structure is associated with self reported dental attendance patterns. Young single mothers with more than two children may be failing to monitor their oral health appropriately.

Adolescent↗

PubMed2001

Who has difficulty in registering with an NHS dentist?--A national survey.

AIMS: The aims of this paper are first, to determine the extent of difficulties the public are experiencing in obtaining a dentist undertaking NHS dental care. Second, to describe the personal and socio-demographic details of these groups using data from a national study. METHOD: The vehicle for this study was the Office for National Statistics Omnibus Surveys, undertaken in June and July of 1999. A random probability sample of 5,385 addresses was selected from the British Postcode Address File. Respondents were interviewed in their homes about how difficult they found it to obtain an NHS dentist. RESULT: A total of 3,739 adults took part in this study and the response rate was 69%. Nineteen per cent (705) claimed they found it difficult to get an NHS dentist. Bivariate analysis revealed that difficulty in obtaining an NHS dentist [excluding those who claimed they did not seek NHS dental care (781) and those who refused to answer or did not know (66)] was associated with age group (P < 0.01), gender (P < 0.05), social class (P < 0.01) and area of residency (P < 0.01). Moreover, difficulty in obtaining NHS dental care was also associated with time since last dental visit (P < 0.01), method of payment for last dental visit (P < 0.01) and use of 'out of hours' emergency dental services (P < 0.01). Further analysis revealed that among the socio-demographic variables, area of residency emerged as the most important factor in determining difficulty in obtaining an NHS dentist. Those who lived in the South of England (London, South-East or South West) were more than twice as likely to experience difficulty in obtaining an NHS dentist, OR = 2.40, 95% CI 2.00-2.88 compared with those who lived elsewhere in Great Britain. CONCLUSION: One in five adults in Britain claim that they are experiencing difficulties in finding a dentist who will provide NHS dental care. In particular, those using private dental services and residents of the South of England have experienced such difficulties.

Adolescent↗

PubMed2001

Can dental attendance improve quality of life?

OBJECTIVE: The aim of this study was to determine the relationship between reported dental attendance patterns and the public's perception of how oral health impacts on quality of life (QoL). METHOD: A national UK study involving a random probability sample of 2,668 adults. Respondents were interviewed in their homes about how oral health affects their QoL and about their dental attendance pattern. Responses were coded as oral health having a negative impact, positive impact or impact in general (either positive and/or negative) on QoL. RESULTS: The response rate was 70% with 1,865 adults participating in the study. 72% (1,340) reported that their oral health affected their QoL in general, 57% (1,065) reported that it had a positive effect, and 48% (902) that it had a negative effect. 61% (1,136) reported to have attended the dentist within the last year- 'regular attenders'. Bivaraite analysis identified association between perception of how oral health impacts on QoL and dental attendance pattern (P < 0.01). When socio-demographic factors (age, gender, and social class) were taken into account in the analysis, 'regular attenders' reported that oral health had greater impact in general on QoL (OR = 1.30, 95% CI = 1.04, 1.63) and, specifically, a greater positive impact (OR = 1.49, 95% CI=1.44, 1.77). CONCLUSION: Dental attendance is associated with perceptions of how oral health impacts on QoL, specifically enhanced life quality. This may have implications for understanding the health gain of regular dental attendance.

Adolescent↗

PubMed2001

Can dentures improve the quality of life of those who have experienced considerable tooth loss?

OBJECTIVES: The aim of this study was to identify variations in the impact of oral health on quality of life (OHQOL) among UK residents in relation to self-reported number of teeth possessed and denture status. In addition, to determine whether recourse to a removable prosthesis for those who claimed that they had experienced considerable tooth loss (having <20 teeth) was associated with quality of life. METHODS: The vehicle for this was the Office for National Statistics Omnibus survey in Great Britain. A random probability sample of 2667 addresses was selected in a multistage sampling process. Participants were interviewed about their oral health status. The impact of oral health on quality of life was measured utilising the OHQoL-UK(W) measure. RESULTS: The response rate was 68%. Variations in OHQoL-UK(W) scores were apparent in relation to self-reported number of teeth possessed (P < 0.001) and denture status (P < 0.001). Moreover, disparities in OHQOL were apparent among those who experienced considerable tooth loss who didn't have recourse to a denture (P < 0.001). In regression analysis, those who claimed that they had <20 natural teeth but had no recourse to a denture were less than half as likely to enjoy enhanced oral health related quality of life compared to others in the population (OR = 0.46, 95% Cl 0.30, 0.71), controlling for socio-demographic factors. CONCLUSIONS: Experience of considerable tooth loss without recourse to a removable dental prosthesis is an important predictor of oral health related quality of life, as captured by OHQoL-UK(W), and associated with reduced quality of life.

Adolescent↗

PubMed2001

Experimental determination and calculations of redox potential descriptors of compounds directed against retroviral zinc fingers: Implications for rational drug design.

A diverse set of electrophilic compounds that react with cysteine thiolates in retroviral nucleocapsid (NC) proteins and abolish virus infectivity has been identified. Although different in chemical composition, these compounds are all oxidizing agents that lead to the ejection of Zn(II) ions bound to conserved structural motifs (zinc fingers) present in retroviral NC proteins. The reactivity of a congeneric series of aromatic disulfides toward the NC protein of the human immunodeficiency virus type 1 (HIV-1), NCp7, has been characterized by HPLC separation of starting reagents from reaction products. We calculated the absolute redox potentials of these compounds in the gas phase and in aqueous solvent, using a density functional theory method and a continuum solvation model. Pulsed polarography experiments were performed and showed a direct correlation between calculated and experimentally determined redox propensities. A dependence between protein reactivity and redox potential for a specific compound was shown: Reaction with NCp7 did not take place below a threshold value of redox potential. This relationship permits the distinction between active and nonactive compounds targeted against NCp7, and provides a theoretical basis for a scale of reactivity with retroviral zinc fingers. Our results indicate that electrophilic agents with adequate thiophilicity to react with retroviral NC fingers can now be designed using known or calculated electrochemical properties. This may assist in the design of antiretroviral compounds with greater specificity for NC protein. Such electrophilic agents can be used in retrovirus inactivation with the intent of preparing a whole-killed virus vaccine formulation that exhibits unaffected surface antigenic properties.

Anti-HIV Agents↗

PubMed2001

An evaluation of a new measure of oral health related quality of life--OHQoL-UK(W).

OBJECTIVE: The aim was to test the reliability and validity of an instrument used to measure the impact of oral health on quality of life. BASIC RESEARCH DESIGN: The instrument tested was the indicator OHQoL-UK(W), which was developed, based on a general UK population's perceptions of how oral health affects life quality. OHQoL-UK(W) consists of a battery of 16 questions, which takes into account both 'effect' and 'impact' of oral health on life quality, incorporating dimensions and an individualised weighting system. A questionnaire containing the indicator was administered to a sample of 500 adults. Determining associations between OHQoL-UK(W) scores, socio-demographic and self-reported oral health status assessed its construct validity. The criterion validity of the indicator was assessed in the absence of a 'gold standard' by correlating OHQoL-UK(W) scores to self-rating of oral health status. The internal reliability of the indicator was assessed using Cronbach's alpha. RESULTS: The response rate was 78%. Associations between OHQoL-UK(W) scores and self-reported number of natural teeth (P<0.01) and denture status (P<0.01) supported the construct validity of the indicator. In addition, OHQoL-UK(W) scores were associated with socio-demographic factors; age (P<0.05), employment status (P<0.01) and ethnicity (P<0.05). The instrument was also associated with self-rating of oral health status (P<0.01), supporting the criterion validity of the indicator. The internal reliability was high with a Cronbach alpha value of 0.94. CONCLUSION: OHQoL-UK (W) appears to be a valid and reliable measure for assessing the impact of oral health on life quality.

Adolescent↗

PubMed2000

Factors associated with dental anxiety among older people in Britain.

OBJECTIVE: This paper reports on a study of dental anxiety among adults aged 60 years living independently in Britain. DESIGN: A national cross-sectional study carried out with the assistance of the Office for National Statistics' Omnibus Surveys in 1999. SETTING: Data was collected by face to face interviews with older people in their homes. MEASUREMENTS: Data on dental anxiety were collected from 973 subjects by means of face to face interviews and was measured by the Dental Anxiety Scale (DAS) (Corah, 1969). In addition, data on dental service use and oral health status (self-reported) was collected. RESULTS: The mean DAS score was 8.4 (sd 3.5), and 13% (129) of subjects were classified as dentally anxious (DAS > or = 13). DAS scores were associated with numerous socio-demographic factors (P < 0.01), self-reported oral health status (P < 0.01) and dental service (P < 0.01) factors. A series of regression analyses revealed that dental anxiety was a significant predictor of a number of behavioural and oral health outcomes. CONCLUSION: One in eight older people in Britain are dentally anxious and this is associated with their use of services and oral health status (self-reported).

Age Distribution↗

PubMed1999

Xenotransplantation of cells using biodegradable microcapsules.

BACKGROUND: The use of immunoisolation to protect transplanted cells from the immune system of the host has broad application to the treatment of major diseases such as diabetes and a wide range of other disorders resulting from functional defects of native cell systems. In most cases, limitations in functional cell longevity will necessitate periodic replenishment of the cells. We describe a hydrogel-based microcapsule that breaks down at a rate that can be adjusted to correspond to the functional longevity of the encapsulated cells. These injectable capsules can be engineered to degrade over several weeks to months for short-term drug delivery, or to remain intact and immunoprotective for more extended periods. When the supply of cells needs to be replenished, no surgery will be required to localize and remove the old capsules. METHODS: Porcine and bovine islets were immobilized in "composite" microcapsules fabricated from alginate and low-relative molecular mass (Mr) poly (L-lysine[PLL]) (Mr exclusion <120 Kd) and implanted into the peritoneum of normal and streptozotocin-induced diabetic rats. In addition to demonstrating long-term islet viability and function, a series of in vitro studies were carried out to determine the permeability and biodegradability of the microcapsules used in the present system. RESULTS: Xenogeneic islets implanted in nonimmunosuppressed rats remained in excellent condition indefinitely (>40 weeks)(viability was comparable to that of preimplant control specimens). In contrast, no islets survived in uncoated alginate spheres after 2 weeks postimplantation. By changing the concentration of the alginate, it was possible to vary the rate of capsule breakdown in rats from mechanically unstable (outer matrix <0.5-0.75% alginate) to stable for >1 year (> or =1.5% alginate). In addition to in vivo breakdown studies, the biodegradability of the capsular components was verified in vitro using a mixture of tritosomes (enzymes isolated from animal cells). CONCLUSIONS: We have designed a microcapsule system with controllable biodegradability which allows breakdown and absorption of implants when the cells die or become functionally inactive. These results may have application to other alginate-PLL encapsulation systems. The ability to cross species lines using these biodegradable microcapsules has the potential to expand dramatically the number of patients and the scope of diseases that can be successfully treated with cellular therapy.

Absorbable Implants↗

PubMed1999

Onset of the effects of the 5-HT1A antagonist, WAY-100635, alone, and in combination with paroxetine, on olfactory bulbectomy and 8-OH-DPAT-induced changes in the rat.

5-HT1A receptor antagonists have recently been shown to accelerate the effects of some antidepressant drugs in clinical trials. In this study we investigate the effects of combining a full antagonist at the 5-HT1A receptor, WAY 100635 (0.2 mg/kg, SC) with the selective serotonin reuptake inhibitor (SSRI) paroxetine (5 mg/kg. SC) in the olfactory bulbectomized (OB) rat, an animal model of chronic (but not acute) antidepressant activity. Ambulation scores were measured in the open-field apparatus, following 3, 7, and 14 days of treatment. Further to the OB study, we simultaneously studied adaptive changes in 5-HT1A receptor function, utilizing alterations in the hypothermic response to the 5-HT1A receptor agonist 8-OH-DPAT. Paroxetine, in combination with WAY 100635, attenuated the hypothermic effects of 8-OH-DPAT as early as 3 days, with a full reversal evident following 7 days, whereas paroxetine, although attenuating the hypothermic effects in OB group by day 7, only reversed it fully after 14 days. Paroxetine alone and in combination with the antagonist reversed the olfactory bulbectomy-induced hyperactivity in the open field following 14 days of treatment only, this being the normal time of an "antidepressant" response in this model. However, there was no significant attenuation at any of the earlier time points. This further demonstrates that the reversal of this aspect of the olfactory bulbectomy-induced behavioral syndrome is insensitive to the potential faster onset of antidepressant action induced by 5-HT1A receptor antagonists. Nonetheless, WAY 100635, unlike previous studies with pindolol, did not interfere with the effects of the antidepressant in the model. The ability of the combination group to attenuate the hypothermic effects of 8-OH-DPAT faster than paroxetine alone, further emphasizes the role of the 5-HT1A receptor in the mechanism of action of antidepressants, and as a target for the development of faster acting antidepressants.

8-Hydroxy-2-(di-n-propylamino)tetralin↗