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Biomedical subjects

D Sadowsky

Publications and source records attributed to D Sadowsky.

At least 37 records · Page 2Linked to original sources
PubMed1991

Effect of maternal cocaine administration on maternal and fetal glucose, lactate, and insulin in sheep.

Although cocaine use during pregnancy is an important cause of perinatal morbidity and mortality, there are no reports of its effect on maternal and fetal carbohydrate metabolism. Six pregnant ewes and their fetuses were instrumented under halothane general anesthesia at 113-119 days' gestation. Between 124-135 days' gestation, the ewes received a single infusion of vehicle or cocaine (1.0 or 2.0 mg/kg) into the jugular vein. At least 24 hours was allowed between successive injections. Maternal and fetal blood samples were drawn at 30 and 20 minutes before and at 5, 15, 30, and 60 minutes after the injection. Both maternal and fetal glucose and lactate concentrations increased (P less than .05) after injection of cocaine at 2.0 mg/kg. There were no significant changes in maternal or fetal plasma insulin concentrations after vehicle or cocaine administration. Induction of hyperglycemia and lactacidemia could be mechanisms whereby cocaine exerts its adverse effects during pregnancy.

Animals↗
PubMed1989

Professional life cycle changes and their effect on knowledge level of dental practitioners.

Utilizing a national data set (U.S.A.), the effect of age and age-related professional characteristics on dentists' knowledge with regard to prevention of infective endocarditis was examined. The following research questions were addressed: (1) Do age-related characteristics produce different effects on knowledge level at various stages of professional careers?; (2) What are the key changes in these age-related characteristics and what processes are suggested by these changes? Multiple regression analysis assessed the influence of potential predictors of variation in knowledge level with regard to prevention of infective endocarditis for the entire sample. Using these findings as a guide, variation in the effect of significant predictor variables was then analyzed for three time segments of approximately equal duration: early professional life less than 40, mid-professional life 40-54, and older professional life 55 or greater than. Age had a profoundly negative effect on knowledge level, i.e. the level progressively declines as clinicians grow older. The impact of the age-related characteristics on knowledge level of infective endocarditis prevention also varied according to the stage of the professional life cycle. Indices measuring the size or extent of theoretical understanding, in-office networks, institutional affiliations, and consulting networks were significant predictors of endocarditis prevention knowledge for younger clinicians. For those 40-54, only practice organization (office business and staff size and diversity) was a significant predictor, while for older clinicians theoretical understanding was the only significant predictor. Differences in the mean levels of these predictor (independent) variables across age groups were also examined via ANOVA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

'Usual and customary' practice versus the recommendations of experts: clinician noncompliance in the prevention of bacterial endocarditis.

Data were collected from a representative sample of American general practitioners to ascertain adherence to the recommendations by the American Heart Association (AHA) concerning management of patients at risk for bacterial endocarditis. Inconsistencies were found in the prescribing of appropriate risk-related therapies such as proper timing, selection of antibiotics, and associated dosages. It is suggested that clinicians' compliance level with these recommendations may be raised by a careful reading of the AHA's latest findings.

Adult↗
PubMed1989

Knowledge acquisition processes: dissemination of expert recommendations to general practice dentists.

We examined structural determinants of general practice dentists' knowledge of the most recent American Heart Association recommendations for the prevention of bacterial endocarditis. Using data from a 1986 national telephone survey of 578 respondents (response rate = 81%), we developed and analyzed a structural model, in which we investigated the contributions to knowledge by age, professional practice settings, colleague networks, and formal educational experiences. Age, practice organization, and institutional affiliations are direct contributors to knowledge. Formal professional channels of reeducation do not contribute directly to knowledge level; rather, their effect is expressed through institutional affiliations.

Age Factors↗
PubMed1988

Dentists' knowledge, case-finding behavior, and confirmed diagnosis of oral cancer.

A questionnaire was developed for dental general practitioners that was used to measure three types of clinician knowledge believed to be central to the early detection and management of oral cancer. Oral cancer management issues (case-finding behavior and clinician knowledge of patient outcomes) were also studied. The hypothesis that clinician knowledge is associated with oral cancer case-finding behavior could not be validated, but the hypothesis that clinician case-finding behavior is associated with knowledge of confirmed oral cancer or precancerous diagnoses was substantiated.

Analysis of Variance↗
PubMed1988

Recommendations for prevention of bacterial endocarditis: compliance by dental general practitioners.

Telephone interviews were conducted with a national sample of general practice dentists (n = 460). Clinical vignettes were used to test clinicians' knowledge of, and compliance with, the 1984 American Heart Association (AHA) recommendations for prevention of bacterial endocarditis. Analyses of the data document a relatively low level of knowledge of correct indications and regimens for antibiotic prophylaxis to prevent endocarditis. Respondents were unsure, and often incorrect, about the relationship between a variety of cardiac conditions and potential risk for endocarditis. Compliance with the guidelines for proper dosage and timing of antibiotics was also problematic. Those clinicians who had a better understanding of patient risk factors and the principles underlying the AHA recommendations were more likely to follow them, as were practitioners who kept a copy of the recommendations in the office. The findings are significant in view of previous suggestions that use of inappropriate antibiotic regimens may predispose to adverse outcomes.

American Dental Association↗
PubMed1987

Toward a typology of preventively oriented dentists.

This study identifies predictors of preventive behavior among dental general practitioners in New York State. A total of 217 clinicians was interviewed by telephone. Dentists practicing in an urban area (n = 120) and in a rural area (n = 97) were studied. A unit-weighted index of clinician preventive orientation was created, by summing z-score values for two preventive variables: the number of content items and the number of patient visits in an organized preventive program that entailed more than one visit. Multiple regression of this preventive orientation index on selected independent variables showed that, for the entire sample, variables representing involvement in academic and institutional dentistry, exposure to education through journals and courses, a predeliction for innovation, and the presence of a hygienist in the office, were most influential in creating a model that successfully predicted reported preventive behavior. Differences between urban and rural clinicians in predictors of preventive behavior are also identified. Data collected are compared with those of four previous studies that attempted to describe potential predictors of preventive behavior in dentists.

Age Factors↗
PubMed1987

Dentists' consulting behavior and associated knowledge levels.

Telephone interviews with stratified random samples of urban and rural dental general practitioners (GPU, n = 120; GPR, n = 97) and oral surgeons (OS, n = 105) in New York State indicated that requests for expertise, additional data, confirmation of patient's medical status, or medico-legal issues were frequent motives for requesting a consult. Those who consulted more frequently had lower mean knowledge scores than those who consulted less frequently, suggesting that the quality of patient care is potentially improved via the consulting process.

Data Collection↗
PubMed1986

How oral surgeons learn: an epistemological investigation.

The elements of knowledge required for the successful management of patients at high risk for bacterial endocarditis were used to construct a scale that was the dependent variable in a study designed to investigate factors influencing the knowledge level of oral surgeons. A telephone interview was used to collect data from a sample of New York State members of he AAOMS. Analyses of these data showed comparatively high knowledge levels among respondents. Variations in knowledge were accounted for by age, access to highly reviewed journals, career patterns that maximized the opportunity for continuous professional interaction with colleagues, and a predilection for being up-to-date. The latter, in turn, was correlated with additional opportunities for integration into a community of oral surgeons.

Anti-Bacterial Agents↗
PubMed1986

Monocular blindness secondary to a non-displaced malar fracture.

We report a case of monocular blindness subsequent to a non-displaced malar fracture. Injury to the optic nerve, secondary to orbital apex syndrome, was implicated as the cause of blindness. Although most non-displaced malar fractures require no surgical intervention and resolve quite uneventfully, they can be associated with significant morbidity. Patients diagnosed as having non-displaced malar fractures should be followed on admission by careful observation and ophthalmologic consultation.

Adult↗
PubMed1985

Predictors of dentists' level of knowledge regarding the recommended prophylactic regimen for patients with rheumatic heart disease.

Maintaining knowledge of clinical practices, conforming to the latest scientific information, is a major challenge for health professionals. The study aims were to measure clinicians' knowledge and to determine what social factors could best explain and predict those dental clinicians who are most knowledgeable about current expert recommendations for the use of appropriate antibiotic regimens for patients at risk for bacterial endocarditis. Telephone interviews were conducted with 322 New York State dentists, assigned to the study by a computer-generated randomization procedure from lists of oral surgeons, urban general practitioners and rural general practitioners. Data demonstrated extraordinary differences in level of knowledge between oral surgeons and general practitioners, while the level of knowledge between urban and rural general practice groups was quite similar. General Linear Model (GLM)-based analyses indicated that practice size, rationalization of practice, and practice setting and affiliations contributed to the explanation of knowledge level among general practitioners, when adjusted for age. R2s for each of those variables and age, ranged from a low of 0.132 to a high of 0.334. Age made a significant contribution to the explanation of knowledge level in all of the models presented, while the explanatory power of the practice structure variables varied according to respondent's locale (urban vs rural) and age (younger vs older). In order to assess the impact of these structural variables, they were dichotomized (high-low) and entered into a GLM program which accounted for age and locale. Differences in excess of 20 points (on a 0-100 knowledge scale) were sometimes noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1985

Educational factors associated with clinician knowledge about bacterial endocarditis.

This study measured the impact of relatively formal educational experiences (general practice residency and continuing education) and a variety of informal educational opportunities (professional membership activities, dental journals received, patterns of consulting and referral) on a particular body of knowledge (dentists' knowledge about the management of patients at risk for bacterial endocarditis). Data were collected through telephone interviews with 217 dental general practitioners in New York State. Linear regression analyses indicated that age made a significant contribution to the explanation of knowledge level in all models tested. Neither general practice residency experiences nor continuing education exposure in the past year made a significant contribution to the explanation of knowledge. The other more informal educational variables tested sometimes made a significant contribution when controlled for age; however, the explanatory power of these variables often varied according to respondents' locale (urban vs. rural).

Adult↗
PubMed1984

Clinician compliance and the prevention of bacterial endocarditis.

Analysis of our data indicates confusion about, and lack of compliance with, the AHA recommendations. Clinician level of knowledge varies with issues of risk management and by specialty group membership. Patient groups that are particularly problematic include children and all patients with congenital heart disease, those receiving a continuing antibiotic regimen for secondary prevention of rheumatic fever, those with a penicillin allergy, and those with prosthetic heart valves. Another area of clinician uncertainty concerns dental procedures which may or may not be associated with the possible causation of bacterial endocarditis. The biodynamic principles involved in endocarditis are central to the structure of the AHA recommendations. These principles, as well as those which provide theoretical support for the loading dose, timing, sequence, and duration recommended by the AHA, have been presented with the hope that clinician compliance with these recommendations will be increased.

Adult↗
PubMed1984

[Creutzfeldt-Jakob disease in the Paris metropolitan area. Study of annual mortality in different density zones in relation to the age of population].

A study of all patients with Creutzfeldt-Jakob disease in the Paris metropolitan area dying during the 13 year period 1968-1980 reveals a positive correlation between annual mortality and population density, that is independent of variation in population age structure. This observation is consistent with the hypothesis of random interhuman-disease transmission.

Adult↗
PubMed1983

Correlation between population density and the frequency of Creutzfeldt-Jakob disease in France.

Epidemiologic studies of Creutzfeldt-Jakob disease (CJD) in countries throughout the world have consistently shown higher urban than national disease frequencies, but this finding has usually been ascribed to case-finding artefact. A detailed analysis has now been completed of annual mortality rates of CJD in France, based on a systematic study of 255 consecutive cases dying during the period 1968-1980, of whom 85 resided in the paris metropolitan area. In the country as a whole, the frequency of CJD increased from rural, through urban, to the Paris region; and in the Paris region, the frequency increased from the lowest to the highest density areas. The magnitude of this positive correlation between population density and the frequency of CJD is not explained by differences in age distribution of the various population groups, and suggests a role for random inter-human spread, either direct or indirect, in natural disease transmission.

Adult↗