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Biomedical subjects

L Rose

Publications and source records attributed to L Rose.

At least 37 records · Page 2Linked to original sources
PubMed1996

Reproducibility and condylar position of a physiologic maxillomandibular centric relation in upright and supine body position.

Better understanding of the physiologic features of the masticatory system has led to the evolution of the concept of maxillomandibular centric relation from the mechanical to physiological bases. However, the reproducibility of physiologic methods for centric relation determination has been criticized. In this clinical study the swallowing technique was modified to establish a physiologic centric relation in a reproducible manner. Condylar and disk positioning and reproducibility of the proposed modified swallowing technique (MST) were compared with the same parameters of a traditional technique, namely, the chin point guidance technique (CGT). Both techniques were studied with the patient in the upright and supine positions. Three interocclusal records were obtained for each technique-position combination for each of the 30 patients. The recorded maxillomandibular relations were analyzed on the three-dimensional analyzer. MST positioned the condyles in a more superoanterior position than did CGT, which was interpreted as a better seating of the condyles and disk in the articular fossae. There was no significant difference in reproducibility between MST and CGT on x, y, or z axes (p > 0.05), indicating that it is possible to establish a physiologic centric relation in a reproducible manner. The term "functional centric area" was proposed in this study to define a neuromuscularly determined centric occlusal scheme.

Adult↗
PubMed1996

Effects of chemical disinfectant solutions on the stability and accuracy of the dental impression complex.

Currently available impression materials were not designed for disinfection or sterilization, and it is conceivable that disinfectants may adversely affect impressions. This study evaluated the accuracy and dimensional stability of polyether (Permadyne/Impregum) and polyvinyl siloxane (Express) impression materials retained by their adhesives in two different acrylic resin tray designs (perforated and nonperforated) when the materials were immersed for either 30 or 60 minutes in three high-level disinfectants. Distilled water and no solution served as controls. A stainless steel test analog similar to ADA specification No. 19 was used. A total of 400 impressions were made with all combinations of impression materials, tray designs, disinfectant, and soaking times. Samples were evaluated microscopically before and after immersion and 48 hours after soaking. Results indicated that these two impression materials were dimensionally stable. Because the results emphasized the stability and accuracy of the impression complex under various conditions, dentists can perform disinfection procedures similar to the protocol of this study without concern for clinically significant distortion of the impression.

Analysis of Variance↗
PubMed1996

Recognition of the scope of oral and maxillofacial surgery by the public and health care professionals.

PURPOSE: A recent British study has reported a lack of awareness among the general public as to the benefits provided by the specialty of oral and maxillofacial surgery (OMFS). Medical and dental practitioners surveyed had a greater awareness of OMFS than the general public, yet were deficient in knowledge of the wide range of services provided by them. Therefore, a similar survey was conducted in the Boston area to determine the awareness among the general public and health professionals of the proper providers of treatment for the maxillofacial region and the level of knowledge of the specialty of OMFS. MATERIALS AND METHODS: The study incorporated five groups of respondents: dental students, dental practitioners, medical students, medical practitioners, and the general public. The survey was mailed, or distributed, randomly to persons representing each group in the Boston area. Between 200 and 300 surveys were sent to each group, and data collection was stopped at 100 responses per group. Surveys from the general public were screened to eliminate responders involved in health professions. For each of 20 specific situations or treatments, respondents were asked to choose a source of treatment from among four categories of specialists: ear nose and throat surgery (ENT), plastic surgery, OMFS, and periodontology. A chi-square analysis was performed for each question to compare the pattern of responses among categories of respondents. RESULTS: The data showed that most of the health professionals, 90% of students, and 98% of practitioners had heard of OMFS, whereas only 62% of the public have heard of this specialty. Furthermore, only 22% of the lay responders had ever been treated by an OMFS. The results also suggested that many health professionals had a lack of understanding about the wide scope of surgical procedures that OMFSs offer. CONCLUSION: Despite all the progress that has occurred in OMFS, a large portion of the American population is still unaware of the specialty. If patients are to receive the best treatment available, it is essential to educate health care consumers and providers about the different specialties available and their role within the health profession.

Attitude of Health Personnel↗
PubMed1995

Non-uniform dose/time fractionated radiation therapy and chemotherapy for non-small cell lung cancer.

PURPOSE: A Non-uniform Fractionation schedule of large priming doses combined with concurrent chemotherapy and protracted RT was undertaken for the treatment of NSCLC. With several 5-year survivors, this study is reviewed with regard to local control, toxicity, and survival of patients. METHODS AND MATERIALS: Forty-two patients with unresectable NSCLC were treated prospectively with initial priming doses followed by large field irradiation to the tumor and regional nodes to 3500 cGy. Patients were given a 1-week break and the treatment was repeated. A total dose of 7000 cGy was delivered over 9 weeks. Thirteen patients (Group A) were treated with RT alone. Twenty-nine patients (Group B) received concurrent chemotherapy; Cisplatin, 100 mg/m2, and 5-FU, 1 g/m2 for 24 h times 5 days. Sixteen patients also received Vinblastine, 3 mg/m2 on a weekly schedule. All patients have been followed more than 5 years. RESULTS: Overall complete response rate was 36% and partial response rate was 57%. Absolute survival at 2 years was 26% and at 5 years was 14%. Local failure occurred in 28/42 (67%) patients. Late complications included pulmonary fibrosis (3), and osteochondritis (2). CONCLUSION: This approach of high-dose Non-uniform fractionated radiation therapy has yielded an absolute 5-year survival of 14%, which appears better than the long-term results often seen in treatment of NSCL cancer.

Adult↗
PubMed1995

Ability of various impression materials to produce duplicate dies from successive impressions.

This in vitro study evaluated the ability of five different impression techniques to make duplicate dies of two different types of tooth preparation. One mandibular second premolar Ivorine tooth was prepared for a complete crown and one for an onlay. A master impression was made of each tooth preparation with the use of five impression techniques for a total of 10 master impressions, and a master die was made from each of these impressions. Castings were made on these master dies, and the fit of each casting was verified on the respective Ivorine tooth. Marginal openings of the castings on the master dies were recorded under magnification at four predetermined points. Five successive impressions, with the use of each impression material, were then made of each tooth preparation for a total of 50 test impressions, and 50 test dies were made from these impressions. The fit of the respective casting was evaluated under magnification for each test die at the four predetermined points, and marginal openings were recorded. Differences between the marginal discrepancies of the casting on the master die and on the test die were tabulated and the results were statistically analyzed. Results indicated that none of the impression materials was capable of producing exact replicas. Polysulfide rubber performed significantly better than two materials for the production of duplicate dies with the complete crown preparation; and polyvinyl siloxane used with a putty-light body, single-stage technique produced mean marginal discrepancies that were significantly greater than the other four techniques when used for the onlay preparation.(ABSTRACT TRUNCATED AT 250 WORDS)

Bicuspid↗
PubMed1994

Homophobia among doctors.

Homophobia creates stress for gay men and women. An interview study of 28 doctors, 20 gay and eight non-gay, was performed to assess whether homophobia is strong among the medical profession, the stress it causes, and whether the advent of AIDS and HIV infection has increased the stress. The doctors, recruited by word of mouth and by a letter in the medical and gay press, were asked about their own attitudes to homosexuality and AIDS. Only one (non-gay) doctor thought that there was no prejudice against gay doctors in the medical profession. The gay doctors certainly perceived prejudice, which they claimed caused them extra stress; the advent of AIDS had increased this stress to an extent. Doctors who had not openly declared themselves to be gay feared doing so because of the effect on their job prospects, but those who had declared themselves openly reported less stress than previously. Homophobia clearly exists within the medical profession. Non-gay doctors should use the power of the profession to challenge homophobia in the profession and in society. HIV infection could then be treated as a purely medical condition; sufferers would receive wider understanding and the pressures of extra workload could be more equally shared.

Attitude of Health Personnel↗
PubMed1994

A nationwide survey of contemporary philosophies and techniques of restoring endodontically treated teeth.

Contemporary endodontic therapy has allowed patients to retain severely damaged teeth. The restoration of most endodontically treated teeth involves complex and controversial procedures. There is a diversity of opinion about the need for coronoradicular stabilization, and numerous post systems and techniques have been described. It is not known what materials and techniques are most commonly used. To expand the knowledge of current philosophies and prevailing techniques, a comprehensive nationwide survey of 1525 dentists was conducted. Of the 1066 respondents, 909 (85%) reported restoring more than 30 endodontically treated teeth per year, and this subset became the focus group of the survey. Board-certified prosthodontists comprised 40% of this group, educationally qualified prosthodontists 28%, and general dentists 32%. Responses to questions were statistically analyzed. Statistical analysis revealed that philosophies and techniques varied significantly with the dentist's geographic location, age, specialty status, and dental school faculty status.

Adult↗
PubMed1994

Tactile extinction and functional status after stroke. A preliminary investigation.

BACKGROUND AND PURPOSE: Research has identified a number of factors associated with poststroke recovery, but the prediction of long-term functional outcome remains an uncertain endeavor. In previous work, extinction to tactile, double-simultaneous stimulation has been shown to have short-term predictive utility. The present study was designed to examine its long-term prognostic value and to determine the relative importance of tactile extinction, cognitive functioning, and visual neglect as predictors of poststroke functional status. METHODS: Successive admissions to an acute-care facility (n = 26) were assessed three times: 1 month, 3.5 months, and 6 months after stroke. Hierarchical multiple regression, a procedure that maximizes the effect of the variables first entered, was used to predict functional status. Cognitive functioning and visual neglect were forced into the equation on the first step; tactile extinction was entered on the second step. Multivariate analysis of variance was used to compare the functional status of subjects with no extinction versus those who demonstrated extinction at the first assessment and later improved and those who continued to manifest the deficit. RESULTS: Tactile extinction on the left-hand side of the body was the most important predictor of functional outcome. A significant group-by-time interaction implied that the course of improvement in functional status differed between the groups. CONCLUSIONS: Tactile extinction shows promise as a predictor of poststroke functional status, but further work is required to substantiate the present findings.

Activities of Daily Living↗
PubMed1994

Behavior, family function, school performance, and predictors of persistent disturbance in sexually abused children.

OBJECTIVE: Although sexual abuse is widely considered to have severe sequelae, most studies of children's status after sexual abuse have had major limitations, including retrospective design, small sample sizes, selective enrollment of subjects, no comparison groups, and lack of information about potentially confounding characteristics of studied children. The aim of this study was to clarify the impact of sexual abuse on children's psychological well-being. METHODS: We prospectively studied 154 children who were brought to urban, university-affiliated hospitals for assessment of recently disclosed sexual abuse and compared them with a control group of 53 demographically similar children not known to have been sexually abused. RESULTS: In comparison with the control children, fewer of the sexually abused children had health insurance and more had received psychiatric care unrelated to the sexual abuse. Most initial ratings of behavior, maternal psychiatric status, family function, and school performance were less favorable among the sexually abused than among the control children (P < .05). At follow-up 6 months later, the psychiatric status of the mothers of the abused children apparently improved, but the children's difficulties largely persisted. Baseline characteristics of the abused children significantly or suggestively associated with persisting problematic behavior were older age (P = .04), lower maternal educational attainment (P = .06), poorer maternal psychiatric status (P = .04) and lower family integration (P < .001). These four factors accounted for 31% of the variance in the children's behavior at 6-month follow-up (P < .001). Unexpectedly, characteristics of the children's sexual abuse experiences did not predict their later behavioral status. CONCLUSIONS: These findings suggest that preexisting, long-standing adverse psychosocial circumstances may contribute importantly to persistently problematic behavior and school performance among sexually abused children. The findings also suggest that it is children's preexisting psychosocial circumstances, rather than the abuse, that determine, at least in part, the nature of their functional outcomes.

Achievement↗
PubMed1992

Agoraphobic avoidance and panic frequency as predictors of laboratory induced panic reactions.

This study examined the importance of agoraphobic avoidance and frequency of panic as predictors of psychological and physiological responses of panic sufferers to a laboratory based provocation procedure. Psychophysiologic comparisons were made between 22 panic disorder patients and 15 controls, at baseline and across three periods of carbon dioxide gas inhalations (1, 3, 5%; balance oxygen). Subjective measures of anxiety, frightening cognitions and body sensations were obtained across the phases. Physiological measures of minute ventilation, breathing rate, tidal volume, end tidal CO2 and heart rate were also obtained. Between group comparisons revealed significant differences between the groups on the subjective measures with no significant differences occurring on the physiological measures. Within group analyses revealed that pre-session questionnaire measures of agoraphobia avoidance and panic frequency predicted the degree of anxiety, frightening sensations and cognitions during baseline and 5% CO2 inhalation. The results indicated that both self-reported agoraphobic avoidance and panic frequency are strong clinical predictors of psychological reactions of panic sufferers during laboratory provocation.

Adult↗
PubMed1992

The moral journey of the first Viennese psychoanalysts.

By exploring the cultural concerns of Freud's first Viennese disciples, this article explains how these concerns helped inspire both intellectual conviction in Freudianism and inner commitment to the psychoanalytic movement. In this way, it illuminates an important underlying identity between medical practitioners and laypersons within Freud's circle. At the same time, it brings to light the tension between values and science in Viennese psychoanalysis.

Austria↗
PubMed1991

Effects of communication skills training on students' diagnostic efficiency.

This study evaluates the impact of a training programme in communications skills on subsequent diagnostic efficiency. Videotaped history-taking interviews conducted by groups of specially trained and control groups of students were rated for their diagnostic efficiency by two medical practitioners. Students in the trained group had shown greatly increased skills in interviewing and interpersonal effectiveness as a result of their training. A comparison of ratings given by the two experimentally naive, independent observers revealed that trained students were significantly better at eliciting full, relevant data from patients--they were diagnostically more efficient, but took no longer than their control group counterparts to elicit the information. Further research with the medical interview rating scale will clarify the skills required of medical students in interviewing and diagnosis and facilitate remedial training for students who show poor interview skills.

Clinical Competence↗
PubMed1991

Combination balloon-ultrasound imaging catheter for percutaneous transluminal angioplasty. Validation of imaging, analysis of recoil, and identification of plaque fracture.

BACKGROUND: We investigated the hypothesis that an ultrasound transducer positioned within an angioplasty balloon could be used to perform quantitative assessment of arterial dimensions before and after percutaneous transluminal angioplasty (PTA) and to identify certain mechanical alterations consequent to PTA, including vascular wall recoil and the initiation of plaque fractures. METHODS AND RESULTS: A combination balloon-ultrasound imaging catheter (BUIC) that houses a 20-MHz ultrasound transducer within and halfway between the proximal and distal ends of an angioplasty balloon was used to perform PTA in 10 patients with peripheral vascular disease. Each PTA site was also evaluated before and after PTA by standard (nonballoon) intravascular ultrasound (IVUS) technique. In eight patients in whom satisfactory images were recorded with the BUIC before PTA, luminal cross-sectional area (XSA) of stenotic sites (0.10 +/- 0.01 cm2) did not differ significantly from measurements of XSA by IVUS (0.09 +/- 0.01 cm2, p = NS). Likewise, minimum luminal diameter (Dmin) measured by BUIC (0.34 +/- 0.02 cm) was similar to that measured by IVUS (0.33 +/- 0.01 cm, p = NS). In nine patients in whom satisfactory images were recorded with the BUIC after PTA, XSA measured by BUIC (0.29 +/- 0.03 cm2) did not differ significantly from XSA measured by IVUS (0.30 +/- 0.03 cm2, p = NS). Dmin measured by BUIC after PTA (0.57 +/- 0.02 cm) was also similar to Dmin measured by IVUS (0.57 +/- 0.03 cm, p = NS). After PTA, XSA and Dmin measured immediately after deflation were significantly less than balloon XSA and diameter at full inflation, indicating significant elastic recoil of the dilated site. For the nine patients in whom post-PTA images were satisfactory for quantitative analysis, including four patients in whom recoil was 39%, 46%, 50%, and 61%, percent recoil measured 28.6 +/- 7.2%. Finally, plaque fractures were identified on-line in six of 10 patients (60%); in each case, initiation of plaque fracture was observed at inflation pressures of 2 atm or less. CONCLUSIONS: The results of this preliminary human investigation indicate that an ultrasound transducer positioned within an angioplasty balloon can be used to perform quantitative and qualitative analyses of lumen-plaque-wall alterations immediately preceding, during, and immediately after PTA in patients with peripheral vascular disease.

Angiography↗
PubMed1991

[Magnetic resonance in the diagnosis of aneurysmal bone cyst].

A patient of 12 suffering from aneurysmal cyst of the ischium was studied with traditional radiology, computed tomography (CT) and magnetic resonance imaging (MRI). The advantages of MRI in the study of this pathology compared to traditional radiography and CT are assessed. It was shown that the CT and MRI techniques are superior to standard X-ray examinations in anatomic definition and in evaluating the lesions's relationships with neighbouring structures and, in particular, that MRI is superior to CT in extension.

Bone Cysts↗
PubMed1990

Physiologic responses to arm ergometry exercise relative to age and gender.

Arm ergometry exercise testing is a valuable alternative method used in the evaluation and management of patients with both cardiac disease and lower limb impairment. The purpose of this study is to provide information concerning the physiologic responses of normal healthy subjects to arm ergometry relative to age and gender, which could serve as a standard for comparison. Eighty healthy subjects (age 22 to 59 years) cycled at 75 to 80 rpm (on a bicycle adapted for arm ergometry) starting at a power output of 10 W, increasing at 10 W/2 min until exhaustion. Sixty subjects were classified on the basis of age into three groups, each with 10 men and 10 women. Men achieved significantly (p less than 0.001) higher power output (95 +/- 25 W) and oxygen consumption (20.7 +/- 3.9 ml/kg per min) than did women (56 +/- 19 W and 15.5 +/- 3.1 ml/kg per min, respectively). The heart rate response to total body oxygen demand during arm ergometry was significantly higher in women than in men (p less than 0.001). These findings were also present when men and women of each age group were analyzed separately. Older subjects reached a significantly (p less than 0.02) lower peak power output than did younger subjects although they reached a similar level of oxygen consumption. Separate regression equations for predicting oxygen consumption at each power output were formulated for men and women and validated in 20 other subjects. Small differences in measured and predicted oxygen consumption at each stage were found. These data provide additional information concerning arm ergometry testing and should prove useful in diagnostic exercise testing and cardiac rehabilitation.

Adult↗
PubMed1989

Changes in survival following stroke in five North Carolina counties observed during two different periods.

We evaluated survival following stroke for patients from a five-county area of rural North Carolina enrolled in either of two community hospital-based stroke survey programs. In this area, the first program enrolled 843 stroke patients between 1970 and 1973 and the second program enrolled 786 stroke patients between 1979 and 1980. One-year survival increased from 49% in the first program to 62% in the second for all stroke patients, from 54% to 68% for patients with cerebral infarction, and from 18% to 55% for patients with cerebral hemorrhage. While other reports have attributed declining stroke mortality to a decline in the incidence of stroke, our study suggests that increased survival after stroke may account for a large portion of the decrease in stroke mortality.

Actuarial Analysis↗