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Biomedical subjects

Tatiana V Macfarlane

Publications and source records attributed to Tatiana V Macfarlane.

11 recordsLinked to original sources
PubMed2007

Anal plugs for the management of fecal incontinence in children and adults: a randomized control trial.

GOALS: To evaluate the contribution of the anal plug to the management of fecal incontinence in children and adults. BACKGROUND: Effective management of fecal incontinence remains problematic. Previous studies of an anal plug have yielded conflicting results. STUDY: A randomized controlled trial was conducted. The intervention was the Conveen anal plug (Coloplast Limited) used for 12 months. Outcomes measures included: generic measures of child health [Functional Status II-R, Child Health Questionnaire (CHQ-PF50) and Dartmouth Primary Care Cooperative Information Project Charts]; generic measures of adult health for patients and carers (the SF-36, and Patient Generated and Carer Generated indices); condition-specific measures for adults and children; qualitative interviews, bowel charts, and diaries. The main outcome measure was a condition-specific score on a 0 to 100 scale, where 0 was the most severe and 100 was the least severe incontinence. RESULTS: Thirty-one intervention and 17 control patients were recruited. Fecal incontinence was due to 1 of 3 reasons: congenital, acquired, and neurogenic. At baseline, patients managed their condition preemptively or protectively. Intervention patients used the plug as a complete management substitute or as an adjunct to existing management. The majority of intervention respondents retained the plug most of the time. There was greater improvement from baseline in mean condition-specific score in intervention group compared with control group but this difference was not statistically significant (t test P=0.053). Complete data analysis using analysis of covariance showed the mean difference between the treatment groups in condition-specific score of 9.9 (95% confidence interval-1.4, 21.1). Intention to treat analyses using imputation showed similar results. There was generally greater improvement in intervention groups subjects using other measures for children, adults, and carers. CONCLUSIONS: The anal plug is of benefit to the majority of patients. It does not suit all eligible patients with in situ plug retention being a problem for some.

Adolescent↗
PubMed2005

Development and validation of the Manchester orofacial pain disability scale.

OBJECTIVE: To design and validate a self-administered instrument for assessing orofacial pain related disability in the general population. METHODS: The 32-item questionnaire was developed by open-ended interviews with patients attending dental hospital clinics and was subsequently tested on 171 community subjects with self-reported orofacial pain and 48 dental hospital patients. RESULTS: Construct validity of the instrument was demonstrated in three ways. First, levels of reported disability were greater in dental hospital patients than for community subjects reporting orofacial pain. Secondly, the instrument was able to detect differences in disability levels reported by community subjects who did and did not consult with a healthcare professional and those who had acute and chronic pain. Thirdly, amongst community subjects with pain, disability scores increased with higher pain intensity, pain duration and were greater amongst subjects who had sought a consultation. Results of factor analysis identified two constructs: physical and psychosocial disabilities, associated with orofacial pain. The Cronbach's alpha score was 0.78 and 0.92 for the physical and psychosocial constructs, respectively, and this along with item correlation values between 0.43 and 0.80 confirmed the internal consistency. CONCLUSION: We have therefore designed a valid instrument for assessing the impact of painful orofacial conditions in both community and clinic settings.

Adolescent↗
PubMed2004

A double-blind randomised controlled clinical trial of the effect of preoperative ibuprofen, diclofenac, paracetamol with codeine and placebo tablets for relief of postoperative pain after removal of impacted third molars.

We conducted a randomised double-blind placebo-controlled single-centre study to compare the effect of preoperative ibuprofen 600 mg, diclofenac 100 mg, paracetamol 1 g with codeine 60 mg or placebo (Vitamin C 50 mg) tablets for relief of postoperative pain in 119 patients who had day case operations under general anaesthesia for removal of impacted third molars. Patients were given the tablets 1 h before operation. Pain was assessed using visual analogue scales and verbal rating scales preoperatively at 15 and 30 min and 1 and 3 h postoperatively. After they had gone home, patients were contacted by telephone at 6 and 24 h postoperatively to find out whether they had any adverse effects from the analgesics. There was no significant difference in the extent of postoperative pain among the four groups, but the placebo group had significantly shorter times before their first request for postoperative analgesics (median 17 min, range 14-90) than the diclofenac group (median 32, range 15-150). Preoperative analgesics at the stated doses are effective in providing immediate postoperative pain control after operations on third molars. There were, however, some side-effects including nausea, vomiting, headaches, and gastrointestinal discomfort, but there were no significant differences among the active analgesic groups with respect to adverse events either shortly after operation or at 6 or 24 h.

Acetaminophen↗
PubMed2004

Can one predict the likely specific orofacial pain syndrome from a self-completed questionnaire?

To estimate the prevalence of orofacial pain (OFP) by specific diagnostic subgroups in the general population. Cross-sectional population study. General medical practice in South East Cheshire, UK. Participants of baseline investigation who completed the full postal questionnaire (1510, adjusted study participation rate 81%). Clinical examination was attended by 126 (43%) of all the participants who reported OFP in the questionnaire. These individuals were classified as musculoligamentous/soft tissue type, dentoalveolar or neurological/vascular. OFP duration, location, descriptors and statements on OFP were predictors of classification group. The estimated prevalence in the general population of musculoligamentous/soft tissue type of OFP was 7%, dentoalveolar 7% and neurological/vascular 6%. This study has derived a statistical model to classify participants with OFP into three broad groups (musculoligamentous/soft tissue, dentoalveolar and neurological/vascular) based on questionnaire information about OFP (OFP chronicity, location and verbal descriptors of pain). It is potentially useful in large population studies of OFP, where a clinical examination is not possible, however, further validation of its performance in large populations are necessary.

Adolescent↗
PubMed2002

Gait analysis as an objective measure in a chronic pain model.

The aim of this study was to investigate objective characterisation of gait as a marker of the chronic pain of adjuvant arthritis (AA). Video recorded images of spontaneous rat ambulations were analysed to quantify various temporal and spatial parameters and compare these between the AA and control groups. Changes were also recorded after the administration of a single dose of buprenorphine (15 ?g). Individual temporal parameters were significantly reduced (velocity (P=0.05), stride length (P=0.007), single stance time (P<0.001), swing time (P=0.001)), or increased (dual stance time (P<0.001)) at 10 days in the AA group compared to control. The rear paws showed reduced ground contact and the fore paws an increase in proximal pad and decrease in digit area, although these changes were not all statistically significant. Some of the gait parameters showed significant reversal following administration of buprenorphine (velocity (P<0.001) and stride length (P<0.001) were increased and single stance time (P=0.014) reduced). It is proposed that changes in gait are a marker of AA chronic pain in this model. These behavioural changes were significant at a very early stage (day 10), before the development of physical deformities and increase in paw volume and might permit an earlier detection of pain than other models.

Analgesics, Opioid↗
PubMed2002

Orofacial pain: just another chronic pain? Results from a population-based survey.

Features of somatisation have been shown to predict the onset of widespread body pain. This study aims to determine to what extent persons with orofacial pain syndromes share these features and to what extent they are uniquely related to oral mechanical factors. We have conducted a population-based cross-sectional survey in the South-East Cheshire area of the United Kingdom involving 2504 individuals aged 18-65 years. All participants completed a postal questionnaire which enquired about the occurrence of both orofacial pain and widespread body pain. It also enquired about potential risk factors for one or both conditions. In total, 473 subjects (23%) reported orofacial pain only, 123 (6%) widespread pain only, while 85 (4%) reported both. The number reporting both was significantly higher than would be expected if the symptoms were independent (P<0.001). Several oral mechanical factors were significantly associated with both orofacial pain and widespread body pain (grinding teeth, clicking jaw, missing teeth), while two (facial trauma, locking jaw) were specifically related to orofacial pain. Both pain syndromes were associated equally with high levels of psychological distress, indicators of somatisation and maladaptive response to illness. These results suggest that orofacial pain syndromes may commonly be a manifestation of the process of somatisation and the excess reporting of some local mechanical factors amongst persons with these symptoms, may not be uniquely associated with pain in the orofacial region.

Adult↗
PubMed2002

The association between psychological factors and oro-facial pain: a community-based study.

OBJECTIVE: To examine the hypothesis that psychological factors of psychological distress, maladaptive response to illness and perception of happiness in childhood, are associated with self-reported oro-facial pain (OFP). METHOD: A cross-sectional population-based study was conducted in South-East Cheshire, UK. The adjusted participation rate was 74%, and 2504 adults aged 18-65 years participated in the study. RESULTS: A report of not having had a happy childhood was associated with risk of 1.6 (95% CI 1.4-2.0) of reporting OFP. An increased propensity to report symptoms associated with OFP was seen for those individuals with higher levels of psychological distress measured using the general health questionnaire (GHQ) with the risk of 2.7 (95% CI 2.3-3.2) in the highest category. All components of the illness behaviour questionnaire (IBQ) were associated with presence of OFP. There was a linear increase in risk (test for trend, P<0.01) associated with the report of OFP for general hypochondriasis, disease conviction, affective inhibition, affective disturbance, and irritability. However there was a significant decrease in risk with a high score for perception of illness (0.6; 95% CI 0.6-0.7) and denial (0.6; 95% CI 0.5-0.7). None of the factors showed significant change in estimates when adjusted for age and gender. CONCLUSIONS: This large cross-sectional community-based study showed significant association for all of the factors considered. The obtained data raise interesting questions of cause and effect for which further, longitudinal studies are required to establish temporal relationship between these factors and the onset, cause, and treatment of OFP.

Adolescent↗
PubMed2002

Oro-facial pain in the community: prevalence and associated impact.

STUDY OBJECTIVE: To determine the prevalence of oro-facial pain (OFP) in the population and within-population subgroups and to describe the associated disability. DESIGN: Cross-sectional population study. SETTING: General medical practice in South East Cheshire, United Kingdom. PARTICIPANTS: A random sample of 4000 adults aged 18-65 years of whom 2504 responded (adjusted participation rate 74%). MAIN RESULTS: The overall prevalence of OFP was 26% (95% Confidence Interval (CI) 24%, 28%). The prevalence of symptoms was higher in women (30%) than in men (21%) and in both sexes the highest (30%) prevalence was found in the 18-25 year age group and the lowest (22%) in the 56-65 age group. Of all the participants, 12% had pain in or around the eyes, 10% reported pain in and around the temples, 6% pain in front of the ears and 6% pain in the jaw joints. Only 46% of the participants with OFP had sought professional advice from a dentist or general medical practitioner and 17% had to take time off work or were unable to carry out normal activities because of pain. CONCLUSIONS: OFP is a common symptom experienced by a quarter of the adult population, of whom only 46% seek treatment. The prevalence is higher in women and younger age groups.

Absenteeism↗
PubMed2002

In vivo bracket retention comparison of a resin-modified glass ionomer cement and a resin-based bracket adhesive system after a year.

Glass ionomer orthodontic adhesives cause less enamel demineralization during fixed orthodontic appliance treatment than do traditional resin-based products. An in vivo randomized clinical trial was performed comparing the clinical performance of a resin-modified glass ionomer (RMGI) adhesive with a no-mix, resin-based (the control) adhesive over a 12-month period. The split-mouth technique was used to analyze bracket retention, bracket failure causes, and mode of failure for both adhesives in 61 patients. Bracket-failure rates were 10% for the RMGI and 4% for the resin-based adhesive. Both adhesives had 4 times more bracket failures when opposing occlusion was present. The resin-based product demonstrated a higher proportion of resin-to-enamel adhesive failures than did the RMGI. Compared with the resin-based adhesive, the RMGI-bracketed teeth showed improved clinical performance, no enamel surface loss, less enamel demineralization, and faster adhesive removal. However, the RMGI had a 2.6 times greater bracket-failure rate than did the resin-based product.

Adolescent↗
PubMed2002

Factors that affect the adhesion of two irreversible hydrocolloid materials to two custom tray materials.

STATEMENT OF PROBLEM: Little evidence is available on the length of time that adhesive should be allowed to dry before irreversible hydrocolloid impression making. PURPOSE: This study investigated the effect of adhesive drying times on the bond strengths of 2 irreversible hydrocolloid impression materials to 2 "custom" tray materials. MATERIAL AND METHODS: A total of 1,632 specimens were tested: 816 in tensile tests and 816 in tests of the shear bond strength (megapascals) of 2 irreversible hydrocolloid impression materials to an autopolymerizing and a visible light-polymerizing acrylic resin tray material. In the first part of the investigation, a single coat of adhesive was applied to specimen plates that simulated the custom impression tray surface; in the second part, a second coat of adhesive was applied after the irreversible hydrocolloid was removed, and the effect of this second coating on bond strength was examined. In both parts, the adhesive was allowed to dry for a range of times (0 to 8 minutes at 30-second intervals, for a total of 17 time periods) before the addition of the impression material. The specimen plates were placed in a humidor and separated in a universal testing machine operated at a crosshead speed of 100 mm/min with 0- to 5-kN load cell. Data from each of the 1,632 specimens were collected and evaluated with analysis of variance, regression analysis, and t tests (P<.05). RESULTS: Significant differences in mean bond strengths were found between specimens with a 4-minute adhesive drying time (0.179 MPa tensile, 0.068 MPa shear) and specimens with a 0-minute drying time (0.065 MPa tensile, 0.015 MPa shear). Any period over 4 minutes produced no significant difference. The mean bond strengths of the single-coated specimens were 0.179 MPa (tensile) and 0.076 MPa (shear). These values were significantly greater than those for specimens with a second adhesive layer (0.136 MPa tensile, 0.035 MPa shear) over all time periods. Mean tensile bond strengths (0.158 MPa) were consistently higher than shear bond strengths (0.056 MPa) for all combinations of tray material, adhesive application, and time. CONCLUSION: Within the limitations of this study, the results suggest that adhesive applied to the autopolymerized and light-polymerized custom tray materials tested should be allowed to dry for at least 4 minutes before irreversible hydrocolloid is applied. Better results were obtained when the adhesive layer from a failed irreversible hydrocolloid impression was removed and replaced rather than overlaid with an additional adhesive coating.

Acrylic Resins↗