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Biomedical subjects

S L Silberman

Publications and source records attributed to S L Silberman.

At least 19 recordsLinked to original sources
PubMed1999

Patient and parent preferences for orthodontic practices.

This study was designed to identify who chooses an orthodontic office and what factors might induce the attraction. Patients and parents from the lists provided by suburban orthodontic offices were contacted. A mail-out survey instrument was used to gather the data. Results revealed that the reputation of the practitioner was most important along with the level of caring attitude the office projected. It was also important that the office is located near home, interestingly, the mother is the most significant decision-maker in the family in choosing an orthodontic office. Moreover, not the cost of treatment but the payment plan was the critical element in the decision process. The higher income families with three or less children were attracted to office characteristics such as excellence of the orthodontist, attention, and convenience. A marketing strategy based on these elements might provide the best return on the investment.

Choice Behavior↗
PubMed1999

Randomized phase II study of the neurokinin 1 receptor antagonist CJ-11,974 in the control of cisplatin-induced emesis.

PURPOSE: To determine the efficacy and safety of the neurokinin type 1 receptor antagonist CJ-11,974 for the control of high-dose cisplatin-induced emesis. PATIENTS AND METHODS: A double-blind, randomized, phase II design with a group sequential stopping rule was used in this study. Sixty-one patients with cancer who were receiving cisplatin at a dose of at least 100 mg/m2 for the first time were enrolled. All patients received granisetron 10 microg/kg and dexamethasone 20 mg intravenously 30 minutes before they were given cisplatin. Patients were randomly assigned to two groups: group 1 received CJ-11,974 100 mg, and group 2 received placebo orally 30 minutes before and 12 hours after cisplatin and then twice daily on days 2 through 5 after cisplatin. The primary end point was the percentage of patients who developed delayed emesis (emesis on the second to fifth days after cisplatin). RESULTS: Thirty patients were enrolled in group 1, and 31 patients were enrolled in group 2. Fifty-eight patients were assessable for efficacy. Complete control of emesis (expressed as the percentage of patients who had no emesis) was as follows: day 1, 85.7% (group 1) and 66.7% (group 2) (P = .090); days 2 through 5, 67.8% (group 1) and 36.6% (group 2) (P = .0425, adjusted); days 1 through 5, 64.3% (group 1) and 30% (group 2) (P = .009). Patients in group 1 experienced significantly less nausea than patients in group 2 on day 1 (P = .024). Treatment was well tolerated in both groups. CONCLUSION: We conclude from this exploratory phase II trial that CJ-11,974 is superior to placebo in controlling cisplatin-induced delayed emesis and may provide additive benefit in acute emesis and nausea control when combined with a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. Additional larger trials are indicated to confirm the clinical value of CJ-11,974.

Adult↗
PubMed1998

Sending a policy signal: state legislatures, medical schools, and primary care mandates.

In the past few years, eleven states have directed medical schools in their states to produce more primary care practitioners or to change the training of physicians to make careers in primary care more attractive to medical students. This article outlines the progress and politics of the states' desire to hold medical schools accountable for producing more primary care practitioners. It analyzes the coerciveness and scope of the laws, including the provisions for implementation and accountability. Interviews with legislative staff, legislators, and university and medical school lobbyists provide information on the measures' political rationale and expectations. Most striking was the signaling nature of the provisions. The laws were not strident or especially onerous; they contained many loopholes and no real sanctions. They were important, however, in the message they conveyed. In state after state, legislatures sent a message to the medical schools that they were part of the solution to distributional problems of health care delivery and must be responsive to legislative desires for action. State legislators sent a policy signal, and most medical schools apparently understood its significance.

Career Choice↗
PubMed1998

A method for determining patient oral care skills: The University of Mississippi Oral Hygiene Index.

The plaque control record (O'Leary index) appears to be a commonly used oral hygiene index for assessing oral health skills. This index provides sufficient information for patient education; however, the time involved in data collection reduces its value. Most other indices limit the number of teeth and surfaces and function well for researchers, but are limited for patient education. A new oral hygiene index was developed based on the concepts of the Periodontal Screening and Recording (PSR). The highest score obtained in each buccal and lingual sextant is recorded. In addition, proximal and gingival plaque are noted separately. This study assesses the index for inter- and intrarater reliability and validity. Two calibrated hygienists examined 47 patients 3 times. The University of Mississippi Oral Hygiene Index (UM-OHI) was recorded for times 1 and 3, the O'Leary for time 2. There was a strong positive correlation between scores obtained for both hygienists for each method and repetition. The intrarater reliability was high for the 2 methods and also over time for the UM-OHI. Pearson's correlation coefficients ranged from 0.79 to 0.92. Paired t-tests used to compare scores for the 2 hygienists over time showed significant differences. Despite observer bias, these data seem to indicate that the UM-OHI has sufficient reliability and validity to be used as a health education teaching tool.

Calibration↗
PubMed1997

Tenidap inhibits replication of the human immunodeficiency virus-1 in cultured cells.

Interleukin-6 (IL-6) may be important in the pathogenesis of HIV-1 because of its ability to induce HIV-1 expression in infected cells in vitro. Tenidap, a structurally and functionally novel antirheumatic drug affecting diverse biologic processes, has been shown to reduce IL-6 production by peripheral blood mononuclear cells stimulated with lipopolysaccharide. Tenidap also inhibits the activity of chloride-bicarbonate exchangers and causes acidification of the cytoplasmic compartment that is similar to the effect of the anion transport inhibitor UK5099. Furthermore, tenidap inhibits the cyclooxygenase-mediated pathway of arachidonic acid metabolism as do the nonsteroidal antiinflammatory drugs (NSAIDs). Here we show that tenidap decreased HIV-1 replication as measured by p24 core antigen in the acutely infected CD4+ T-lymphocyte lines H9 and Jurkat, in the acutely infected monocyte line U937, and in its chronically infected subclone U1.8/HIV. These effects were seen at concentrations in the range of 3 to 15 microM, well below those toxic to cells. The antiviral effects of tenidap may be independent of its ability to reduce IL-6 production based on the observations that these effects were as prominent in IL-6 nonresponsive lines as in IL-6 responsive lines and that the inhibition of p24 production was not reversed by exogenous IL-6.

Acrylates↗
PubMed1997

The effect of tenidap on cytokines, acute-phase proteins, and virus load in human immunodeficiency virus (HIV)-infected patients: correlation between plasma HIV-1 RNA and proinflammatory cytokine levels.

Proinflammatory cytokines may be important in the pathogenesis of human immunodeficiency virus type 1 (HIV-1) disease. Tenidap decreases interleukin (IL)-6, IL-1, and tumor necrosis factor (TNF) production by peripheral blood mononuclear cells and decreases IL-6 plasma levels in rheumatoid arthritis patients. In this randomized double-blind study, 43 HIV-1-infected patients received tenidap (120 mg) or placebo daily for 6 weeks and then crossed over to the alternative therapy for an additional 6 weeks. Mean entry CD4 cell count was 140/microL. Analyses were performed on cytokines, acute-phase proteins, virus load, and CD4 cell counts. With the exception of small differences in plasma TNF levels, tenidap had no significant effect on these indices. Significant correlations of plasma IL-6 and TNF levels with HIV-1 RNA were noted. Six patients discontinued tenidap due to rash. The effects of tenidap in HIV-1 infection contrast to results in arthritis patients, in whom tenidap decreased plasma levels of IL-6 and acute-phase proteins.

Acute-Phase Proteins↗
PubMed1995

How dentists perceive the effects of orthodontic extraction on facial appearance.

In recent years, orthodontic treatment, particularly that involving premolar extractions, has been alleged to cause flat facial profiles. Those who make such assertions also claim to be able to instantly identify from a distance faces of patients who have received orthodontic treatment. These are strong claims that could profoundly affect the public's perception of dentistry and its specialties. This study examined whether dentists could distinguish between profiles of treated and untreated patients as well as between patients who had undergone extraction and those who had not.

Analysis of Variance↗
PubMed1994

Infection control in Mississippi dental practices: a comparison of Mississippi Dental Association members and non-members.

In conclusion, the results of the survey were reassuring in many ways. The data indicate that the dental profession in Mississippi seems to have taken advantage of continuing education opportunities, paid increased attention to infection control, and in general, were using appropriate techniques before the OSHA mandate of 1992. Furthermore, members of the MDA not only demonstrated a greater understanding of infections diseases, but were also 20 percent more likely to report behavior known to reduce the risk of cross infection. It will be important to continue to identify the "gaps" and provide information, additional training, and encouragement to the dental profession and to dental auxiliaries to improve infection control procedures where improvement appears to be needed.

Data Collection↗
PubMed1992

A longitudinal study of dental students' personality type preferences.

The Myers-Briggs Type Indicator was administered to five classes of students at the beginning and end of their dental education. The 161 students who completed both tests were categorized according to personality type. The Spearman rank-order correlation of the two sets of data was calculated and tested. Changes in personality type between the tests were noted using two different standards. The first standard defined change as any alteration in the four-letter MBTI designation and thus was a measure of change in type. The second standard defined change utilizing the 95 percent confidence interval of the continuous score of each of the four MBTI scales and thus was a measure of change in the underlying construct, personality. The first standard indicated 75.8 percent of students change type; the second indicated 11.2 percent changed personality. These data are consistent with previously reported studies, but raise questions regarding what is being measured and how the data are being analyzed.

Confidence Intervals↗
PubMed1991

The interaction of CD4 with HIV-1 gp120.

CD4 is an integral cell surface glycoprotein that is able to enhance T cell specific antigen responses when it interacts with its physiological ligand, class II major histocompatibility (MHC) molecules. In addition, CD4 is a specific cell-surface receptor for the human immunodeficiency virus-1 (HIV-1). Infection by HIV-1 is initiated by the binding of the envelope glycoprotein, gp120, to the first domain of CD4. The binding of CD4 to class II MHC is inhibited by gp120, one possible mechanism for immunosuppression in AIDS patients. In addition, the CD4/gp120 interaction may directly inhibit T cell function. Recently we have synthesized small molecules (CPFs) that specifically inhibit this interaction. CPFs bind to gp120 and prevent the binding of gp120 to CD4, and also inhibit the infectivity of HIV-1.

Animals↗
PubMed1990

A simplified hypoplasia index.

A simplified hypoplasia index for deciduous teeth has been developed. The index utilizes a two-digit system to signify the type and severity of the hypoplastic lesion. The types of lesions recorded are primary canine hypoplasia (PCH) and linear enamel hypoplasia (LEH). The severity ranges from minimal to severe and accounts for the presence of dental caries, dental restorations, and recurrent caries. To determine the reliability of the index, two tests were conducted. The first measure was a repeat reliability coefficient (test-retest) to calculate the stability of the instrument. This measure was calculated for two populations by two examiners under the same examination conditions and exams were conducted seven weeks apart. The second measure calculated the interrater reliability (standardization). Test results were analyzed by employing the Pearson product moment correlation. The repeat reliability coefficients were .75 (P less than or equal to .0001) and .74 (P less than or equal to .0001). The interrater reliability coefficient was .87 (P less than or equal to .0001). These data seem to indicate that the index is reliable over time and between examiners.

Dental Caries↗
PubMed1989

Primary canine hypoplasia in Head Start children.

Primary canine hypoplasia is an incomplete or defective development of the enamel matrix. The lesion is located on the labial surface and is seen more frequently on mandibular teeth. The purpose of this preliminary study was to determine the prevalence of this lesion among Head Start children. During a dental needs assessment of Mississippi Head Start children, 371 children from 11 centers were examined for this lesion. Of the centers, four were located in optimally fluoridated communities, and six were located in fluoride-deficient communities. Ages ranged from three to five years. There were 206 males and 165 females, 334 black and 37 white children. At ten centers all children were black, while all children at one center were white. Results indicated no significant differences in the black population between fluoridated (38.2%) and fluoride-deficient (36.3%) communities (P = .729) or between males (36.8%) and females (37.6%) (P = .877). When data were collapsed on sex and fluoridation status, the racial differences were highly significant (P = .001). The prevalence rate of dental caries associated with primary canine hypoplasia was 26.0 percent. These preliminary data indicate that the presence of primary canine hypoplasia may result in an increased potential for the tooth becoming carious.

Black People↗
PubMed1989

Dental caries assessment of Mississippi Head Start children.

This study assessed the dental caries status and treatment needs of Mississippi Head Start children during the 1987-88 school year. The 2,393 children examined, representing a 10 percent random sample of all Mississippi Head Start children, were three to six years old with a majority being four to five years old. The mean deft ranged from 1.34 for three-year-olds to 4.32 for six-year-olds; the mean defs ranged from 2.33 to 9.99. More than 50 percent of primary teeth of three-year-olds with dental caries experience required treatment, whereas less than one-quarter of similarly affected teeth of six-year-olds were in need of treatment.

Age Factors↗