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PubMed2004

DNA damage checkpoint maintenance through sustained Chk1 activity.

The G2 DNA damage checkpoint prevents mitotic entry in the presence of DNA damage. This requires the activation of the phosphoinositide-3-kinase-related protein kinases ATR and ATM in human cells and the ATR homologue Rad3 in the fission yeast Schizosaccharomyces pombe. Rad3 activates the effector protein kinase Chk1 by phosphorylation. However, in fission yeast, inactivation of Rad3 following checkpoint activation has no impact on checkpoint duration. This demonstrates that Rad3 is not required for checkpoint maintenance and that the processes of checkpoint initiation and maintenance are distinct. Chk1 is required for checkpoint initiation but its role in checkpoint maintenance has not been investigated. We show here that Chk1 kinase activity is rapidly induced following irradiation and is maintained for the duration of a checkpoint arrest. On entry to mitosis, there is a transient decrease in Chk1 activity and phosphorylation, but Chk1 activity remains higher than that observed in unirradiated cells. We have generated temperature-sensitive alleles of chk1, which phenocopy chk1 deletion at the non-permissive temperature. Using these alleles, we have shown that inactivation of Chk1 during a checkpoint arrest leads to premature checkpoint termination, resulting in catastrophic mitoses that are a hallmark of checkpoint failure. Therefore, unlike Rad3, Chk1 is an important determinant of both checkpoint initiation and maintenance.

Amino Acid Sequence↗
PubMed1988

Metabolic costs of growth and maintenance in the toad, Bufo bufo.

Metabolic costs of growth and maintenance were determined from the relationship M (metabolism) = m + nG (growth), where m is the metabolic rate at the feeding level at which growth is zero. In the past, the slope n was interpreted as indicating the metabolic costs of growth, and the costs of maintenance that arise with the increase in body mass were disregarded. These costs are included in n. In female toads, Bufo bufo, feeding at different rates, the uncorrected value of n was 0.44, when metabolism and growth were expressed as kJ kJ-1. After correction for increased metabolic maintenance expenditure with increased body mass, the value became 0.35, indicating that the physiological costs of growth were equivalent to about one-third of the body mass deposited. Metabolic costs of growth accounted for 80% of the increase in metabolism with growth, leaving 20% for costs of maintenance. At maximum growth rate the metabolic costs of growth amounted to about 60% of the total metabolism, total mass-specific metabolic rate being 2.5 times the rate at zero growth. The physiological costs of growth in young toads were compared with the costs in teleosts. Recalculation of published data on the relationship between metabolism and growth in the African catfish Clarias lazera indicated that the metabolic costs of growth amounted to about 28% of body mass deposited. The costs represented about 80% of the increase in metabolism with growth. The physiological costs of growth are several times higher than the net biochemical costs of synthesis of the macromolecules constituting the increase in body mass.

Animal Feed↗
PubMed1996

Maintenance of the K+ activity gradient in insect muscle compared in diptera and lepidoptera: contributions of metabolic and exchanger mechanisms

Using a comparative approach, the mechanisms involved in maintenance of the transmembrane K+ activity gradients in the larval body-wall muscles of two insects, Phormia terraenovae (Diptera) and Spodoptera exigua (Lepidoptera), have been investigated. Double-barrelled K+-selective microelectrodes were used to obtain simultaneous measurements of intracellular K+ activity and membrane potential, whilst ordinary microelectrodes were used to monitor input resistance. By application of a variety of general metabolic blockers, the K+ gradients in both P. terraenovae and S. exigua muscle were found to be maintained, at least in part, by a metabolic component. Differences in sensitivity to dinitrophenol of the two insects suggested that the ATP-dependence of maintenance of the K+ gradient was significantly higher in P. terraenovae than in S. exigua. Vanadate sensitivity suggested that both insects possess P-type ATPases. The K+ activity gradient in P. terraenovae muscles was also found to be ouabain-sensitive, indicating the involvement of a Na+/K+-ATPase. In contrast, the K+ gradient in S. exigua muscles proved to be totally insensitive to ouabain but sensitive to amiloride. Application of the H+/K+-ATPase-specific inhibitor SCH 28080 suggested the presence of an H+/K+ pump similar to the mammalian gastric H+/K+-ATPase in the lepidopteran muscles. P. terraenovae muscles, however, were found to be totally insensitive to this inhibitor. Using the anion (Cl-)-dependent transport inhibitors bumetanide and SITS (4-acetamide-4-isothiocyanostilbene-2,2-disulphonic acid), P. terraenovae muscles were shown not to possess a Cl--dependent K+ transport mechanism. In contrast, a bumetanide-sensitive K+/Cl- cotransporter was likely to be involved in maintenance of the K+ gradient in S. exigua muscle. An additional SITS-sensitive Cl-/HCO3- exchanger could also have some indirect involvement in K+ maintenance through regulation of the inward Cl- gradient. The results are integrated in two ionic models, one for each insect, which could account for the bulk of K+ transport in the body-wall muscles of these insects.

Journal Article↗
PubMed1998

[Hypoparathyroidism in maintenance dialysis patients (Pts)--a clinical study].

With the recent development of measurement in intact PTH, increases of hypoparathyroidism and adynamic bone disease have been reported in patients on chronic maintenance dialysis. To clarify the frequency of hypoparathyroidism in maintenance dialysis patients, the present study investigates the relationship between the occurrence of hypoparathyroidism and clinical background, several bone metabolic markers and the bone mineral density. We divided 298 maintenance dialysis patients (HD 270, CAPD 28) without parathyroidectomy into 4 groups based on intact PTH. Group A was absolutely hypo (intact PTH < 60 pg/ml), group B was relatively hypo (60 < or = intact PTH < 160), group C was normal (160 < or = intact PTH < 300), and group D was hyperparathyroidic (300 < or = intact PTH). Groups A and B together accounted for 71.8% of the patients. The mean age in groups A and B was higher than in group D (p < 0.05), and the dialysis duration was shorter (p < 0.01). The concentration of 1, 25 (OH)2D was significantly higher in groups A and B than in group D (p < 0.01), and remarkably higher in group A than in group C. The level of Ca, i-P did not differ among the groups. In our investigation of bone metabolic markers, group D was found to have significantly higher Al-p, intact-BGP, and P 1 PC compared with the other 3 groups (p < 0.01), and the concentration of intact BGP was lower in group A than in groups B and C (p < 0.01). The bone mineral density measured by DEXA did not differ among the groups. The results suggest that, due to multiple factors, the actual occurrence of hypoparathyroidism in maintenance dialysis patients is higher than the predicted occurrence.

Alkaline Phosphatase↗
PubMed1993

Reduction of AIDS risk among 41 heroin addicted female street prostitutes: effects of free methadone maintenance.

Interviews were previously conducted with 72 heroin-addicted female street prostitutes who spread HIV by sharing injection paraphernalia and engaging in unprotected sex with multiple male customers. Most were willing to enroll in free methadone maintenance if made available. Forty-one female addict-prostitutes subsequently entered free methadone maintenance. Twenty-five remained in treatment after one year. Their personal income from prostitution and other crime was reduced 58%; income from legal sources increased 86%. Total urinalyses positive for non-prescribed drugs decreased from 80% on admission to 51%. This pilot study validates the attraction of free methadone maintenance and concomitant reduction of illegal drug use and prostitution, two predictors of HIV infection. However, close supervision and effective counseling and rehabilitative services provided by better trained staff are required for successful outcomes among addict-prostitutes in methadone maintenance.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Cocaine abuse in methadone maintenance patients is associated with low serum methadone concentrations.

Cocaine abuse in methadone maintenance patients has emerged as a significant clinical problem. To determine if raising the daily methadone dosage is an effective way to eliminate cocaine abuse, 74 methadone maintenance patients maintained at daily dosages between 30 and 80 mg and who chronically abused cocaine were studied by a standard protocol. A total of 21 (28.4%) subjects ceased cocaine abuse when their methadone dosage was progressively raised to a maximal daily dose of 160 mg. Cocaine abuse appeared to accelerate elimination of methadone, since inadequate methadone serum concentrations (below 100 ng/ml) were found in 48 of 67 (71.6%) subjects tested 24 hours after a 100 mg oral methadone dose. Although cocaine abuse in methadone maintenance patients may respond to raising the daily methadone dosage, alternative treatments for cocaine abuse in methadone maintenance patients must be identified since cocaine abuse may lower serum methadone concentrations.

Adult↗
PubMedDate not supplied

Hydroxyurea plus didanosine as maintenance therapy for HIV-infected patients on long-term successful highly active antiretroviral therapy.

BACKGROUND: Toxicity and quality of life issues have moved to delay the initiation of highly active antiretroviral therapy (HAART) and to explore novel treatment strategies for HIV infection. The switch to simpler regimens or treatment discontinuation has been attempted with limited success. The combination of hydroxyurea (HU) plus didanosine (ddI) is a simple regimen that might be able to restrain virus replication for long periods of time and could be an acceptable option as maintenance therapy in patients on prolonged successful HAART. METHOD: The combination of HU (500 mg bid) plus ddI (400 mg qd) was offered to participants with viral load (VL) <50 HIV RNA copies/mL and CD4 counts >350 cells/microL for more than 6 months under HAART. The prior HAART regimen was resumed if VL rose to >5,000 copies/mL and/or the CD4 count fell to <200 cells/microL after being on HU + ddI maintenance therapy. RESULTS: A total of 187 participants replaced HAART with HU + ddI. In an intent-to-treat analysis at 48 weeks, 109 (58%) and 77 (41%) patients had VL below 5,000 and 500 HIV RNA copies/mL, respectively. The mean CD4 count dropped from 809 +/- 283 to 573 +/- 270 cells/microL, while 77% of patients remained above 350 cells/microL. The proportion of participants with hypercholesterolemia declined from 70% to 46% (p <.001), while those with hypertriglyceridemia fell from 36% to 21% (p <.05). Significant improvements in lipohypertrophy and lipoatrophy were observed in 52% and 64% of participants, respectively. Grade 3-4 toxicities appeared in 20 patients (11%), including 3 cases of pancreatitis and 1 of peripheral neuropathy. Prior history of VL >5 log, CD4 counts <200 cells/microL, and ddI experience were independently associated with lower response to HU + ddI maintenance therapy. CONCLUSION: The combination of HU + ddI may be a satisfactory maintenance therapy for more than half of patients on successful HAART who want to alleviate drug-related toxicities and/or pill burden. Patients with metabolic and/or body-shape abnormalities might particularly benefit from switching to this simple regimen.

Adult↗
PubMedDate not supplied

Long-term follow-up of a cohort of HIV-infected patients who discontinued maintenance therapy for cytomegalovirus retinitis.

PURPOSE: To determine the long-term safety of discontinuation of maintenance therapy for cytomegalovirus retinitis (CMVR) and to identify predictors for relapse. METHOD: This was a prospective cohort study. Patients with treated CMVR who responded to HAART were followed by ophthalmologic assessment, markers for CMV replication (blood and urine cultures, CMV antigenemia, CMV DNA by PCR), and in vitro lymphoproliferative responses to CMV and other antigens after discontinuation of CMVR maintenance therapy. RESULTS: 23 patients were followed a median of 34 (range, 5-61) months. Median CD4 count was 321/mm3 at enrollment and 395/mm3 at last follow-up. HIV RNA was <50 copies/mL in 78% of patients at enrollment and 65% at last follow-up. One CMVR reactivation occurred at 12 months at a CD4 count of 395/mm3 (21%) and HIV RNA <50 copies/mL. Urine cultures were a poor predictive marker for reactivation. Other CMV replication markers had good negative predictive value. 96% of patients had a good lymphoproliferative response to CMV antigen in vitro. CONCLUSION: Maintenance therapy for CMVR can safely be discontinued in patients who have responded to HAART. Combining our results with the published literature, the risk of reactivation is estimated at 0.016 per person year of follow-up. Markers to predict relapse and the need for re-initiation of maintenance therapy are not yet identified.

AIDS-Related Opportunistic Infections↗
PubMed2003

[Relapse in depressive disorders--is there a need for maintenance psychotherapy? ].

OBJECTIVES: Patients with depressive disorders who enroll in typical short-term clinical studies have a high risk of early relapse (30-70 %) and chronicity (ca. 20 %). Factors which contribute to this risk are residual symptoms at termination, previous recurrent episodes, chronic stress, etc. Pharmacological strategies offer a multitude of means of relapse prevention, while in psychotherapeutic interventions there is a dearth of such recommendations. Studies on relapse-preventing continuous contacts (maintenance therapy), for example, are very rare. METHODS: We present empirical data on risk factors for early relapse and chronic course in depressive disorders together with general strategies for relapse prevention. Results of controlled studies with maintenance psychotherapy will then be reported. RESULTS: Psychotherapeutic maintenance strategies have been shown to be successful in several controlled studies. Furthermore, recent studies show typical moderating mechanisms for better resilience against stressors in formerly depressed patients. The typical setting under study was monthly sessions over a period of at least 8 months and up to three years. In case of severe risk factors continuous pharmacotherapy also has to be taken into consideration. DISCUSSION: The issue is discussed in respect to differential indication (primarily long-term therapy vs. a rather quick change to maintenance contacts of low frequency). Moreover, the ethical questions of inadequate dependency as well as the clinical aspects of transference-countertransference dynamics are viewed.

Antidepressive Agents↗
PubMed2005

Knowledge accessibility, achievement goals, and memory strategy maintenance.

BACKGROUND: An important aim of educational psychology is to account for the difficulties in cognitive strategy maintenance. Possible explanations may be found in developmental studies concerning the interdependence of knowledge accessibility and strategy use, and in current achievement goal models which assume that individuals with a learning goal use deeper strategies than those with a performance goal. AIMS: The purpose of this study was to examine how knowledge accessibility and achievement goals separately or conjointly affect the maintenance of a categorization strategy, recall performance, and perception of the strategy (utility, difficulty, effort) in a free recall task. SAMPLE: Participants were 93 first-year students from a human science university in France. METHOD: In the first phase, the students were taught how to use a categorization strategy in a recall task involving highly accessible (typical) items. In a subsequent transfer task, the same students were assigned to one of four experimental conditions where they were asked to recall a typical or atypical list and where a learning or performance goal was induced. RESULTS: Analysis showed that whatever the typicality of the list, a learning goal promoted maintenance of the categorization strategy, and of perception of its utility. Performance goal participants only maintained this strategy and its perceptions on typical lists, while on atypical lists they display less clustering and found the strategy less useful. CONCLUSION: Results suggest that maintenance of a cognitive strategy is facilitated when there is compatibility between a performance goal and the task demands, or when the participants are learning-goal oriented.

Achievement↗
PubMed2002

Infusion of maintenance fluids with glucose (Veen 3G) is superior to maltose infusion (Actit) in the rate of energy utilization in rabbits.

In the present study, we examined the rates of urinary excretion of glucose and maltose after an infusion of maintenance fluid with glucose or maltose in adult rabbits. Three maintenance fluids (sugar-free, 5% glucose [Veen 3G] and 5% maltose [Actit]), which contained different sugars but were identical in electrolyte and acetate compositions and concentrations (Na: 45, K: 17, Mg: 5, Cl: 37, H2PO4: 10 and CH3COO: 20 mEq/l), were used in this study. In addition, the optimum infusion speed for maintenance therapy (10 ml/kg/h) was used. Animals were not given food or water during the 10-day period of administration. The body weights of the animals were measured every day. The concentrations of total protein, albumin, free fatty acids and glucose in the serum were measured. Urine samples for determination of glucose and maltose concentrations were collected from the 1st to 10th administrations. After infusion with 5% maltose, urinary maltose excretion decreased time-dependently, while that of glucose increased. This suggests that maltase activity time-dependently increases after infusion with maltose. In addition, total sugar was only minimally excreted into urine in the 5% glucose group compared with the 5% maltose group. Thus, the glucose infusion was superior to the maltose infusion in the rate of energy utilization. However, neither the loss of body weight nor the increase in concentration of free fatty acids in serum differed significantly among the 3 groups. In conclusion, infusion of maintenance fluid with 5% maltose results in the excretion of maltose and glucose into urine, since enzymatic hydrolysis of maltose to glucose is limited to that by maltase.

Analysis of Variance↗
PubMed2005

Gamma-herpesvirus latency requires T cell evasion during episome maintenance.

The gamma-herpesviruses persist as latent episomes in a dynamic lymphocyte pool. Their consequent need to express a viral episome maintenance protein presents a potential immune target. The glycine-alanine repeat of the Epstein-Barr virus episome maintenance protein, EBNA-1, limits EBNA-1 epitope presentation to CD8(+) T lymphocytes (CTLs). However, CTL recognition occurs in vitro, so the significance of such evasion for viral fitness is unclear. We used the murine gamma-herpesvirus-68 (MHV-68) to define the in vivo contribution of cis-acting CTL evasion to host colonisation. Although the ORF73 episome maintenance protein of MHV-68 lacks a glycine-alanine repeat, it was equivalent to EBNA-1 in conferring limited presentation on linked epitopes. This was associated with reduced protein synthesis and reduced protein degradation. We bypassed the cis-acting evasion of ORF73 by using an internal ribosome entry site to express in trans-a CTL target from the same mRNA. This led to a severe, MHC class I-restricted and CTL-dependent reduction in viral latency. Thus, despite MHV-68 encoding at least two trans-acting CTL evasion proteins, cis-acting evasion during episome maintenance was essential for normal host colonisation.

Animals↗
PubMed2005

Warfarin maintenance dosing patterns in clinical practice: implications for safer anticoagulation in the elderly population.

BACKGROUND: The use of anticoagulant therapy is expanding among the elderly population, in part because of the increasing prevalence of atrial fibrillation. Published data describing the warfarin maintenance dose requirements for this age group are limited. Because warfarin therapy is often initiated in the outpatient setting where significant barriers to daily monitoring exist for this patient population, a better understanding of the factors that predict lower dose requirements may reduce the risk of unanticipated over-anticoagulation and hemorrhage. OBJECTIVE: To define the effects of age and gender on the warfarin maintenance dose among ambulatory adult patients with an international normalized ratio target between 2.0 and 3.0. DESIGN: Prospective cohort study and retrospective cohort secondary data source. SETTING: One hundred one community-based physician practices with dedicated warfarin management systems and an academic medical center anticoagulation clinic. PATIENTS: A total of 4,616 patients comprised the prospective cohort, and 7,586 patients comprised the retrospective cohort. Of the 12,202 patients, 2,359 were > or = 80 years of age. MEASUREMENTS: Median weekly and daily maintenance warfarin dose. RESULTS: The warfarin dose was inversely related to age and was strongly associated with gender. The median weekly dose ranged from 45 mg (6.4 mg/d) for men who were < 50 years of age to 22 mg (3.1 mg/d) for women > or = 80 years of age. The weekly dose declined by 0.4 mg/yr (95% confidence interval [CI], 0.37 to 0.44; p < 0.001) and women required 4.5 mg less per week than men (95% CI, 3.8 to 5.3; p < 0.001). Among patients who were > 70 years of age, the often-suggested initiation dose of 5 mg/d will be excessive for 82% of women and 65% of men. CONCLUSIONS: Warfarin dose requirements decrease greatly with age. Older women require the lowest warfarin doses. These observations suggest that, when warfarin is being initiated, the commonly employed empiric starting dose of 5 mg/d will lead to over-anticoagulation for the majority of patients in the geriatric age group; lower initiation and maintenance doses should be considered for the elderly.

Adult↗
PubMed2002

Maintenance of spermatogenesis in hypogonadotropic hypogonadal men with human chorionic gonadotropin alone.

OBJECTIVE: It is generally accepted that both gonadotropins LH and FSH are necessary for initiation and maintenance of spermatogenesis. We investigated the relative importance of FSH for the maintenance of spermatogenesis in hypogonadotropic men. SUBJECTS AND METHODS: 13 patients with gonadotropin deficiency due to idiopathic hypogonadotropic hypogonadism (IHH), Kallmann syndrome or pituitary insufficiency were analyzed retrospectively. They had been treated with gonadotropin-releasing hormone (GnRH) (n=1) or human chorionic gonadotropin/human menopausal gonadotropin (hCG/hMG) (n=12) for induction of spermatogenesis. After successful induction of spermatogenesis they were treated with hCG alone for maintenance of secondary sex characteristics and in order to check whether sperm production could be maintained by hCG alone. Serum LH, FSH and testosterone levels, semen parameters and testicular Volume were determined every three to six Months. RESULTS: After spermatogenesis had been successfully induced by treatment with GnRH or hCG/hMG, hCG treatment alone continued for 3-24 Months. After 12 Months under hCG alone, sperm counts decreased gradually but remained present in all patients except one who became azoospermic. Testicular Volume decreased only slightly and reached 87% of the Volume achieved with hCG/hMG. During treatment with hCG alone, FSH and LH levels were suppressed to below the detection limit of the assay. CONCLUSION: Once spermatogenesis is induced in patients with secondary hypogonadism by GnRH or hCG/hMG treatment, it can be maintained in most of the patients qualitatively by hCG alone, in the absence of FSH, for extended periods. However, the decreasing sperm counts indicate that FSH is essential for maintenance of quantitatively normal spermatogenesis.

Adult↗
PubMed2004

Decrease of CD4+ and B-lymphocyte populations is not associated with severe infectious complications in children with acute lymphoblastic leukemia during maintenance.

The suppression of lymphopoiesis and immune competence during the maintenance phase in children with acute lymphoblastic leukemia (ALL) and the occurrence of infectious complications remain an unexplored area. In this study we assessed lymphocyte subpopulation disturbances during maintenance for childhood ALL along with the incidence, type, and severity of infections that occur during that period in the absence of neutropenia. Twenty-eight children (13 boys, 15 girls) with ALL aged 3-14 years (median 7 years) and treated according to the ALL-BFM 90/95 protocol were studied during maintenance for ALL. Complete white blood cell (WBC) counts and peripheral blood lymphocyte (PBL) analyses were performed. Major lymphocyte subsets (CD19+, CD3+CD4+, CD3-CD8+, CD3-CD16+CD56+, CD45RA-, CD45RO+) and markers of T-cell activation (CD25, CD38, CD69, HLA-DR) were analyzed with flow cytometry. Serum immunoglobulin G (IgG), IgA, and IgM levels were measured by a nephelometric assay. All infectious episodes during the study period were recorded in detail. Additionally, 41 age-matched immunocompetent children were used as controls. Absolute WBC counts (median, 3627/microL) and PBL counts (median, 1206/microL) were significantly below the age-adjusted control values (7400/microL and 2673/microL, respectively; P < .0001). B-lymphocyte, total CD4+, and memory CD4+ (CD4+CD45RO+) subsets were also significantly decreased (33/microL versus 377/microL [P < .0001], 531/microL versus 1045/microL [P < .01], and 80/microL versus 299/microL [P < .001], respectively). Significantly lower immunoglobulin levels were found in all patients. Twenty-two of the 28 patients presented with 74 episodes of a variety o minor infections (mostly respiratory viral [39], skin [7], and gastrointestinal [3]), none demanding prolonged hospital treat ment. Our findings demonstrate a profound immunosuppression throughout maintenance therapy in children with ALL tha has no major clinical impact in terms of increased incidence or severity of systemic infections.

Adolescent↗
PubMedDate not supplied

Long-term maintenance of hematopoietic stem cells does not require contact with embryo-derived stromal cells in cocultures.

We recently established that two midgestation-derived stromal clones--UG26-1B6, urogenital ridge-derived, and EL08-1D2, embryonic liver-derived--support the maintenance of murine adult bone marrow and human cord blood hematopoietic repopulating stem cells (HSCs). In this study, we investigate whether direct HSC-stroma contact is required for this stem cell maintenance. Adult bone marrow ckit+ Ly-6C- side population (K6-SP) cells and stromal cells were cocultured under contact or noncontact conditions. These experiments showed that HSCs were maintained for at least 4 weeks in culture and that direct contact between HSCs and stromal cells was not required. To find out which factors might be involved in HSC maintenance, we compared the gene expression profile of EL08-1D2 and UG26-1B6 with four HSC-nonsupportive clones. We found that EL08-1D2 and UG26-1B6 both expressed 21 genes at a higher level, including the putative secreted factors fibroblast growth factor-7, insulin-like growth factor-binding proteins 3 and 4, pleiotrophin, pentaxin-related, and thrombospondin 2, whereas 11 genes, including GPX-3 and HSP27, were expressed at a lower level. In summary, we show for the first time long-term maintenance of adult bone marrow HSCs in stroma noncontact cultures and identify some secreted molecules that may be involved in this support.

Animals↗
PubMed1981

Toward a methodology of withdrawal designs for the assessment of response maintenance.

Single-case experimental designs have advanced considerably in the evaluation of functional relationships between interventions and behavior change. The systematic investigation of response maintenance once intervention effects have been demonstrated has, however, received relatively little attention. The lack of research on maintenance may stem in part from the paucity of design options that systematically evaluate factors that contribute to maintenance. The present paper discusses three design options potentially useful for the investigation of response maintenance. These include: (a) the sequential-withdrawal, (b) the partial-withdrawal, and (c) the partial-sequential withdrawal designs. Each design is illustrated and potential limitations are discussed.

Behavior Therapy↗
PubMed1982

Oral hygiene and maintenance of periodontal support.

The role of personal plaque control in periodontal maintenance care was studied in 78 patients who had undergone periodontal therapy and were on 3-month recall for prophylaxis over 8 years. Variations in pocket depth and attachment levels were related to individuals with plaque scores above and below the median. The results also were analyzed by comparing the 25% of the sample having the lowest plaque scores with the 25% having the highest scores over 7 years of maintenance care. Students t test was used. It was found that personal oral hygiene as expressed in plaque scores was not critical for maintenance of post-treatment pocket depth and attachment levels in patients with professional tooth cleaning every 3 months. The initial post-treatment reductions in pocket depth and variations in attachment levels were more favorable in patients with good than with poor oral hygiene, but, these differences were not significant after 3 to 4 years of maintenance care.

Dental Plaque↗