Biomedical subjects
Publications and source records attributed to R Taylor.
This article proposes a multimethod strategy as a way to reduce the existing confusion of methods for determining which neighborhoods within a community are at high risk for child maltreatment, and identifying neighborhood characteristics and problems associated with child abuse and neglect. Description of the multimethod strategy includes examples of the type of data that can be obtained.
At a median follow-up of 5 years, adjuvant razoxane (125 mg b.d.) given 5 days/week indefinitely following resection of colorectal cancer provided no benefit in terms of survival or recurrence for Dukes' A or B patients when compared to untreated controls. However in Dukes' C patients this treatment reduced the recurrence rate (P = 0.05) and possibly increased survival time (P = 0.08). Analysis now of the development of metastases in this trial which entered 272 patients over 7 years shows that in the Dukes' C group the incidence of liver metastases in the razoxane-treated patients is only about half that of the untreated patients (18 per cent versus 34 per cent) and that the time to first appearance of the liver metastases is twice as long in the razoxane-treated group as it is in the untreated group (80 weeks versus 40 weeks). It is concluded that the benefit of adjuvant razoxane observed in the Dukes' C patients is due to the antimetastatic activity of the drug in reducing and slowing down the development of hepatic secondaries.
Explore the source record for details and available documents.
The screening of different ethnic groups who live in the same natural system have enabled the authors to study interaction between genetic and environmental factors as a part of etiology of diabetes mellitus. In New Caledonian country areas, the prevalences of glucose tolerance abnormality (GTA) and diabetes mellitus (DM) have been higher with people of polynesian descent than with Melanesians. GTA 7.6 p. ct. versus 5.1 p. ct. DM 6.5 p. ct. versus 2.2 p. ct. The prevalence of these combined diseases have been 14 p. ct. with the Polynesians and 7.2 p. ct. with Melanesians. These two ethnic groups have shown mean ages and obesity rates similar enough to lead the authors to deny these two factors a major part in the difference between the ethnic prevalences of DM. Besides, the mean plasmatic glycemia two hours after a dose of glucose and the relative risk of DM and GTA according to age and obesity rate have shown that the slight differences between these groups are not involved in the different prevalences of DM. This inter-ethnic difference may be due to genetic factors. However, some environment linked factors besides obesity (such as diet and daily life activity) may share a major part in this difference.
Explore the source record for details and available documents.
An international prospective study of Brånemark implants retaining overdentures was conducted at nine clinical centers. One hundred thirty-three subjects were recruited in a 12-month period and provided with 510 implants, 117 of which were in maxillae and 393 were in mandibles. This study reports the 3-year follow-up status of 120 overdentures and 444 implants. There were 11 overdenture failures (9.2%). Maxillary overdenture failure rates (27.6%) were nearly nine times greater than mandibular overdenture failure rates (3.3%). Maxillary overdenture treatment was less successful than previously reported fixed implant-supported restorations. However, their mandibular counterparts had success rates slightly higher than those reported for fixed implant-supported restorations. At 3 years, 150 implants remained submerged and 66 implants had been withdrawn because the subjects discontinued study participation. Eleven mandibular and 29 maxillary implants had failed and had been removed from 21 subjects. Logistic regression with forward model selection indicated that one two-way interaction was significantly related to implant failure. At highest risk were the subjects who possessed dental arches with bone quantity E and bone quality 4. Subjects with one implant failure were likely to have more than one failure. The Generalized Estimating Equation was used to adjust for the cluster effect in this population because multiple implants (2 to 6) were placed and evaluated in each of the 133 subjects.
Depot injections of long-acting neuroleptic drugs, by maintaining a consistent drug regime, together with regular contact with health-care professionals, are an important factor in helping psychiatric patients who live in the community. As these injections are administered over a long period--often for years--it is important that care is taken to minimise discomfort and to reduce the incidence of problems at the injection site. Seepage of even small amounts of the medication will result in an inaccurate dose being absorbed and, owing to the irritant nature of many of these drugs, leakage into subcutaneous tissue and on to the skin surface can cause pain, irritation and lesions. This study was set up to compare two techniques of administering deep intramuscular injections to determine which best fulfilled the criteria of preventing seepage while causing as little discomfort as possible. The two methods used were the Z-track, which is standard practice in the UK, and the air bubble, which is widely taught and used in Canada and the USA. The study showed the air-bubble method to be significantly more effective at controlling seepage than the Z-track.
Explore the source record for details and available documents.
Diabetes sometimes appears for the first time during pregnancy. It is important that all cases are detected, so all pregnant woman should be screened for this condition. Screening protocols vary but usually involve urinalysis at all clinic visits plus a blood glucose test, taken after a meal, at 24-28 weeks. Risk factors include increasing maternal age (25 years upwards); obesity; family history of diabetes; and previous unexplained stillbirths or babies with congenital abnormalities. There is an increased frequency of gestational diabetes in Oriental women and those from the Indian subcontinent and the Middle East Once diagnosed, careful monitoring of diabetes is essential during pregnancy to minimise complications to mother and baby Mothers should be taught to monitor their own blood glucose levels. There is no place for urinalysis in the management of gestational diabetes mellitus. Advice from a dietitian is important and there should be easy access to a diabetes specialist nurse. The baby may be born large (macrosomia), with an increased risk of respiratory distress syndrome and hypoglycaemia. Hypocalcaemia and hyper-bilirubinaemia are other complications. Mothers may suffer birth trauma and require an assisted delivery because of the baby's large size. Although most women return to normal blood glucose levels in the puerperium, they are at considerably increased risk of developing non-insulin dependent diabetes mellitus in the following years. General education about recognising the symptoms of diabetes should be given, as well as advice about future pregnancies-including the need to seek preconceptual advice.
This report presents the results of a 5-year prospective multicenter study including nine centers worldwide. A total of 30 patients received 117 Brånemark implants in the maxillae, and 103 patients received 393 implants in the mandibles. According to the protocol, all integrated maxillary implants were to be loaded; however, only two of four mandibular implants were planned for support of the overdentures, leaving the remaining implants covered by mucosa as backup for possible implant failures. Thirty-five patients (26.3%) who were provided with 127 implants (24.9%) were withdrawn from the study. Six patients treated in the maxilla lost all their implants and resumed wearing complete dentures. The cumulative success rates for implants and for overdentures supported by two implants in the edentulous mandible were 94.5% and 100%, respectively. The corresponding cumulative success rates for implants and for overdentures supported by an optimal number of implants in the maxilla were 72.4% and 77.9%, respectively. Significantly better jawbone characteristics at the time of implant surgery were considered to contribute to the better cumulative success rates in the mandibles. Mean marginal bone loss was 0.8 mm (SD 0.8) and 0.5 mm (SD 0.8) for loaded implants during a 5-year period of time in the maxillae and mandibles, respectively. Measurements of the clinical height of the abutment cylinders indicated a mean recession (0.2 mm) of peri-implant mucosa during the follow-up period in the mandibles. Conversely, hyperplasia was observed in the maxillae.
The prosthodontic methods and outcomes of treating 127 patients in nine centres over a period of 5 years is described. The benefits perceived by patients and the changes induced in the denture-bearing tissues and temporomandibular joints are reported. To sustain effective treatment outcomes, the levels of maintenance needed by the overdentures are contrasted for restoration of the edentulous mandibles and maxillae.
Accident and Emergency Departments offer a unique opportunity for identifying and monitoring new drugs of misuse. This series of six case reports describes the potentially serious medical complications associated with the use of gamma-hydroxybutyrate (GHB) a new drug of misuse on the UK scene. Profound unconsciousness occurred in all cases and despite full (and often rapid) recovery all patients required medical intervention. Adverse effects occurred both when GHB was used alone or in combination with other illicit drugs and alcohol.
Explore the source record for details and available documents.