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Biomedical subjects

K Simmons

Publications and source records attributed to K Simmons.

At least 19 recordsLinked to original sources
PubMed2003

The efficacy of an essential oil antiseptic mouthrinse vs. dental floss in controlling interproximal gingivitis: a comparative study.

BACKGROUND: The use of dental floss has long been considered to be effective in controlling interproximal plaque and gingivitis. The authors compared this method with that of use of a mouthrinse. METHODS: Subjects with mild-to-moderate gingivitis enrolled in a long-term, six-month study. They received a dental prophylaxis and were randomized into one of the three following treatment groups: brushing and rinsing with an essential oil-containing mouthrinse (the BEO group), brushing and flossing (the BF group) and brushing and rinsing with a control rinse (the B group). RESULTS: A total of 326 subjects were evaluated. The BEO and BF had significantly lower (P < .001) mean interproximal Modified Gingival Index, or MGI, scores than did the B group at six months. The BEO group had lower mean interproximal Plaque Index, or PI, scores than the other two groups at both three and six months. The BF group's mean PI score was significantly lower than the B group's mean score at six months only. The magnitude of reductions for the BEO and the BF groups (vs. the B group) in MGI were 11.1 percent and 4.3 percent and for PI were 20.0 percent and 3.4 percent, respectively. CONCLUSIONS: In conjunction with professional care (prophylaxis) and toothbrushing over six months, rinsing twice daily with an essential oil-containing mouthrinse was at least as good as flossing daily in reducing interproximal plaque and gingivitis. Clinical Implications. When weighing recommendations for oral hygiene home care, clinicians should consider that an essential oil-containing mouthrinse may be a useful adjunct in patients with gingival inflammation.

Adolescent↗
PubMed2001

Psychological influences on acceptance of postsurgical treatment in cancer patients.

OBJECTIVE: Many cancer patients fail to complete treatment for reasons that are unclear in previous research which, nevertheless, suggested hypotheses for this study about the characteristics of the patients and their consultations. METHOD: 158 adults with breast cancer or other cancers who had been chosen for postsurgical treatment in the Lister Hospital or the Mount Vernon Hospital had completed published questionnaires to assess either (n=74) personal attributes or circumstances viz. locus of health control, health habits, support, affiliative drive, anxiety, depression, or (n=84) their attitudes to cancer or their consultations, viz. the Mental Attitudes to Cancer Scales, Trust in Physicians, Perceived Empathy, and Satisfaction With Recent and Diagnostic Consultations. RESULTS: 32% then failed to complete treatment. In logistic multiple regression analyses, only diagnosis (P=.0001), gender (P=.005), and treatment center (P=.0002) predicted this although the effect of gender was not significant among patients without breast cancer. Among the patients without breast cancer intended for the Mount Vernon Hospital, a National Cancer Centre, fewer completed treatment than those did not complete. CONCLUSION: The breast cancer patients, unlike women with other cancers, and patients referred to the local hospital rather than the regional cancer center, were more likely to complete treatment. Thus, uptake of treatment may be favored by accessibility and familiarity of its source and by the unique impact in women of breast cancer and the wider public attention given to that illness. Research on patients' expectations, fears, and corresponding experiences of treatment, rather than personal attributes, should clarify failure to complete cancer treatment especially in patients without breast pathology.

Aged↗
PubMed2001

Synthesis and biological evaluation of destruxin A and related analogs.

This report describes the development of an efficient solid-phase synthesis protocol and adaptation of reported solution phase procedures for the synthesis of the cyclic depsihexapeptide destruxin A and related analogs. The solid-phase method described is based on standard Fmoc peptide chemistry, including a new synthetic method for the assembly of the depsi bond-containing unit. In order to select analogs of destruxin A for synthesis and evaluation of insecticidal activity, the work of Hellberg et al., describing a set of Z-descriptors for amino acid side-chains comparing their physicochemical properties, was utilized. Destruxin A and 27 different analogs with structural variations in four residues were synthesized and insecticidal activity was evaluated via injections into tobacco budworm (Heliothis virescens) larvae. Several destruxin A analogs were found to be at least as potent as the native compound.

Animals↗
PubMed2001

EVT endovascular graft for abdominal aortic aneurysm.

BACKGROUND: A variety of prostheses are now available for the endovascular treatment of abdominal aortic aneurysm (AAA). Significant advantages of the EVT device are its unibody design, secure hook attachment system and graft fabric approximating that used in conventional surgery. METHODS: Implantation of the EVT device was attempted in 60 patients who were studied prospectively with an analysis of subsequent problems encountered. RESULTS: Conversion to open repair was required in four cases (6.7%). There were nine tube grafts inserted, 13 aorto-unilateral iliac with crossover grafts and 34 aorto-bi-iliac grafts. There was one death (mortality 1.7%). Endoleaks were identified in eight patients (14%), none of which were proximal; three sealed spontaneously, two were treated with coil embolization, two are being observed and one patient had an iliac attachment converted to an open anastomosis. Access vessel problems were seen in 21 patients (35%); two-thirds were corrected at the time of initial surgery. Seven patients (12%) had primary graft limb problems identified and treated before leaving the operating room. Nine patients (16%) developed secondary graft limb problems, which were diagnosed and treated after the initial surgery. Endovascular treatment was used in eight and was successful in six with surgical revision required in two. On review of these cases to assess if the problem could have been predicted at the time of initial surgery, it was felt that more aggressive treatment of intraoperatively diagnosed graft limb stenoses, even though considered mild, may have prevented 50% of subsequent secondary graft limb occlusions. CONCLUSION: Although the EVT device has significant advantages in the endovascular management of aortic aneurysm, potential graft limb problems need to be actively identified with the majority able to be successfully managed by supplementary endovascular techniques.

Aged↗
PubMed2001

The pharmacodynamics of gatifloxacin and ciprofloxacin for pneumococci in an in vitro dynamic model: prediction of equiefficient doses.

Enhanced activity against Streptococcus pneumoniae is one of the putative advantages of gatifloxacin over older fluoroquinolones such as ciprofloxacin. This study examined ciprofloxacin and gatifloxacin pharmacodynamics against two differentially susceptible clinical isolates of S. pneumoniae (gatifloxacin MIC, 0.125 and 2 mg/L; ciprofloxacin MIC, 1 and 32 mg/L). The pharmacokinetics of gatifloxacin (single dose) and ciprofloxacin (two 12 hourly doses) with half-lives of 6 and 5 h, respectively, were simulated using a two-compartment dynamic model. The AUC/MIC ratios in the peripheral compartments that contain bacterial cultures varied over a four- to five-fold range, from 11 to 48 h with ciprofloxacin and from 15 to 78 h with gatifloxacin. The intensity of the antimicrobial effect (IE) increased with increasing AUC/MIC ratios in a strain-independent fashion, although different relationships of IE to log AUC/MIC were inherent for each drug (r2 0.73 for gatifloxacin and r2 0.94 for ciprofloxacin). Subsequently, the respective dose-response relationships of gatifloxacin and ciprofloxacin for a hypothetical strain of S. pneumoniae with MIC equal to the MIC50 were modelled. Based on these relationships, the equiefficient doses of gatifloxacin and ciprofloxacin were predicted for MIC50S of 0.4 and 1 mg/L, respectively. Gatifloxacin 400 mg was predicted to be equiefficient to ciprofloxacin 1400 mg. To provide the same anti-pneumococcal effect as the usual 1000 mg daily dose of ciprofloxacin, the respective daily dose of gatifloxacin could be as low as 180 mg. This in vitro study demonstrates advantages of gatifloxacin relative to ciprofloxacin in terms of the dose-dependent total antimicrobial effect.

Anti-Infective Agents↗
PubMed2000

Comparative activities of ciprofloxacin and levofloxacin against Streptococcus pneumoniae in an In vitro dynamic model.

The activities of levofloxacin (500 mg every 24 h) and ciprofloxacin (750 mg every 12 h) against six pneumococcal isolates in an in vitro dynamic model were compared. For one strain, levofloxacin reduced the inoculum by over 4 log CFU/ml and ciprofloxacin reduced the inoculum by over 2 log CFU/ml. For four isolates, both drugs reduced inocula by 4 log CFU/ml within 6 h, suggesting that this dose of ciprofloxacin should be as effective as levofloxacin against these pneumococci.

Anti-Infective Agents↗
PubMed2000

Decisions concerning the allocation of scarce medical resources.

This paper aimed to determine the criteria participants use to make decisions about scarce medical resources (allocation to use a kidney machine). It varied information about patients on 4 factors (sex, smoking, employment status, community service). It also set out to see if decisions made in groups differed from aggregated decisions of those made alone. In the first study, participants completed a simple questionnaire requiring them to rank-order sixteen hypothetical patients. In the second study, a group discussion (in groups of three participants) preceded the group putting an agreed rating on the identical questionnaire. Participants favoured patients who were employed, non-smokers and participated in community service. This suggests that participants adopted a utilitarian moral ideology. Participants' smoking habits interacted with the hypothetical patients' smoking habits, indicating in-group favouritism. In the second study it was found that when the decision was made in a group of three it amplifies the decision made by an individual. In this sense there was clear evidence of group polarization.

Choice Behavior↗
PubMed1998

Occlusal rehabilitation using implants for orthodontic anchorage.

Osseointegration is defined as a direct interaction of bone to an implant surface. As a result, the implant fixture is immobilized in the bone and lends itself to function as an anchor for orthodontic tooth movements. When properly treatment-planned, these implants can also be used as prosthodontic abutments for single crowns, or removable or fixed partial dentures. This article describes how implant fixtures were surgically placed within the maxillary and mandibular arches of a partially edentulous patient, and used for orthodontic anchorage to reposition the remaining teeth into a more favorable arch position, creating increased posterior interocclusal space. The fixtures were then restored with fixed partial dentures to rehabilitate the patient into a mutually protected occlusion.

Adult↗
PubMed1995

Assessment of abdominal aortic aneurysm with magnetic resonance imaging.

Pre-operative imaging of abdominal aortic aneurysms (AAA) is important in determining suitability for operation and operative approach. Ultrasound imaging is an excellent screening modality but is relatively poor at identifying renal arteries and the extent of iliac involvement. Computed tomography scanning with intravenous contrast and arteriography are invasive modalities that are associated with a small risk. Magnetic resonance imaging (MRI) offers the potential of accurate anatomical definition without use of contrast agents and passage of an intra-arterial catheter. Eight patients who had their AAA evaluated with MRI are reported. All had renal arteries accurately defined, intra-aneurysmal thrombosis was well delineated, and iliac extension was correctly identified in four cases. The initial experience has been most encouraging and the authors consider that MRI may become the investigation of choice for pre-operative AAA assessment.

Aged↗
PubMed1993

Management of postoperative intra-abdominal abscesses by routine percutaneous drainage.

Postoperative intra-abdominal abscess (IAA) is a dreaded surgical complication. Percutaneous drainage (PD) has been offered as an alternative to surgical drainage for IAA because of the perceived lower morbidity and mortality rates. Seventeen consecutive unselected instances of IAA were reviewed to determine the value of the routine use of PD. Two patients with obvious anastomotic dehiscence and one with a retroperitoneal abscess were believed to be inappropriate for PD. Patients who could be managed by PD (group 1, n = 6) were similar to patients undergoing PD plus surgical drainage (group 2, n = 8) with respect to age, initial procedure, interval from operation to diagnosis of IAA and extent of organ failure. However, in group 2, more abscesses were greater than 5 centimeters (16.7 versus 62.5 percent), associated with polymicrobial growth (0.0 versus 50.0 percent), associated with enteric organisms (16.7 versus 100 percent; p < 0.05), accompanied by anastomotic dehiscence (16.7 versus 62.50 percent) and followed by a greater degree of mortality (16.7 versus 50 percent). Overall, only 33 percent of IAA were successful managed with PD alone. We conclude from these data that PD is of value only in selected instances of IAA. If an anastomotic dehiscence is a possibility, the patient should be managed operatively.

Abdomen↗
PubMed1989

Developmental and individual differences in performance on phonological synthesis tasks.

This study was conducted in order to examine the role of individual differences in working memory and lexical access in accounting for age and reading skill related differences in performance on phonological synthesis tasks. The performance of 28 kindergarten, first-, and second-grade children with normal reading skills, as well as that of 28 reading-disabled second graders, was compared under four testing conditions. The testing conditions were formed by completely crossing rate of presentation of phoneme strings with type of stimulus to be blended (real or nonword). Both independent variables affected performance on the blending tasks, with better performance obtained at faster presentation rates and with real words. There was a developmental discontinuity in overall performance, with the kindergarten children obtaining substantially lower scores than the first or second graders. In the comparison of second-grade good and poor readers, there was a significant interaction between groups, presentation rates, and type of stimulus. The findings are discussed in terms of their implications for a general model of performance on the sound blending task, as well as their value for interpreting individual differences on the task.

Awareness↗
PubMed1988

Corrective measures and pregnancy outcome in in vitro fertilization in patients with severe sperm morphology abnormalities.

Sperm morphology evaluated by new, strict criteria is a good predictor of outcome in in vitro fertilization (IVF). This study aimed (1) to determine whether the fertilization rate of preovulatory oocytes in patients with abnormal morphology can be improved by increasing insemination concentration at the time of IVF and (2) to evaluate the pregnancy outcome in patients with abnormal sperm morphology. Three groups were studied: (1) normal morphology, (2) good prognosis pattern, and (3) poor prognosis pattern. All other sperm parameters were normal. Group 3 had a lower overall fertilization rate, lower pregnancy rate/cycle, and lower ongoing pregnancy rate/cycle. Groups 2 and 3 showed a higher miscarriage rate, although not significantly different from group 1. By increasing insemination concentration from 2- to 10-fold, the fertilization rate in group 3 increased from 14.5% to 62.6%. However, pregnancy outcome did not improve. We conclude that patients with severe sperm head abnormalities have a lower ability to establish successful pregnancies, even though fertilization may be achieved.

Abortion, Spontaneous↗