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Biomedical subjects

S Richmond

Publications and source records attributed to S Richmond.

At least 91 records · Page 5Linked to original sources
PubMed1994

A preliminary comparison of the DPB's grading of completed orthodontic cases with the PAR Index.

The PAR (Peer Assessment Rating) Index was compared to the grading system currently in use for completed orthodontic cases at the Dental Practice Board of England and Wales. Forty completed cases were graded by the two systems, which were compared for their intra- and inter-examiner reliability, as well as for their agreement and disparity in judging outcomes of cases. The implications of the results on the monitoring of standards in the General Dental Services are discussed.

Confounding Factors, Epidemiologic↗
PubMed1994

The obstetric management of fetal distress and its association with cerebral palsy.

OBJECTIVE: To determine the relation between the obstetric management of fetal distress and cerebral palsy. METHODS: The obstetric details of all 78 children with cerebral palsy born in a geographically defined area between 1975-1980 were compared with those of 591 control children. RESULTS: Fetal distress was identified more frequently in children with cerebral palsy who were born at term (24%) than among controls (11%). There was an inappropriate response to fetal distress in 12% of children with cerebral palsy but in only 3% of controls. CONCLUSIONS: If fetal distress in some way causes subsequent cerebral palsy, then the data in this study suggest that its complete elimination might be expected to reduce the birth prevalence of cerebral palsy by 15.6%. "Perfect" obstetric management of fetal distress might reduce the birth prevalence of cerebral palsy by 9% in term infants or 6% overall.

Case-Control Studies↗
PubMed1993

Orthodontics in the general dental service of England and Wales: a critical assessment of standards.

Out of a sample of 1210 orthodontic patients treated within the General Dental Services in England and Wales, a high proportion showed no improvement. Upper and lower fixed appliances had the greatest influence on the outcome of treatment in terms of aesthetics, dental health need and standards. When treatment was analysed according to the appliance used, there were no statistically significant differences in the standard of treatment undertaken by specialist orthodontists and general dental practitioners. Methods for improving British orthodontic standards are considered.

Analysis of Variance↗
PubMed1993

Consultant opinion on orthodontic treatment plans used by dental practitioners: a pilot study.

Prior to 1987, dental practitioners in England and Wales intending to carry out all but the simplest orthodontic treatment within the National Health Service, were required to submit pretreatment study models, details of the orthodontic assessment and the proposed treatment plan to the Dental Estimates Board prior to starting treatment. Models taken at the end of treatment were required by the Board to enable payment to be made. In this pilot study, the acceptability of orthodontic treatment plans used by practitioners working in the General Dental Services was assessed by eight hospital consultants, using information about 40 cases submitted to the Dental Estimates Board in 1987/88. All consultants considered a high proportion of plans to be unacceptable, but agreement between the consultants was variable and some agreed with one another on very few plans. A single scorer used the weighted PAR (Peer Assessment Rating) index to assess the degree of departure from normal occlusion of both pre- and post-treatment models. Using accepted standards, only nine cases were greatly improved (PAR reduction > 70%) and the mean percentage reduction in PAR score was low. Consultant opinion on the appropriateness of treatment planning was not related to the outcome of orthodontic treatment.

Clinical Competence↗
PubMed1993

Orthodontic treatment standards in Norway.

The outcome of orthodontic treatment is reported for a sample of 220 patients treated by Norwegian specialist orthodontists. The outcome was assessed using objective measures. The indices can be used to identify differences not only between individual practitioners, but also health care systems. It can be confirmed that the Norwegian orthodontists are producing a high standard of orthodontic treatment, the malocclusion is on average reduced by 78 per cent.

Adult↗
PubMed1993

Evidence for Chlamydia pneumoniae of non-human origin.

This paper describes the characterization and taxonomic status of N16, a chlamydial isolate from the respiratory tract of a horse. N16 contains plasmid DNA, has normal elementary body morphology and its inclusions do not stain with iodine. Its major outer-membrane protein (MOMP) gene was completely sequenced and compared with the MOMP genes of Chlamydia pneumoniae, C. psittaci, C. trachomatis and C. pecorum. This analysis revealed that N16 is closely related to the TWAR strain of C. pneumoniae (94.5% and 94.4% DNA homology with TWAR isolates IOL-207 and AR-39 respectively). By comparison, N16 shows between 72.1% and 73.7% DNA homology with C. psittaci strains, 70.9% and 71.1% homology with C. pecorum strains LW613 and 1710S and 69.2% homology with C. trachomatis serotype E. The MOMP gene of N16 shares 93.8% DNA homology with the MOMP gene of a chlamydial isolate KC from the conjunctiva of a koala. Monoclonal antibodies raised to C. pneumoniae IOL-207 and shown to be C. pneumoniae-specific confirmed that N16 was more closely related to C. pneumoniae than to C. psittaci. Thus DNA homology and monoclonal antibody data both suggest that horse chlamydiae, as exemplified by N16, form a new second strain of C. pneumoniae. This species is probably more widespread and diverse than the current literature would suggest.

Amino Acid Sequence↗
PubMed1993

Personal audit in orthodontics.

The use of different criteria to assess outcome of orthodontic treatment makes it difficult to compare treatment from one individual practitioner to the next. This article describes a method for all dentists to use to record outcome for self-audit purposes. A sample of 51 consecutively treated patients was assessed. On average, the mean percentage reduction in PAR score was 74 per cent. Eight per cent of patients were categorized as 'Worse or no different', 39 per cent 'Improved' and 53 per cent 'Greatly improved'. To achieve a good standard of orthodontic treatment it is proposed that the mean percentage reduction in PAR score should be greater than 70 per cent. The proportion of patients falling into the 'Worse or no different' category should ideally be less than 5 per cent.

Esthetics, Dental↗
PubMed1993

Calibration of non-dental and dental personnel in the use of the PAR Index.

Training and calibration in use of the PAR Index was given to a number of clerical staff and dental advisers at the Dental Practice Board of England and Wales. The results show that it is possible to teach nondentally trained personnel to apply this index to a high degree of reliability and they could, therefore, be trained to measure occlusal changes produced by orthodontic treatment, both for third party payment agencies, and for internal or regional audit programmes. Application of indices by non-dental staff would not only be more economical on clinical time, but should augment the objectivity and impartiality of the index.

Administrative Personnel↗
PubMed1993

The provision of orthodontic care in the general dental services of England and Wales: extraction patterns, treatment duration, appliance types and standards.

A systematic sample of 1010 cases was collected by the Dental Practice Board. The commonest type of treatment involved extraction of the first premolars followed by removable appliances. Treatment duration was on average 1.9 years, one-arch fixed appliances were started in an older age group and two-arch fixed appliance treatment took longer to complete than other appliance types. The best standard of treatment was achieved using upper and lower fixed appliances.

Adolescent↗
PubMed1993

Effect of ibuprofen use on muscle soreness, damage, and performance: a preliminary investigation.

Twenty subjects were randomly assigned to: 1) prophylactic ibuprofen (N = 5) [400 mg TID initiated 4 h before collection of baseline data and strenuous eccentric exercise bout], 2) therapeutic ibuprofen (N = 5) [400 mg TID initiated 24 h after baseline], 3) placebo (N = 5), or 4) control (N = 5). Muscle soreness perception, plasma creatine kinase, knee extensor torque, and EMG of the quadriceps were evaluated at baseline, 24, and 48 h. The prophylactic ibuprofen group had between 40 and 50% less muscle soreness perception and significantly less decline in isometric, concentric, and eccentric torque at 24 h compared with the other three groups (P < 0.05). At 48 h both prophylactic and therapeutic ibuprofen had significantly less muscle soreness perception and decline in torque than the placebo and control groups (P < 0.05). There was no difference between the amount of muscle damage between the four groups at 24 and 48 h. Vastus medialis and lateralis EMG magnitude decreased across time. Vastus lateralis EMG magnitude had significantly less decline from baseline for prophylactic ibuprofen compared with the other three treatments at 24 h, while both prophylactic and therapeutic ibuprofen had significantly less decline at 48 h. These data indicate that a prophylactic dosage of ibuprofen does not prevent CK release from muscle, but does decrease muscle soreness perception and may assist in restoring muscle function.

Adolescent↗
PubMed1993

The use of the index of orthodontic treatment need (IOTN) as a public health tool: a pilot study.

Many attempts have been made in the past to develop indices of malocclusion. The index of orthodontic treatment need was developed in the United Kingdom to assess both dental health and aesthetics, primarily for clinical purposes. This study was designed to assess the use of the index of orthodontic treatment need in dental public health. Dentists in the community dental service were taught how to use the index from a hierarchical training and calibration programme. These dentists then tested the index in the field and reported back their findings. The results indicate that the index of orthodontic treatment need has potential in dental public health but some modifications are suggested. These suggestions will be incorporated into a full study alongside caries prevalence in the future.

Adolescent↗
PubMed1992

Orthodontics in the General Dental Services of England and Wales: the provision of treatment.

A survey has been undertaken on a representative sample of 1210 patients collected from a 5% sampling procedure employed by the Dental Practice Board. Discontinued cases were excluded from the study. It was revealed that the majority of orthodontic treatment was undertaken by practitioners who had in general been qualified for at least 10 years and, in the main, did not possess an orthodontic qualification. The greater proportion of treatment was undertaken using removable appliances, although fixed appliances were used in 43% of prior approval cases and treatments attracted an average fee of 171 pounds (1988 prices). There was a marked variation in the proportion and type of treatment carried out in the various regions within the General Dental Services.

Certification↗
PubMed1992

The development of the PAR Index (Peer Assessment Rating): reliability and validity.

The PAR Index has been developed to provide a single summary score for all the occlusal anomalies which may be found in a malocclusion. The score provides an estimate of how far a case deviates from normal alignment and occlusion. The difference in scores between the pre- and post-treatment cases reflects the degree of improvement and, therefore, the success of treatment. Excellent reliability was exhibited within and between examiners (Intraclass Correlation Coefficient, R greater than 0.91). The components of the PAR Index have been weighted to reflect current British orthodontic opinion and is flexible in that the weightings could be changed to reflect future standards and standards currently being achieved in other countries. The PAR Index offers uniformity and standardization in assessing the outcome of orthodontic treatment.

Bicuspid↗
PubMed1992

The PAR Index (Peer Assessment Rating): methods to determine outcome of orthodontic treatment in terms of improvement and standards.

In orthodontics it is important to objectively assess whether a worthwhile improvement has been achieved in terms of overall alignment and occlusion for an individual patient or the greater proportion of a practitioner's caseload. An objective measure is described that has been validated against the subjective opinions of 74 dentists. Using the weighted PAR Index it was revealed that at least a 30 per cent reduction in PAR score is required for a case to be considered as 'improved' and a change of 22 PAR points to bring about 'great improvement'. For a practitioner to demonstrate high standards the proportion of an individual's case load falling in the 'worse or no different' category should be negligible and the mean reduction should be as high as possible (e.g. greater than 70 per cent). If the mean percentage reduction in PAR score is high and the proportion of cases that have been 'greatly improved' is also high, this indicates that the practitioner is treating a great proportion of cases with a clear need for treatment to a high standard.

Discriminant Analysis↗
PubMed1992

Leukocyte CD11b/18 antigen-directed monoclonal antibody improves early survival and decreases hypoxemia in dogs challenged with tumor necrosis factor.

This study examined the effect of monoclonal antibody (MAb) directed against leukocyte CD11b/18 glycoprotein complex (904MAb) on cardiopulmonary injury induced by tumor necrosis factor (TNF), and death. Eighteen 2-yr-old, purpose-bred beagles with chronic tracheostomies were challenged with TNF (60 micrograms/kg of body weight) intravenously. Nine of 18 animals were treated with 0.5 to 1.0 mg/kg of body weight 904MAb intravenously 45 min before and 12, 36, and 48 h after TNF infusion. Serial femoral and pulmonary arterial catheter hemodynamics, blood gas analysis, and radionuclide cineangiographic left ventricular ejection fractions (EF) were done before and after a fluid challenge. Serial bronchoalveolar lavages (BAL) with cell and protein analysis also were performed using the chronic tracheostomies. Compared with animals given TNF alone, animals treated with 904MAb did not differ in overall survival (TNF alone, 2/9; 904MAb, 3/9); however, the group of animals treated with 904MAb had significantly (p less than 0.01) fewer deaths within the first 30 h of TNF challenge. At 4 h after TNF challenge, all animals had significantly (p less than 0.05) reduced PaO2 after fluid challenge; however, animals given 904MAb (compared with animals given TNF alone) had significantly (p less than 0.05) smaller reductions in PaO2. Throughout the study, animals given 904MAb before TNF or TNF alone had similar changes in cardiac index, mean arterial pressure, EF, and BAL protein and neutrophil concentration. Thus, MAb directed against the leukocyte CD11b/18 glycoprotein complex prolonged survival and reduced the hypoxemia occurring after TNF challenge, but this antibody did not improve overall survival or cardiopulmonary function.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗