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Biomedical subjects

S Wilson

Publications and source records attributed to S Wilson.

At least 667 records · Page 37Linked to original sources
PubMedDate not supplied

Electromyography: its potential as an adjunct to other monitored parameters during conscious sedation in children receiving dental treatment.

The purpose of this study was to evaluate the effect of a combination of a low dose of chloral hydrate and hydroxyzine on the frontalis muscle electromyogram in addition to other physiologic parameters in pediatric dental patients. A double blind, two-appointment cross-over design was used. Either a placebo or a combination of chloral hydrate and hydroxyzine was given to children during the first visit with the sequence of placebo/drug conditions being randomly determined. During the second visit, the children received that agent not given during the first visit. Baseline physiologic data was obtained at the beginning of each visit and the physiologic measures were again recorded during topical and local anesthesia administration, high-speed tooth preparation, and at the end of the dental appointment. The results indicated that the frontalis muscle activity and cardiovascular parameters were significantly affected by the drug and dental procedures. Oxygen saturation was least affected. The frontalis muscle appears to be a sensitive physiologic parameter to monitor during conscious sedation as an index of the amount of patient relaxation.

Blood Pressure↗
PubMedDate not supplied

Comparative trial of succinylcholine vs low dose atracurium-lidocaine combination for intubation in short outpatient procedures.

Despite its many disadvantages, succinylcholine is the most commonly used drug for intubation of patients for short out-patient procedure. This double blind trial compared a low dose atracurium/lidocaine combination to succinylcholine for intubation in 40 ASA1 adult patients. Low dose atracurium/lidocaine provided clinical intubating conditions at two minutes and cardiovascular stability equivalent to succinylcholine with significantly less myalgia. Spontaneous respiration was slower after low dose atracurium/lidocaine relative to succinylcholine. Low dose atracurium/lidocaine may provide an acceptable alternative to succinylcholine for intubation in short outpatient procedures.

Adult↗
PubMedDate not supplied

Two-point rapid palatal expansion: an alternate approach to traditional treatment.

Rapid palatal expansion (RPE) causes separation of the lateral halves of the palate and traditionally has used four maxillary teeth as anchorage. The purpose of this study was to introduce a rapid palatal expander that requires only two anchor teeth (two-point RPEe) and to compare the expansion obtained with that from a Hyrax appliance. This study involved two groups of 25 children aged 7 to 15 years who were treated in a private orthodontist's office with either a Hyrax appliance or a two-point RPEe. Dental casts and occlusal radiographs were made before treatment and at least three months after stabilization of the appliance. Paired t-tests were performed to identify significant intragroup changes, and independent t-tests were performed to determine intergroup differences. The findings showed the two-point RPEe was as efficient as the Hyrax in obtaining dental expansion of the maxillary posterior teeth with less effect on the maxillary anterior and mandibular teeth. Therefore, the two-point RPEe may be useful in certain clinical situations.

Adolescent↗
PubMedDate not supplied

Angiography, gingival hyperplasia and Sturge-Weber syndrome: report of case.

This syndrome, also known as encephalotrigeminal angiomatosis, is a condition with multiple clinical findings, including vascular anomalies and intraoral involvement. The patient was a nine-year-old black boy with Sturge-Weber syndrome. He had a lesion removed and diagnosed as pyogenic granuloma. There were no complications and the tissue healed normally.

Angiography↗
PubMedDate not supplied

LPN to ADN.

Explore the source record for details and available documents.

Education, Nursing, Associate↗
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Visceral leishmaniasis in Teresina, n. e. Brazil: towards a DNA probe kit and its adaptation to processing blood-contaminated samples.

The Lmet2 chemiluminescent DNA probe is a valuable tool for identifying parasites of the Leishmania donovani -complex in sand flies, dogs and human samples. Recent blood meals in sand flies or blood contamination of tissue samples inhibited probe sensitivity, whether radiolabelled or chemiluminescent detection systems were used. Treatment of membranes with protease before hybridisation restored positive signal. Alternatively samples could be lysed with protease and applied to membranes with a vacuum blotting apparatus. The Lmet2 protocol provides the basis for a DNA probe kit that is adaptable for use with a wide range of other probes.

Animals↗
PubMedDate not supplied

Temperament as a predictor of behavior during initial dental examination in children.

Temperament refers to children's behavioral style, or the manner in which they interact with their environment. Temperament has been quantified into nine temperament categories and five temperament constellations by Thomas and Chess. Temperament categories and constellations of children can be measured using one of several parental questionnaires, each of which focuses on age-appropriate behavior. For this study the Behavioral Style Questionnaire (BSQ) was administered to the parents of 50 healthy children (mean age 48.8 months) receiving initial dental examinations. The examinations were videotaped and The Ohio State Behavior Rating Scale (OSUBRS) was used to rate each child's behavior into one of four behavioral categories: 1) quiet; 2) crying only; 3) disruptive movement only; and 4) crying and disruptive movement. For data analysis the percentage duration of each behavioral category was calculated. Using one-way ANOVA, significant differences between constellations were found for quiet (P = 0.03) and combination behavior (P = 0.03). Using a stepwise linear regression, the temperament category of approach/withdrawal was found to predict the percentage of quiet (multiple R = 0.42357, R2 = 0.17941, and P = 0.002), crying (multiple R = 0.42124, R2 = 0.17744, and P = 0.002), and combination behaviors (multiple R = 0.30008, R2 = 0.09005, and P = 0.03). Additionally, significant regressions were found with temperament categories predicting behavioral categories depending on the child's age. The results of this pilot study suggest that the BSQ temperament constellations and categories appear to be modest predictors of a child's specific behaviors in the dental environment. Knowledge of a child's temperament may prepare the clinician to predict patient behaviors in the dental environment.

Analysis of Variance↗
PubMedDate not supplied

Facial electromyography and chloral hydrate in the young dental patient.

The purpose of this report is to describe facial electromyography (EMG) as a monitoring technique and to demonstrate the relationship of EMG amplitude to rated patient behavior during sedative trials using variable doses of chloral hydrate (CH) [25, 50, and 70 mg/kg]. Twenty healthy, uncooperative children (mean age = 30.7 +/- 4.8 months) participated in this institutionally approved double-blind, repeated-measures study. Following baseline vital signs, administration of CH, and a 45-min period, the children were secured in a Papoose Board (Olympic Medical Group, Seattle, WA) with electronic monitors attached including the EMG. EMG amplitude was recorded continuously by computer and each visit was videotaped for later analysis of behavior using the Ohio State University Behavior Rating Scale (OSUBRS). Statistical analysis using SPSS/PC+ V2.0 (SPSS Inc., Chicago, IL) included descriptive statistics of the study sample, one-way ANOVA, and Pearson Product-Moment Correlation Coefficient to determine differences in EMG amplitude as a function of CH dose and associations between per cent of rated behavioral categories of the OSUBRS to EMG amplitude, respectively. The results indicated a significant difference in EMG amplitude, per cent crying and quietness as a function of dose (F = 3.87, P < 0.03; F = 4.64, P < 0.01; F = 3.38, P < 0.04, respectively). Scheffe post-hoc analysis indicated that the difference was between 25 and 70 mg/kg doses. Significant correlations were noted between EMG amplitude and per cent crying and quietness (R = 0.640, P < 0.001; R = -0.664, P < 0.001), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMedDate not supplied

Temperament as a predictor of behavior for conscious sedation in dentistry.

Temperament can be defined as the behavioral style of a child or the manner in which a child interacts with the environment. Nine temperament categories have been identified: activity level, biological rhythmicity, initial approach/withdrawal, adaptability, intensity, mood, persistence/attention span, distractibility, and sensory threshold. Temperament categories can be quantified using the Toddler Temperament Scale (TTS), a written questionnaire completed by the caretaker. For this study, 29 healthy children, 14 males and 15 females, aged 18 to 36 months (mean age 30 = 6.2 months) and a mean weight of 13.8 kg = 2.1 kg were sedated with 2 mg/kg hydroxyzine pamoate (p.o.) and 2 mg/kg body weight of meperidine (submucosal). Parents completed the TTS during dental treatment in an adjoining room. The recording of baseline vital statistics, the mirror and explorer examination, and the entire operative procedure were videotaped. The Ohio State University Behavior Rating Scale was used to rate the videotapes of each child's behavior according to the following discrete categories: quiet behavior, crying without struggling, and struggling movement with or without crying. For data analysis, all negative behavior (struggling and for crying) was summed. Using a stepwise linear regression, approach/withdrawal tendency (multiple R = 0.38, r2 = 0.15, and P = 0.0015) and adaptability (multiple R = 0.58, r2 = 0.34, and P = 0.009) were found to predict the total percentage of struggling behavior, and approach/withdrawal also approached significance in predicting the percentage of all negative behavior (multiple R = 0.35, r2 = 0.12, and P = 0.055).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMedDate not supplied

The effects of nitrous oxide on behavior and physiological parameters during conscious sedation with a moderate dose of chloral hydrate and hydroxyzine.

The purpose of this study was to determine differences in heart rate (HR), blood pressure (BP), peripheral oxygen saturation (pO2), expired CO2 (CO2), and behavior (using two scales) comparing nitrous oxide/oxygen (N2O) with oxygen (O2) alone in 20 children (mean age 45 +/- 5.1 months) sedated with chloral hydrate (CH) and hydroxyzine in a double-blind crossover design. Administration of CH (40 mg/kg) and hydroxyzine (2 mg/kg) was held constant for each patient visit; however, N2O (50%) was administered during one visit and O2 (100%) at the other in a randomly determined manner. Physiologic and behavioral parameters were collected during eight specific procedural events (e.g., administration of local anesthesia). Data were analyzed with a repeated-measures ANOVA, one-way ANOVA, t-test, Kruskal Wallis ANOVA, and descriptive statistics. There was no statistically significant difference in any physiologic or behavioral parameter as a function of inhalation agent. However, significant differences were found for certain physiological parameters (i.e., HR [F = 5.41, P < 0.001], pO2 [F = 6.04, P < 0.001], and CO2 [F = 2.33, P < 0.027]) and all behavioral measures (% crying [F = 2.82, P < 0.008], % quiet [F = 5.38, P < 0.001], % movement [F = 3.88, P < 0.001], and % struggle [F = 2.83, P < 0.007]) of one scale (Ohio State University Behavioral Rating Scale [OSUBRS]) as a function of procedural events. Although no statistically significant differences were attributable to inhalation agent, evidence suggests that N2O resulted in less crying and struggling and more quiet behaviors than O2. Significant correlations existed between sub-categories of the two behavioral rating scales, suggesting some association between the scales. One may conclude from the results of this study that moderate doses of CH and hydroxyzine in combination with nitrous oxide are not associated with any significant potentiation effects on physiologic parameters compared with the same oral agents with oxygen alone. Certain procedural events (e.g., administration of local anesthesia) do result in patient responses that affect specific behaviors and physiology. Although the effects of N2O may not be statistically significant, generally it produces an attenuation in physiological and behavioral responses as measured under the conditions of this study.

Analysis of Variance↗
PubMedDate not supplied

A review of important elements in sedation study methodology.

The table demonstrates that there are few studies of behavioral indices mediated by a sedative(s) involving such sound scientific principles as blinding, reliability and validity, and control groups. Indeed, as is reflected in this report, it is not common to have measured physiological parameters along with the behavioral indices. Nonetheless, the reader should be aware that these clinical studies are difficult to conduct under the best of conditions. Extensive planning, piloting, instruments, and time are necessary to render even simple conclusions in today's studies. The need to standardize sedation protocols within and across studies is great if the profession ever hopes to develop a strong scientific basis for sedation. Only then can studies of drugs, their dosages, and their effects on children during dental procedures be compared and contrasted with any confidence. Behavioral scales need to be assessed and compared repeatedly and independently within and among studies so that an appreciation of the influence of a drug on one scale will have some meaningful translation to another scale. For instance, how does the Frankl scale compare to the Houpt scale, if at all? Should both or some facsimile of each be included in every study? What type of information is derived from the use of a given scale and does that information impact on other factors (e.g., physiological parameters or number of quadrants completed)? Should there be a priority for the use of one scale or another depending on the purpose of the study? Blinding and the establishment of reliability of behavioral measures should become as second-natured as giving local anesthesia.

Adolescent↗
PubMedDate not supplied

A survey of the American Academy of Pediatric Dentistry membership: nitrous oxide and sedation.

Issues concerning the use of nitrous oxide (N2O) and sedative agents by pediatric dentists in relation to recent changes in sedation guidelines of the American Academy of Pediatric Dentistry (AAPD) and the American Academy of Pediatrics (AAP) are relatively unexplored. A 48-item questionnaire addressing demographics, N2O equipment, N2O use, safety, and personnel was mailed to 2,650 active AAPD members in the United States and Canada. The 1,758 (66.3%) responses were reviewed and descriptive statistics were obtained using SPSS/PC+ statistics package. Results suggest that respondents were representative of the demographics of the AAPD membership. The majority of respondents (89%) used N2O, with a central delivery system being most popular. The majority (74%) did not use any monitors when using N2O alone; 10% did not use monitors when N2O was used in combination with other sedative agents. A majority (59%) did not use a time-based recording of physiological parameters. In conclusion, a mixed impression was found about practitioners' use of N2O and sedative agents, suggesting wide variability in practitioner habits related to pharmacologic patient management.

Adult↗