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PubMed1987

Infectious flare-ups and serious sequelae following endodontic treatment: a prospective randomized trial on efficacy of antibiotic prophylaxis in cases of asymptomatic pulpal-periapical lesions.

Without peritreatment antibiotics, infectious flare-ups (about 15% incidence) and serious sequelae follow endodontic treatment of asymptomatic teeth with necrotic pulps and associated periapical lesions. Antibiotics administered after endodontic treatment (4-day regimen) reduce the flare-up incidence to about 2%, but hypersensitivity responses, sensitization, resistant microbes, and drug-taking compliance are potential problems. To ascertain whether a specific prophylactic antibiotic (high-dose, 1-day regimen) would preferentially maintain this low flare-up incidence while overcoming antibiotic-related problems, 315 patients with quiescent pulpal necrosis and an associated periapical lesion were randomly given either penicillin V or erythromycin (base or stearate). Evaluations of flare-up after endodontic treatment were done at 1 day, 1 week, and 2 months. A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (12.4%). A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last two investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment (p less than 0.001).

Adolescent↗
PubMed1990

A comparison of erythromycin and cefadroxil in the prevention of flare-ups from asymptomatic teeth with pulpal necrosis and associated periapical pathosis.

In a previous study by our group with patients having asymptomatic teeth with pulpal necrosis and an associated periapical radiolucent lesion (PN/PL), it was shown that prophylactic administration of penicillin V or erythromycin (high-dose, 1-day regimen) resulted in a low incidence of flare-up (mean = 2.2%) and a low incidence of swelling and pain not associated with flare-up. No hypersensitivity responses occurred, and gastrointestinal side effects were found primarily with the erythromycins. To ascertain whether a single-dose administration of a long-acting 1-gm tablet of the cephalosporin antibiotic cefadroxil would result in a similar outcome, the present study was undertaken with 200 patients having quiescent PN/PL. The patients were randomly given either cefadroxil or erythromycin (base or stearate). Evaluations of flare-up were done 1 day, 1 week, and 2 months after endodontic treatment. A 2.0% flare-up incidence was found, with no statistically significant differences for cefadroxil (1.0%), stearate (2.0%), or base (4.0%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (19.0%). The results showed that a 1-gm, single-dose regimen of cefadroxil was as effective as erythromycin and penicillin in preventing flare-ups and serious sequelae. A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last three investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment of asymptomatic PN/PL (p less than 0.001).

Acute Disease↗
PubMed1989

Two-part pricing and the mark-ups charged by primary care physicians for new and established patient visits.

Patients learn something when they visit a physician for the first time. Primary care physicians may exploit this information by using a two-part pricing strategy to price discriminate between new and established patients. The price of established patient visits will exceed marginal cost; because physicians maximize their profits from the entire relationship with a patient, competition drives new patient prices below marginal cost. Empirical tests indicate that general and family practitioners and obstetricians and gynecologists charge higher mark-ups on established patient visits than on new patient visits. Internists charge similar mark-ups on both types of visit.

Choice Behavior↗
PubMed2004

Value of electrocardiographic algorithm based on "ups and downs" of ST in assessment of a culprit artery in evolving inferior wall acute myocardial infarction.

Acute myocardial infarction (AMI) of the inferoposterior wall is due to occlusion of the right coronary artery (RCA) or the left circumflex (LCx) coronary artery. The outcome of patients depends mainly on the culprit artery. Therefore, the presumptive prediction of a culprit artery based on the electrocardiogram recorded at admission is of clinical importance. The aim of this study was to develop a sequential algorithm based on the "ups and downs" of the ST segment in different leads to predict the culprit artery (RCA vs LCx) in cases of inferoposterior AMI. We analyzed electrocardiographic and angiographic findings of 63 consecutive patients with an evolving AMI with ST elevation in the inferior leads (II, III, and aVF) and a single-vessel occlusion. Specificity, sensitivity, and positive and negative predictive values of different electrocardiographic criteria (ups and downs of the ST segment) were studied individually and in combination to find an algorithm that would best predict the culprit artery. The following electrocardiographic criteria were included in the 3-step algorithm: (1) ST changes in lead I, (2) the ratio of ST elevation in lead III to that in lead II, and (3) the ratio of the sum of ST depression in precordial leads to the sum of ST elevation in inferior leads [( summation operator downward arrow ST in leads V(1) to V(3))/( summation operator upward arrow ST in leads II, III, and aVF)]. Application of this sensitive algorithm suggested the location of the culprit coronary artery (RCA vs LCx) in 60 of 63 patients (>95%). The few patients in whom this algorithm did not work were those with a very dominant LCx that presented ST depression of > or =0.5 mm in lead I. In conclusion, careful sequential analysis of an electrocardiogram of an inferoposterior AMI with ST elevation may lead to the identification of a culprit artery.

Algorithms↗
PubMed2006

Scaling and non-scaling of muscle activity, kinematics, and dynamics in sit-ups with different degrees of difficulty.

The purpose of this study was to investigate how the CNS adjusts motor patterns for variants of a complex axial movement-the sit-up. Adjustments were induced by changing the support surface contact and mass distribution of the body. Healthy adults performed straight-legged sit-ups, 3 s in duration, with support added to or removed from the lumbar trunk, or with mass added to the head or to the legs. Each of these interventions either increased or decreased the difficulty of the task. The study addressed the extent to which changes in sit-up difficulty are compensated by scaling of muscle activity, kinematics, and dynamics versus the extent to which they are compensated by changing discretely the motor pattern. The analysis of muscle activity, kinematics, and dynamics focused on the first 30-40% of the sit-up-the trunk flexion phase-since this is the most critical part of the movement. Our results demonstrate that, in some respects, sit-up kinematics and dynamics scaled with difficulty, but in other respects, they did not. Muscle activity also scaled, in many respects, but in more difficult sit-ups, abdominal flexor activity decreased instead of increased. Non-scaling changes in these parameters suggest that complex movements, such as the sit-up, may require discrete changes in motor pattern in order to deal with large loads, which challenge the available leverage.

Adaptation, Physiological↗
PubMed2002

Comparison of two ICP-MS set-ups for measuring 99Tc in large volume water samples.

Large volume fjord and seawater samples have been radiochemically prepared for ICP-MS analysis in order to test the robustness of the procedure and to carry out a comparison of two ICP-MS set-ups. A sector field instrument (MicroMass PT2) coupled with an ultrasonic nebuliser and a quadrupole ICP-MS (Perkin-Elmer Elan 6000) coupled with an electrothermal vaporisation (ETV) unit were used. The results showed that the radiochemical procedure was robust, removing Ru and Mo to acceptable levels, and that the two set-ups gave results that were in agreement. The correlation coefficient between the sets of 11 results was 1.0 +/- 0.05. The importance of establishing the matrix effect when using an ETV is discussed.

Mass Spectrometry↗
PubMed2002

Neurologic complications of sit-ups associated with the Valsalva maneuver: 2 case reports.

We present 2 cases of potentially catastrophic neurologic consequences occurring in healthy individuals engaged in sit-up exercises. Two young healthy men were engaged in sit-ups when one developed a stroke and the other developed a spinal epidural hematoma. The Valsalva maneuver involved in the sit-up exercise can produce supraphysiologic increases in blood pressure, which can lead to vascular injury and serious neurologic consequences. Proper breathing should be encouraged and patients with known predisposing factors should avoid such exercises. Prompt recognition of neurologic signs and symptoms during exercise can be life saving. This is the first report of the neurologic complications of sit-ups.

Adult↗
PubMed1994

Trends in appropriate adult functioning and biasing risks in longitudinal follow-ups of boys with conduct disorders.

Multiple telephone follow-up interviews have been conducted for a number of years for boys with conduct disorders treated at the Saint Francis Academy. These follow-ups are done 2 years and 5 years after treatment completion and again after the boy's 24th birthday. An overall appropriate adult functioning (AAF) score is obtained for each boy contacted. Because the attrition rate is very low, these data provide an opportunity to investigate the stability of treatment effects over time. A substantial attempt was made to investigate the possibility that mean group changes in AAF over time might be due to differential attrition effects. Two separate analyses indicated that an attrition effect was not a major influence in AAF score changes. AAF was relatively stable between the 2- and 5-year follow-ups and showed some improvement.

Adolescent↗
PubMed2005

Numerical dosimetry for cells under millimetre-wave irradiation using Petri dish exposure set-ups.

We carried out a numerical dosimetry study for in vitro experiments on millimetre-wave (MMW) biological effects on cells. The cell layers are cultured in 35 mm Petri dishes placed in the far-field region of a rectangular horn irradiator generating a 50.0 GHz continuous sinusoidal MMW. The finite-difference time-domain (FDTD) method and the second-order approximation of the absorbing boundary conditions (ABCs) are applied in calculating the specific absorption rate (SAR) in the cells. The 0.125 mm and 0.25 mm voxel models of the Petri dish are used. The permittivity and the conductivity of the cells and those of the culture medium are obtained with Debye's dispersion equation. We measured the power pattern of the irradiator using the plane wave expansion (PWE) method, and developed a program module to calculate the FDTD-compatible incident field from the irradiator, whose position and orientation are adjustable. The MMW multiple reflection between the Petri dish and the irradiator is evaluated before being neglected. For the single-dish, double-dish and quadruple-dish exposure set-ups, the SAR intensity and the SAR uniformity are analysed and compared. The meniscus effect on the SAR distribution over the cell layer is evaluated for the single-dish set-up. The influence of the Petri dish interaction on the SAR distribution is examined for the double-dish and quadruple-dish set-ups.

Animals↗
PubMed1984

Electromyographic analysis of selected muscles during sitting push-ups. Effects of position and sex.

The purpose of this study was to determine if differences in EMG activity of the latissimus dorsi, pectoralis major and triceps brachii occurred between muscles and between the 16 male and 16 female subjects performing push-ups from three different sitting positions. Surface electrodes and associated instrumentation recorded a linear envelope during seated push-ups performed 1) in a wheelchair, 2) in a long-sit position with elbows at 90 degrees, and 3) in a long-sit position with maximum elbow flexion and shoulder abduction. Results showed that women produced greater mean EMG activity than men in all muscles at all positions. Altering the exercise position did not have a consistent effect on level of activity recorded from either sex. The study concludes that use of these exercises should be based on a knowledge of the differences in muscle activity in exercise positions for men and women before treatment objectives can be effectively accomplished.

Adult↗
PubMed1989

Assessing the value of student case write-ups and write-up evaluations.

To investigate the attitudes of medical students concerning the educational value of case write-ups and write-up evaluations and the usefulness of write-up evaluations in assessing clinical skills, the author surveyed 140 students at McGill University after they had completed a 10-week clinical course in internal medicine. He also surveyed internal medicine course directors at the 16 Canadian medical schools to determine their assessments of write-up evaluation practices in their departments. There was broad agreement among the students and directors that case write-ups and their evaluations are useful for learning, but there were major concerns about the variability of the criteria and standards for evaluation. Recommendations are presented.

Attitude of Health Personnel↗
PubMed1998

Rectus abdominis rhabdomyolysis after sit ups: unexpected detection by bone scan.

Uptake of technetium-99m methylene diphosphonate by the rectus abdominis muscle was unexpectedly found in a 29 year old man who had started to perform 30 to 40 sit ups a day for five days before the bone scan. After a week of rest, serum creatine kinase activity was still abnormal but muscle uptake of technetium-99m methylene diphosphonate had ceased. This specific muscle injury after short term sit ups as well as the resolution of the phenomenon within a week are of interest.

Adult↗
PubMed2002

Association between the engagement of relatives in a behavioural group intervention for smoking cessation and higher quit rates at 6-, 12- and 24-month follow-ups.

OBJECTIVE: To assess the effectiveness of a behavioural group intervention for smoking cessation, which included as its most original feature the recommendation to participate with a relative or close friend. METHODS: A total of 1,060 subjects entered the programme, which consisted of 9 group sessions over a period of 5 weeks. The intervention consisted of a modified version of the Five-Day Plan, the main differences being the use of behavioural therapy techniques and small group work, and the addition of 4 weekly booster sessions. About two thirds of the participants came with a relative or close friend. Long-term abstinence from smoking was assessed with follow-up telephone interviews. RESULTS: Very few subjects were lost to follow-ups (9.2% at 6 months, 9.7% at 1 year, 10.8% at 2 years). The observed quit rates were 42.6% at 6 months, 35.5% at 1 year and 32% at 2 years. When considering as smokers all subjects who were lost to follow-ups, quit rates were also satisfactory (38.7% at 6 months, 32.1% at 1 year and 28.6% at 2 years). The main predictors of a good outcome were being male, smoking less than 20 cigarettes per day, having started smoking after 18 years of age, having made previous quitting attempts, not having a history of unsuccessful participation to smoking cessation interventions and attending the sessions with a relative or close friend. DISCUSSION: Although some limitations inherent in the design of our study suggest caution in interpreting the results and in making comparisons, the long-term effectiveness of the intervention was satisfactory. The inclusion of a relative or close friend appeared useful. This simple and inexpensive strategy may deserve recommendation, though in the future it should be tested in controlled trials.

Adolescent↗
PubMed2006

A prospective study of the impact of opening a casino on gambling behaviours: 2- and 4-year follow-ups.

OBJECTIVE: It is widely believed that the rate of pathological gambling is related to the accessibility and availability of gambling activities. Few empirical studies have yet been conducted to evaluate this hypothesis. Using a longitudinal prospective design, the current study evaluates the impact of a casino in Canada's Hull, Quebec region. METHOD: A random sample of respondents from Hull (experimental group) and from Quebec City (comparison group) completed the South Oaks Gambling Screen (SOGS) and gambling- related questions before the opening of the Hull Casino (pretest), 1 year after the opening (posttest), and on follow-up at Years 2 and 4. RESULTS: Although, 1 year after the opening of the casino, we did observe an increase in playing casino games and in the maximum amount of money lost in 1 day's gambling, this trend was not maintained over time (2- and 4-year follow-ups). In the Hull cohort, the rate of at-risk and probable pathological gamblers and the number of criteria on the SOGS did not increase at the 2- and 4-year follow-ups. The residents' reluctance to open a local casino was generally stable over time following the casino's opening. CONCLUSION: The discussion raises different explanatory factors and focuses on the context of the Regional Exposure Model as a potentially more applicable measure of studying the expansion of gambling.

Adolescent↗
PubMed2005

Subjective impact of osteoarthritis flare-ups on patients' quality of life.

BACKGROUND: Clinical trials on osteoarthritis (OA) flare-ups treatment usually focus only on objective measures of health status, albeit recent literature suggestions on the importance of patients' subjectivity. Aim of the study was to evaluate the effects of OA and of its different types of medical treatment(s) on Health Related Quality of Life (HRQoL) in terms of both subjective satisfaction and functional status. METHODS: An observational study on prospective data collected from the Evaluation of Quality of life in OA (EQuO) clinical trial (April 1999-November 2000) was conducted; outpatients from 70 participating centers (Orthopedy or Rheumatology Departments in Italy) with a diagnosis of OA of the hip or knee were consecutively enrolled. Patients were observed at OA flare-ups (baseline) and at follow up 4 weeks after treatment. Patients' objective and subjective HRQoL were assessed by means of the SF-36 and the Satisfaction Profile (SAT-P, which focuses on subjective satisfaction); Present Pain at baseline and Pain Relief at follow up were also evaluated. RESULTS: Among the 1323 patients, 1138 (86%) were prescribed one drug/treatment of osteoarthritis, 169 (13%) 2 drugs/treatments, and 16 (1%) 3 drugs/treatments; most of treatments involved the prescription of NSAIDs; non-coxib, COX2 selective NSAIDs were prescribed in about 50% of patients. Follow-up visits were performed after 29.0 days on average (+/- 7.69 SD). For all SF-36 domains, all SAT-P items and factors, the differences between baseline and follow up scores resulted statistically significant (p < 0.001), enlighting an improvement both in health status and in subjective HRQoL. CONCLUSION: Besides the classic health status measures, the assessment of patients' subjective satisfaction provides important clues on treatments efficacy of OA within the patient-centered medicine model. In clinical practice this could lead to a better doctor-patient communication and to higher levels of treatment adherence.

Aged↗
PubMed2006

Does the 'inverse screening law' apply to oral cancer screening and regular dental check-ups?

OBJECTIVE: Early detection through regular screening is a measure used in certain cancer prevention strategies. This approach has been advocated for the prevention of oral cancers in the UK. The objective of this study was to assess whether people at higher risk of oral cancer in the UK visit dentists on a regular basis, and thereby afford opportunities for oral cancer screening. METHODS: Data from two large national surveys were used. Firstly, data from the Health Survey for England, 2001, were used to assess the relationship between dental attendance (the outcome measure) and recognized oral cancer risk factors; there were 13,784 participants with complete data. We used known risk factors for oral cancer (age >40 years, male sex, alcohol intake >28 units per week, cigarettes >20 per day, and fruit and vegetables <5 times a day) to generate a risk score for oral cancer. Logistic regression was used to compute the odds ratios for regular dental attendance according to risk score. All analyses used education and social class as covariates. We also used data from the British Household Panel Survey to assess whether dental attendance behaviour is sustained over a set period of time (5,547 participants with complete data). RESULTS: In persons in the higher risk category (as defined above) of the five risk factors, age, sex, alcohol, smoking, and fruit/vegetables, 68%, 56%, 52%, 43% and 60%, respectively reported regular dental check-ups. In persons with 0, 1, 2, 3, 4 and 5 of these risk factors, the odds ratio for regular dental check-ups was 1.00, 0.93, 0.81, 0.64, 0.50 and 0.28, respectively. The probability of regular dental attendance was low in all groups with a higher risk of oral cancer. In the longitudinal sample, the low probability of visiting a dentist regularly was stable over time. CONCLUSION: Opportunistic screening for oral cancer in general dental practice in the UK is unlikely to be an effective preventive strategy.

Adult↗
PubMed2006

Effects of differential stretching protocols during warm-ups on high-speed motor capacities in professional soccer players.

The purpose of this study was to examine the effects of different modes of stretching within a pre-exercise warm-up on high-speed motor capacities important to soccer performance. Eighteen professional soccer players were tested for countermovement vertical jump, stationary 10-m sprint, flying 20-m sprint, and agility performance after different warm-ups consisting of static stretching, dynamic stretching, or no stretching. There was no significant difference among warm-ups for the vertical jump: mean +/- SD data were 40.4 +/- 4.9 cm (no stretch), 39.4 +/- 4.5 cm (static), and 40.2 +/- 4.5 cm (dynamic). The dynamic-stretch protocol produced significantly faster 10-m sprint times than did the no-stretch protocol: 1.83 +/- 0.08 seconds (no stretch), 1.85 +/- 0.08 seconds (static), and 1.87 +/- 0.09 seconds (dynamic). The dynamic- and static-stretch protocols produced significantly faster flying 20-m sprint times than did the no-stretch protocol: 2.41 +/- 0.13 seconds (no stretch), 2.37 +/- 0.12 seconds (static), and 2.37 +/- 0.13 seconds (dynamic). The dynamic-stretch protocol produced significantly faster agility performance than did both the no-stretch protocol and the static-stretch protocol: 5.20 +/- 0.16 seconds (no stretch), 5.22 +/- 0.18 seconds (static), and 5.14 +/- 0.17 seconds (dynamic). Static stretching does not appear to be detrimental to high-speed performance when included in a warm-up for professional soccer players. However, dynamic stretching during the warm-up was most effective as preparation for subsequent high-speed performance.

Acceleration↗
PubMedDate not supplied

Bootstrap finance: the art of start-ups.

Entrepreneurship is more popular than ever: courses are full, policymakers emphasize new ventures, managers yearn to go off on their own. Would-be founders often misplace their energies, however. Believing in a "big money" model of entrepreneurship, they spend a lot of time trying to attract investors instead of using wits and hustle to get their ideas off the ground. A study of 100 of the 1989 Inc. "500" list of fastest growing U.S. start-ups attests to the value of bootstrapping. In fact, what it takes to start a business often conflicts with what venture capitalists require. Investors prefer solid plans, well-defined markets, and track records. Entrepreneurs are heavy on energy and enthusiasm but may be short on credentials. They thrive in rapidly changing environments where uncertain prospects may scare off established companies. Rolling with the punches is often more important than formal plans. Striving to adhere to investors' criteria can diminish the flexibility--the try-it, fix-it approach--an entrepreneur needs to make a new venture work. Seven principles are basic for successful start-ups: get operational fast; look for quick break-even, cash-generating projects; offer high-value products or services that can sustain direct personal selling; don't try to hire the crack team; keep growth in check; focus on cash; and cultivate banks early. Growth and change are the start-up's natural environment. But change is also the reward for success: just as ventures grow, their founders usually have to take a fresh look at everything again: roles, organization, even the very policies that got the business up and running.

Capital Financing↗