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Biomedical subjects

S Richmond

Publications and source records attributed to S Richmond.

At least 19 recordsLinked to original sources
PubMed2006

A randomised controlled trial of clinical outreach education to rationalise antibiotic prescribing for acute dental pain in the primary care setting.

OBJECTIVE: To assess the effect of educational outreach visits on antibiotic prescribing for acute dental pain in primary care. STUDY DESIGN: RCT. SETTING: General dental practices in four health authority areas in Wales. SUBJECTS AND METHODS: General dental practitioners were recruited to the study and randomly allocated to one of the three study groups (control group, guideline group or intervention group). Following the intervention, practitioners completed a standardised questionnaire for each patient that presented with acute dental pain. INTERVENTIONS: The control group received no intervention. The guideline group received educational material by post. The intervention group received educational material by post and an academic detailing visit by a trained pharmacist. The educational material included evidence-based guidelines on prescribing for acute dental pain and patient information leaflets. MAIN OUTCOME MEASURES: The number of antibiotic prescriptions issued to patients presenting with dental pain and the number of 'inappropriate' antibiotic prescriptions. Antibiotics were considered to be inappropriate if the patient did not have symptoms indicative of spreading infection. RESULTS: A total of 1,497 completed questionnaires were received from 23, 20 and 27 general dental practitioners in the control, guideline and intervention group respectively. Patients in the intervention group received significantly fewer antibiotic prescriptions than patients in the control group (OR (95% CI) 0.63 (0.41, 0.95)) and significantly fewer inappropriate antibiotic prescriptions (OR (95% CI) 0.33 (0.21, 0.54)). However, antibiotic and inappropriate antibiotic prescribing were not significantly different in the guideline group compared to the control group (OR (95% CI) 0.83 (0.55, 1.21) and OR (95% CI) 0.82 (0.53, 1.29) respectively). CONCLUSIONS: Strategies based upon educational outreach visits may be successfully employed to rationalise antibiotic prescribing by dental practitioners.

Adult↗
PubMed2006

A new method for the 3D measurement of postoperative swelling following orthognathic surgery.

OBJECTIVE: To describe a new method for measuring facial swelling following orthognathic surgery using a 3D laser-scanning device. DESIGN: Prospective clinical trial. Setting and Sample Population -- University Dental Hospital, Wales College of Medicine, Biology Life and Health Sciences. Three subjects requiring bi-maxillary orthognathic surgery were recruited for the study. EXPERIMENTAL VARIABLES: Laser-scanned images of the subjects were obtained under a reproducible and controlled environment with two Minolta Vivid 900 (Osaka, Japan) optical laser-scanning devices assembled as a stereo-pair. A set of left and right scanned images was taken for each subject and each scan took an average of 2.5 s. 3D laser scans were recorded over six time periods (T1 -- pre-surgical scan, postoperatively: T2 -- 1 day, T3 -- 1 week, T4 -- 1 month, T5 -- 3 months and T6 -- 6 months). OUTCOME MEASURE: Facial scans from different time periods were overlaid onto the baseline (T6) facial scan to determine the reduction and changes in swelling following orthognathic surgery. RESULTS: The results showed that swelling could be accurately quantified following surgery. Furthermore, there was a significant reduction in the amount of swelling 1 month postoperatively. Furthermore, the facial morphology returned to approximately 90% of the baseline facial scan at 3 months. CONCLUSION: The 3D laser-scanning device and the method described was a reliable and accurate measure of facial swelling following surgery.

Adult↗
PubMed2006

Facial templates: a new perspective in three dimensions.

PURPOSE: This paper describes the use of adult facial template in gender-specific facial analysis. SUBJECTS AND METHODS: Eighty adults, mean age 24.5, were selected for the study. Laser-scanned images of the subjects were obtained under a reproducible and controlled environment with two Minolta Vivid 900 (Osaka, Japan) optical laser-scanning devices assembled as a stereo-pair. A set of left and right scanned images was taken for each subject and each scan took an average of 2.5 s. These scanned images were processed and merged to form a composite three-dimensional soft tissue reproduction of the subjects using commercially available reverse modelling software. The differences in facial morphology were measured using shell deviation colour maps. The facial template was used to compare differences between males vs. females groups and two subjects with facial disproportions. RESULTS: The difference between the male and female facial templates was 1.28 +/- 1.02 mm. The areas of greatest deviation were at the nasal, zygomatic area and lower jaw line. The results of the surface deviation maps between the templates and subjects with facial disproportion showed that the results could be applied for orthodontic diagnosis. CONCLUSIONS: The construction of the adult facial templates provides an interesting perspective into measuring changes in groups of patients and also acts as a useful template for the comparison of skeletal disproportion.

Adult↗
PubMed2005

[The need for orthodontic treatment. Justification and methods of evaluation (part 1)].

Most adolescents in developing countries undergo orthodontic treatment. Three main reasons are routinely cited to justify the provision of orthodontic treatment i.e. the improvement of facial and/or dental aesthetic, the preservation of the health and functioning of the dentition. Orthodontic indices have been devised to minimise the subjectivity related to the classic orthodontic diagnosis. These indices can be classified under five headings: nosological, epidemiological, treatment need, outcome and complexity.

Adolescent↗
PubMed2005

[Orthodontic treatment need: the IOTN, or Index of Orthodontic Treatment Need (part 2)].

IOTN is an index of orthodontic treatment need that has been devised on the basis of the available evidences of the deleterious effects of malocclusion on the aesthetic and health of the dentition. It has two components i.e. an aesthetic component and a dental health component. This index is widely used in epidemiological research and by third party payment for determination of those patients who should benefit from public funding.

Dental Arch↗
PubMed2005

The investigation of the changing facial appearance of identical twins employing a three-dimensional laser imaging system.

OBJECTIVE: An investigation to determine the changing facial appearance of identical twins. DESIGN: Clinical study. MATERIALS AND METHODS: Two Minolta Vivid 900 3D optical laser scanners were placed as a stereo pair to capture the soft tissues of a pair of identical twins. Each scan took approximately 2.5 s. The scanned whole faces were superimposed to determine changes in facial morphologies at different time intervals. OUTCOME MEASURES: The shell deviations between left and right scans of each patient were recorded and analysed for differences. Furthermore, final merged faces were overlaid to determine the changes in facial morphology over time. RESULTS: The results showed that changes in height and weight correlated with changes in facial morphology. CONCLUSION: The 3D laser scanning device is a clinically useful tool in the study of facial growth and facial morphology in a pair of twins.

Body Height↗
PubMed2005

Chloroethene biodegradation in sediments at 4 degrees C.

Microbial reductive dechlorination of [1,2-14C]trichloroethene to [14C]cis-dichloroethene and [14C]vinyl chloride was observed at 4 degrees C in anoxic microcosms prepared with cold temperature-adapted aquifer and river sediments from Alaska. Microbial anaerobic oxidation of [1,2-14C]cis-dichloroethene and [1,2-14C]vinyl chloride to 14CO2 also was observed under these conditions.

Bacteria, Anaerobic↗
PubMed2005

Early discharge and readmission to hospital in the first month of life in the Northern Region of the UK during 1998: a case cohort study.

AIMS: To study the frequency and associations of early postpartum discharge and infant readmission to hospital. METHODS: Infants readmitted to hospital during the first 28 days of life in 1998 in the Northern Region of the UK were studied. RESULTS: A total of 4743 of 11,338 (42%) babies were discharged on or before the first postnatal day. Rates of early discharge varied significantly between hospitals. Infants <2500 g at birth (adjusted odds ratio (AOR) 0.44, 95% CI 0.29 to 0.66), infants 35-37 weeks gestation at birth (AOR 0.65, 95% CI 0.49 to 0.86), and firstborn infants (AOR 0.09, 95% CI 0.08 to 0.10) were less likely to be discharged early. Women from more deprived areas were more likely to be discharged early (AOR 1.37, 95% CI 1.12 to 1.67). A total of 907 of 32,015 (2.8%) babies liveborn in the region were readmitted to hospital during 1998. Readmission rates varied significantly by hospital of birth but not by timing of discharge. Babies <2500 g at birth (AOR 1.95, 95% CI 1.16 to 3.28) and babies born at 35-37 weeks gestation (AOR 1.72, 95% CI 1.15 to 2.57) were more likely to be readmitted. Breast fed babies were less likely to be readmitted (AOR 0.69, 95% CI 0.53 to 0.90). Infants initially discharged early were not more likely to be readmitted. CONCLUSIONS: Early discharge occurred variably in the Northern Region in 1998. It is not associated with readmission to hospital. Breast feeding is associated with lower rates of readmission to hospital.

England↗
PubMed2005

Three-dimensional cone beam computerized tomography in orthodontics.

There has been an escalating interest in three-dimensional imaging devices over the last decade. Orthodontists are beginning to appreciate the advantages that the third dimension gives to clinical diagnosis, treatment planning and patient education. This article focuses on the cutting edge technology of cone beam CT, which utilizes conventional X-ray technology and computerized volumetric reconstruction to reproduce a three-dimensional image. A variety of applications and range of issues associated with this technology will be discussed.

Alveolar Process↗
PubMed2004

Pharmaceutical care for elderly patients shared between community pharmacists and general practitioners: a randomised evaluation. RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) [ISRCTN16932128].

BACKGROUND: This trial aims to investigate the effectiveness and cost implications of 'pharmaceutical care' provided by community pharmacists to elderly patients in the community. As the UK government has proposed that by 2004 pharmaceutical care services should extend nationwide, this provides an opportunity to evaluate the effect of pharmaceutical care for the elderly. DESIGN: The trial design is a randomised multiple interrupted time series. We aim to recruit 700 patients from about 20 general practices, each associated with about three community pharmacies, from each of the five Primary Care Trusts in North and East Yorkshire. We shall randomise the five resulting groups of practices, pharmacies and patients to begin pharmaceutical care in five successive phases. All five will act as controls until they receive the intervention in a random sequence. Until they receive training community pharmacists will provide their usual dispensing services and so act as controls. The community pharmacists and general practitioners will receive training in pharmaceutical care for the elderly. Once trained, community pharmacists will meet recruited patients, either in their pharmacies (in a consultation room or dispensary to preserve confidentiality) or at home. They will identify drug-related issues/problems, and design a pharmaceutical care plan in conjunction with both the GP and the patient. They will implement, monitor, and update this plan monthly. The primary outcome measure is the 'Medication Appropriateness Index'. Secondary measures include adverse events, quality of life, and patient knowledge and compliance. We shall also investigate the cost of pharmaceutical care to the NHS, to patients and to society as a whole.

Aged↗
PubMed2004

Meeting maximum residue limits: an improved screening technique for the rapid detection of antimicrobial residues in animal food products.

A rapid, high-throughput antimicrobial screening assay was developed using either a physical fluid extraction or a solvent extraction technique coupled to the commercially available PremiTest. The solvent extraction approach was fully validated for a wide range of tissues and the fluid extraction approach partially validated for porcine muscle. Both procedures can detect a wide range of antimicrobial compounds at or below maximum residue limit concentrations. The use of a solvent extraction provides an enhanced test capable of detecting a wider range of drugs than the fluid extraction approach at or below half maximum residue limit levels in a variety of matrices. Biochemical methods for the class-specific identification of beta-lactams and sulphonamides following initial screening were developed and validated. The approach is a significant improvement on existing methodologies as a tool for residues monitoring in surveillance programmes.

Animals↗
PubMed2004

The feasibility of measuring three-dimensional facial morphology in children.

OBJECTIVE: An investigation to determine the feasibility of measuring soft tissue morphology in children using a three-dimensional laser-scanning device. DESIGN: Prospective clinical trial. SETTING AND SAMPLE POPULATION: University of Wales, College of Medicine and one secondary school in the South Wales region. Sixty live subjects (30 adults, 30 children) were recruited in the study. EXPERIMENTAL VARIABLES: Laser scanned images of the subjects were obtained under a reproducible and controlled environment with two Minolta Vivid 900 (Osaka, Japan) optical laser-scanning devices assembled as a stereo-pair. A set of left and right scanned images was taken for each subject and each scan took an average of 2.5 s. These scanned images were processed and merged to form a composite three-dimensional soft tissue reproduction of the subjects using commercially available reverse modelling software. OUTCOME MEASURE: The shell deviations between left and right scan of each patient were recorded and analysed for differences. These differences determined whether the subjects could remain still during the time of the scans. RESULTS: The results showed that the mean differences between shell deviations for the adult scans and children scans were 0.25 +/- 0.09 and 0.30 +/- 0.09 mm, respectively. Paired t-tests showed that the mean error between subject groups was 0.05 +/- 0.15 mm indicating that there was no difference between the two subject groups (p = 0.18). CONCLUSION: The technique as described is clinically reproducible for children and adults and can be used for studies assessing facial changes due to growth or clinical intervention.

Adult↗
PubMed2004

Extractions as a form of interception in the developing dentition: a randomized controlled trial.

OBJECTIVE: To determine if the extractions of lower primary canines are an effective procedure to relieve crowding of the labial segment. STUDY DESIGN: randomized controlled trial. Subject sample: 83 cases were collected in clinics in Italy, Germany and Wales. The groups were followed over a 2-year period. METHODS: Subjects were randomly allocated to a primary canine non-extraction or extraction group. Dental casts of the patients were collected at the start and at the recall period of the trial. The outcome measures recorded were lower incisor crowding, arch length, intermolar width, overbite, overjet, lower clinical crown heights and lower incisor inclinations. STATISTICS: The Mann-Whitney test was used to compare the differences between the extraction and non-extraction groups. RESULTS: In both groups, crowding reduced 1.27 mm in the non-extraction group and 6.03 mm in the extraction group. The difference between the 2 groups was 4.76 mm (P<0.05). The arch perimeter decreased more in the extraction group by 2.73 mm (P<0.05). As the incisor inclination stayed essentially the same, the loss in arch length was attributed to the molars moving forward. The net gain from extracting deciduous canines was 2.03 mm. CONCLUSIONS: There was a reduction in lower incisor crowding as a result of lower primary canine extraction. However, arch perimeter decreased more in the extraction group leaving less space for the eruption of the lower secondary canines.

Child↗
PubMed2004

Evaluating the cost-effectiveness of orthodontic provision.

The assessment of orthodontic provision is important to determine if treatment was necessary and undertaken appropriately. The ICON objectively quantifies orthodontic treatment need, complexity and outcome and is a valuable occlusal index in the assessment effectiveness of orthodontic care. It is possible to develop cost-effectiveness models by analysing the costs and effectiveness of orthodontic treatment. Several methods are illustrated to compare the orthodontic provision of specialist orthodontists.

Cost of Illness↗
PubMed2003

Dehydrated hereditary stomatocytosis with transient perinatal ascites.

The case is reported of a mother and baby with dehydrated hereditary stomatocytosis and perinatal ascites, an autosomal dominant condition not previously reported in Britain. Recognition is important for the management of pregnancy and for avoidance of splenectomy which, if performed, can predispose the patient to fatal thromboembolic events.

Adult↗
PubMed2003

Borjeson-Forssman-Lehmann syndrome and multiple pituitary hormone deficiency.

We describe two brothers with Borjeson-Forssman-Lehmann syndrome and the 22A-->T (Lys8X) PHF6 mutation, who presented with the symptoms and signs of multiple pituitary hormone deficiency. Biochemical investigations and radiology confirmed growth hormone (GH), thyroid stimulating hormone (TSH) and adrenocorticotrophic hormone (ACTH) as well as gonadotrophin deficiency. They were also found to have optic nerve hypoplasia. This family suggests that the BFL gene product may play an important role in midline neuro-development including the hypothalamo-pituitary axis.

Abnormalities, Multiple↗
PubMed2002

Routine pulse oximetry in the asymptomatic newborn.

OBJECTIVE: To assess the effect of routine measurement of postductal oxygen saturation as an adjunct to routine clinical examination in the asymptomatic newborn. DESIGN AND SETTING: Prospective study in a district general hospital. PATIENTS: All 6166 infants inborn between 1 April 1999 and 31 March 2001. INTERVENTION: Oxygen saturation was measured over two minutes, after the age of 2 hours and before discharge, in one foot of all babies not admitted directly to the neonatal unit. Babies with fractional (as opposed to functional) oxygen saturation (SaO(2)) below 95% were examined by the midwife. If this examination was abnormal or if normal but further measurements were below 95%, an echocardiogram was performed. All babies with cardiac malformations diagnosed by 1 year of age were identified from databases maintained at the regional cardiology referral unit and the regional congenital malformation survey. RESULTS: Measurements were made in 98% of eligible babies. A fractional SaO(2) less than 95% was found in 5% but persisted in only 1%. Structural cardiac malformations were found in 50 (8.1/1000), 26 of whom had isolated ventricular septal defects. Of the remaining 24 with other cardiac malformations, attention was first drawn to six by low SaO(2), and four more, first noticed for other reasons, also had low SaO(2). Low SaO(2) also first drew attention to 13 other babies ill for other reasons. CONCLUSION: Newborn babies with important cardiac malformations are often asymptomatic initially and the yield from clinical examination is poor. Measuring postductal saturation routinely in newborn babies before discharge is easy and can alert staff to ill babies.

Age Factors↗