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Biomedical subjects

W H Gilmour

Publications and source records attributed to W H Gilmour.

16 recordsLinked to original sources
PubMed1992

Trends in mortality from stroke in Scotland, 1950-1986.

The Scottish Registrar General's Annual Reports have been used to study trends in mortality from stroke in Scotland during 1950-1986 in those aged 45 to 74. In 1950 the age-adjusted mortality rate was 347.4 per 100,000 population for men and 360.8 for women, falling to 199.6 for men and 155.8 for women in 1986. This downward trend has increased from 1976 for males. The average annual decline in age-adjusted mortality from stroke over the 37-year period was 4.0 per 100,000 in males and 5.5 in females. This reduction in death rates was proportionally higher for women compared with men in all age groups over 55 years. As with cardiovascular deaths, mortality from stroke was lower in the east than in the central region and west of Scotland. The reduction in mortality resulted in a substantial 'saving' of lives, estimated at 12,500 between 1980 and 1984.

Age Factors↗
PubMed1992

The effect of chewing gum use on in situ enamel lesion remineralization.

Two independent cross-over studies investigated the possibility of enhanced early enamel lesion remineralization with the use of chewing gum. The first study involved a sorbitol-containing chewing gum, and the second, which had an identical protocol, tested a sucrose-containing chewing gum. In each study, 12 volunteers wore in situ appliances on which were mounted enamel sections containing artificial caries lesions. Subjects brushed twice daily for two min with a 1100-ppm-F (NaF) dentifrice (control and test) and in the test phase chewed five sticks of gum per day for 20 min after meals and snacks. Microradiographs of the enamel lesions were made at baseline and at the end of the seven-week experimental period. In the sugar-free gum study, the weighted mean total mineral loss (delta z) difference [(wk7-wk0) x (-1)] was 788 vol.% min. x micron for the gum, corresponding to remineralization of 18.2%, vs. the control value of 526 vol.% min. x micron, 12.1% remineralization (p = 0.07). There were no significant differences for the surface-zone (p = 0.20) and lesion-body (p = 0.28) values. In the sucrose-containing gum study, the delta z difference was 743 vol.% min. x micron for the gum, corresponding to a remineralization of 18.3%, vs. the control value of 438 vol.% min. x micron, 10.8% remineralization (p = 0.08). The surface-zone values were not significantly different (p = 0.55). For the lesion body, however, the sucrose-containing gum value of 6.11 vol.% min. was significantly different (p = 0.01) from that of the control (2.81 vol.% min.).

Adult↗
PubMed1991

Incisor enamel mottling prevalence in child cohorts which had or had not taken fluoride supplements from 0-12 years of age.

Blind photographic assessments were made of the permanent incisors of 322 children who had participated in two successful fluoride drop/tablet hygienist-based preventive dentistry programmes. Two groups of four dental and two lay assessors unanimously scored 57% of dentitions as mottling-free. The dental observers unanimously scored 37 children (12%) with some symmetrical homologous tooth-type mottling, although only 13 decisions (4%) were scored "unacceptable easthetically". The lay assessors rated 77 children (24%) with mottling, 15% being easthetically displeasing. However, no significant mottling differences were noted between cohorts which had commenced oral fluoride supplementation at birth and those which either commenced as late as 7 years of age, or which had never taken any such supplementation. Thus other fluoride sources must have been responsible for the non-drop/tablet diffuse symmetrical mottling noted, the most likely being highly fluoridated dentifrices ingested by youngsters unable to control the volume dispensed and swallowed. Hence the evidence does not suggest that this proven caries-inhibiting F- drop/tablet regime dosage should be reduced. There is, however, a clear and continuing need for both the dental profession and the public to be made more aware of the problem of uncontrolled fluoride ingestion from other sources.

Age Factors↗
PubMed1990

Evaluation of a practice information leaflet.

Over 10 months 5,000 practice information leaflets were distributed in a practice in Glasgow. The leaflet was principally evaluated by assessing patients' attitudes to and use of leaflets and changes in their knowledge about the practice. Changes in the pattern of consultation with the practice nurse and the timing of incoming telephone calls were also measured. Most patients read, kept and referred to the leaflet and reported it to be useful. Those who had seen the leaflet had significantly greater knowledge (mean knowledge score 7.5) on 15 questions on practice organization than two comparison groups: the base-line study sample (mean knowledge score 5.2) and those in the follow-up sample who had not seen the leaflet (mean knowledge score 5.7). Improvements in knowledge were statistically significant for 10 out of 15 questions. Two changes of behaviour were noted, increased self-referral to nurses (37% of new consultations at follow-up were self-referred compared with 29% at baseline: P = 0.05) and the timing of incoming telephone calls was more in line with practice policy (for example, 23% of calls for repeat prescriptions were made between 12.00 and 16.00 hours at follow-up compared with only 11% at baseline, P less than 0.001). The leaflet was judged to be useful.

Adolescent↗
PubMed1990

Formation of interdental soft tissue defects after surgical treatment of periodontitis.

This study monitored the development and repair of interdental soft tissue defects following surgical treatment of periodontitis in 21 patients. Open flap curettage was performed at 100 interdental areas with follow-up examinations 1, 3, and 6 months later. Interdental gingival contours were assessed both clinically and indirectly with silicone elastomer impressions from which stone models were obtained; defect depths were then calculated using the Reflex Microscope. Two types of defect were identified at the 1-month follow-up: 13 interdental clefts (mean depth, 1.8 mm); and 30 craters, (mean depth, 1.6 mm). Although clefts tended to persist, craters showed a strong tendency to repair. Thus, at the 6-month follow-up, the depths of clefts and craters were 1.3 mm and 0.7 mm respectively. The development of soft tissue defects did not appear to be related to the use of a periodontal dressing nor did the existence of an underlying bone defect appear to be of etiological importance. Pre-operative probing depths, however, were positively associated with the occurrence of soft tissue craters (P = 0.02). Pre-operatively, the overall mean probing depth and frequency of bleeding on probing were 5.3 mm and 100% respectively. At 6 months, these values were reduced to 2.0 mm and 22%. When clefts, craters, and interdental areas with no soft tissue defect were compared, no significant differences in probing depth reduction or frequency of bleeding were observed at any time point.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Systemic metronidazole in the treatment of periodontitis.

The present study evaluated the effect of systemic metronidazole on advanced periodontitis in 10 patients with inadequate oral hygiene. Clinical and microbiological observations were made at a total of 173 bleeding pockets of 5 mm depth or more. The clinical observations comprised plaque index scores, dichotomous measurements of gingival redness and suppuration, pocket depths and attachment levels. The microbiological variables investigated were the % spirochaetes, % black-pigmented Bacteroides species, % facultative streptococci and presence of absence of Bacteroides gingivalis. At baseline, after clinical measurements and microbiological samples had been taken, each patient received a thorough scaling and root planing. After 3 months, the clinical measurements and microbiological sampling were repeated and a 5-day course of metronidazole was administered while one side of the mouth was scaled and root planed. After a further 3 months, the final measurements and samples were taken. In comparing pre- and post-treatment data, the following significant differences were observed: for debridement alone, a reduction in mean % spirochaetes from 11.5% to 4.9% and an increase in mean % streptococci from 4.7% to 8.8%; for metronidazole alone, a 0.3 mm gain in mean attachment level, a 0.4 mm reduction in mean pocket depth and a reduction in the frequency of suppurating sites from 32% to 16%; for debridement plus metronidazole, a 0.2 mm gain in mean attachment level, a 0.5 mm reduction in mean pocket depth and a reduction in mean % spirochaetes from 5.6% to 2.5%. Thus systemic metronidazole, either alone or accompanied by debridement, produced a modest clinical improvement after debridement alone had failed.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1988

Longitudinal study of untreated periodontitis (I). Clinical findings.

The principal aim of this study was to investigate the use of certain clinical and microbiological criteria to predict periodontal breakdown during a 1-year period. A further aim was to establish whether the act of collecting subgingival plaque samples periodically throughout the observation period would have any effect on the clinical or microbiological variables. Only the clinical data is presented in this paper. The study population comprised 11 volunteers (aged 32-51 years) with persistent advanced periodontitis and inadequate plaque control in spite of a previous intensive course of hygiene therapy. From the left jaw quadrants, 89 teeth were selected, yielding 148 bleeding pockets of 4 mm depth or more. From the right jaw quadrants, 74 teeth were selected, yielding 117 bleeding pockets of 4 mm depth or more. All subjects were examined on 7 occasions at 2-monthly intervals when plaque index scores, dichotomous measurements of gingival redness, pocket depths and attachment levels were recorded. Bacteriological sampling was carried out at each visit for each site only in the left jaw quadrants while the right jaw quadrants were sampled only at the first and last visits. During the study, no subgingival instrumentation was performed, except at 3 sites which exhibited loss of attachment of 3 mm. These teeth were withdrawn from the study for ethical reasons. At the completion of the study, the sequential changes in probing attachment level at each site were subjected to regression analysis to determine the direction and extent of attachment change which had taken place at each site.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Longitudinal study of untreated periodontitis (II). Microbiological findings.

11 volunteer subjects with advanced chronic periodontitis participated in a 1-year longitudinal clinical and microbiological study. Subgingival plaque was collected at each of 7 visits from 148 pre-selected sites in the left jaw quadrants (test sites) and on the first and last visits, only from 117 sites in the left jaw quadrants (control sites). All sites were examined clinically at each of the 7 visits, and the microbiological markers investigated were the % spirochaetes and % black pigmented Bacteroides species in subgingival plaque. At the completion of the study, the sequential changes in probing attachment level at each site were subjected to regression analysis to determine the direction and extent of attachment change. Possible correlations between attachment change and % spirochaetes or % black-pigmented bacteroides were investigated using both individual sites and individual subjects. No significant differences were observed in either of the microbial variables between test and control sites. Possible correlations between the microbiological markers and attachment changes were investigated at baseline, at the 12-month visit and using the microbial data accumulated over all 7 visits. Significant differences were observed only at the 12-month visit when the % spirochaetes of both test and control sites were significantly lower in subjects showing the greatest improvement in attachment level. Overall, these results indicate that quantification of either spirochaetes or black-pigmented Bacteroides species cannot be used reliably to identify or predict disease-active sites.

Adult↗
PubMed1986

Mortality probability in victims of fire trauma: revised equation to include inhalation injury.

There are no clear guidelines on the early diagnosis of injury due to inhalation of smoke. A clinical scoring system in the form of a previously prepared questionnaire may be used in the accident and emergency department by staff who are inexperienced in the management of inhalation injury. By quantifying injury due to smoke inhalation, its contribution to mortality in a large group of fire victims was established and a revised mortality probability equation derived using age, percentage surface area of the burn, and extent of inhalation injury. This mortality probability equation may be used to divide patients into risk categories for early intensive care management and allows the comparison of mortality data between accident and emergency units receiving varying numbers of patients with injuries due to burns and smoke inhalation.

Adolescent↗
PubMed1985

Prediction of outcome following acute variceal haemorrhage.

In order to identify factors predicting survival following acute variceal haemorrhage, data were collected prospectively from 100 admissions in 70 patients managed by a standard policy employing oesophageal tamponade, injection sclerotherapy and, if necessary, oesophageal transection. Of the ten predictive factors identified by univariate analysis, only prothrombin ratio, serum creatinine and the presence of encephalopathy on admission were shown by stepwise logistic regression to have independent significance. The derived regression equation allowed clearer identification than conventional scoring systems of high and low risk groups and successfully predicted outcome in 90 per cent of admissions.

Acute Disease↗
PubMed1985

Prediction of outcome following necrotizing enterocolitis in a neonatal surgical unit.

Retrospective analysis of 27 factors in 80 neonates with necrotizing enterocolitis has enabled us to identify three factors that appear to be of prognostic statistical significance, namely blood pH, platelet count, and the presence of congenital defects. All three factors may be assessed objectively at the time of admission of the patient. Using these factors we have estimated a "probability of death" score for each patient and a high-risk group of neonates has been identified.

Blood Chemical Analysis↗