bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermal imaging of ultrasonic scaler tips during tooth instrumentation
Authors: Lea Simon C. , Landini Gabriel , Walmsley A.Damien 
Published: April 2004

AbstractObjectives: During ultrasonic scaling procedures, contact of the scaler tip with the tooth surface will produce frictional heating. The aim of this study was to assess this heat generation using an Agema 900 thermal imaging system.Materials and Methods: Both the Cavitron sustained performance system (SPS) with TFI‐3 tip and the Mini Piezon with P‐tip were tested. Handpieces were fixed with their sides facing the thermal camera and thermal image sequences or “movies” created. Measurements were performed with tips under loads of 25, 50 and 100 g, at water flow rates of 10, 20 and 40 ml/min and low, medium and high generator power settings. A measurement point was superimposed on the resulting thermal images at the tip/tooth contact site and the temperature variation with time recorded.Results: All combinations of instrumentation produced an increase in temperature. An increase in temperature was generally observed with increasing load (for given power/water), power setting (for given load/water) and a decrease in water flow rate (for given load/power).Conclusion: Heat generation is minimised by using low/medium power settings and light contact. Care must be taken to ensure adequate water is present at the site of instrumentation to prevent patient discomfort due to excessive heating.
The association of gingivitis and periodontitis with ischemic stroke
Authors: Dörfer Christof E. , Becher Heiko , Ziegler Christoph M. , Kaiser Claudia , Lutz Rainer , Jörß Daniela , Lichy Christoph , Buggle Florian , Bültmann Stefan , Preusch Michael , Grau Armin J. 
Published: April 2004

AbstractObjectives:The aim of this study was to assess the associations of different periodontal parameters with cerebral ischemia.Methods:In a case–control study, 303 consecutive patients with ischemic stroke or transient ischemic attack, and 300 representative population controls received a complete clinical and radiographic dental examination. Patients were examined on average 3 days after ischemia. The individual mean clinical attachment loss measured at four sites per tooth was used as indicator variable for periodontitis.Results:Patients had higher clinical attachment loss than population (p<0.001). After adjustment for age, gender, number of teeth, vascular risk factors and diseases, childhood and adult socioeconomic conditions and lifestyle factors, a mean clinical attachment loss >6 mm had a 7.4 times (95% confidence interval 1.55–15.3) a gingival index >1.2 a 18.3 times (5.84–57.26) and a radiographic bone loss a 3.6 times (1.58–8.28) higher risk of cerebral ischemia than subjects without periodontitis or gingivitis, respectively.Conclusion:Periodontitis is an independent risk factor for cerebral ischemia and acute exacerbation of inflammatory processes in the periodontium might be a trigger for the event of cerebral ischemia.
Childhood abuse and risk of smoking onset
Authors: Nichols H B , Harlow B L 
Published: April 2004

Study objective:To determine the association between childhood abuse and becoming a smoker.Design:Retrospective cohort study.Setting:Boston, Massachusetts.Participants:722 women aged 36–45 years who completed the baseline questionnaire for the Harvard study of moods and cycles and the survey of interpersonal relationships.Main results:Women who experienced either physical or sexual abuse as a child were 40% more likely to begin smoking compared with women with no history of abuse (95% CI 1.0 to 2.0). Virtually all of this association was confined to sexual abuse (OR = 2.2, 95% CI 1.1 to 4.3) as compared with physical abuse (OR = 0.7, 95% CI 0.7 to 1.6). However, the joint effect of experiencing both physical and sexual abuse as a child led to a 3.5-fold increase in the likelihood of becoming a smoker (95% CI 1.3 to 9.4) compared with women who did not experience any childhood abuse after adjustment for religion, social class, and poverty.Conclusions:Women who experience childhood abuse, even in the absence of depression, are at increased risk of becoming cigarette smokers.
A framework for modelling differences in regional mortality over time
Authors: Lix L M , Ekuma O , Brownell M , Roos L L 
Published: April 2004

Study objective:To present a conceptual framework for testing differences in mortality for small geographical areas over time using the generalised linear model with generalised estimating equations. This framework can be used to test whether the magnitude of regional inequalities in health status has changed over time.Design:A Poisson regression model for correlated data is used to investigate the relation of population health status to demographic, geographical, and temporal explanatory variables. Differences between regions at one or more points in time are tested with linear contrasts.Setting and participants:A case example shows the application of the framework. All cause mortality and cause specific mortality were compared for three rural regions of Manitoba, Canada between 1985 and 1999. The data were obtained from Vital Statistics records and the provincial health registry.Main results:Tests of linear contrasts on the regression coefficients for time and region show an increase in the magnitude of the difference in the risk of all cause mortality and heart disease mortality between northern and southern regions of the province for the 1985–1989 and 1995–1999 time periods. No significant differences are identified for cancer, injury, or respiratory disease mortality.Conclusions:The proposed framework enables testing of a variety of hypotheses about differences between regions and time periods and can be applied to other measures of population health status.
Is perceived failure in school performance a trigger of physical injury? A case-crossover study of children in Stockholm County
Authors: Laflamme L , Engström K , Möller J , Hallqvist J 
Published: April 2004

Objectives:To investigate whether perceived failure in school performance increases the potential for children to be physically injured.Subjects:Children aged 10–15 years residing in the Stockholm County and hospitalised or called back for a medical check up because of a physical injury during the school years 2000–2001 and 2001–2002 (n = 592).Methods:A case-crossover design was used and information on potential injury triggers was gathered by interview. Information about family socioeconomic circumstances was gathered by a questionnaire filled in by parents during the child interview (response rate 87%).Results:Perceived failure in school performance has the potential to trigger injury within up to 10 hours subsequent to exposure (relative risk = 2.70; 95% confidence intervals = 1.2 to 5.8). The risk is significantly higher among pre-adolescents and among children from families at a higher education level.Conclusions:Experiencing feelings of failure may affect children’s physical safety, in particular among pre-adolescents. Possible mechanisms are perceptual deficits and response changes occasioned by the stress experienced after exposure.
Avoidable mortality among child welfare recipients and intercountry adoptees: a national cohort study
Authors: Hjern A , Vinnerljung B , Lindblad F 
Published: April 2004

Objective:To compare rates of avoidable mortality in adolescence in child welfare recipients and intercountry adoptees with the general population.Design:A register study of the entire national cohort of 989 871 Swedish residents born 1973–82 in the national census of 1990. Multivariate Cox analyses of proportional hazards were used to analyse avoidable deaths between 13 to 27 years of age during 1991–2000.Participants:12 240 intercountry adoptees, 6437 foster children, 15 868 subjected to other forms of child welfare interventions, and the remaining 955 326 children in the cohort.Results:Intercountry adoptees had a high sex and age adjusted relative risk (RR) for suicide death only (RR 3.5; 95% CI 2.3 to 5.0) in comparison with the general population, while foster children and adolescents who had received other kinds of child welfare interventions had high sex and age adjusted RRs for suicide death; 4.3 (2.8 to 6.6) and 2.7 (1.9 to 3.9) respectively, as well as for other avoidable deaths; RRs 2.5 (1.6 to 3.7) and 2.8 (2.1 to 3.6). The RRs of avoidable deaths for foster children and other child welfare recipients decreased considerably when compared with youth brought up in homes with similar psychosocial characteristics as their original home.Conclusion:Children in substitute care in early childhood were at particular risk for suicide death in adolescence and young adulthood. Child welfare interventions were insufficient to prevent excess deaths in children at risk.
The ethics of research related to health care in developing countries
Authors: McMillan J R , Conlon C 
Published: April 2004

A report by the Nuffield Council on Bioethics, contrary to the Declaration of Helsinki, permits most important research initiatives in developing countries.The Ethics of Research Related to Health Care in Developing Countries by the Nuffield Council on Bioethics makes a number of innovative recommendations that depart from codes such as the Declaration of Helsinki. It recommends that standards of care might be relativised to the standard of that nation. It recommends that very good reasons need to be given for not giving post-trial access to medications but recognises that there may be justifiable instances of this. It is the view of the authors that these and other recommendations of the report are sensible pieces of advice given the complexities of the developing world.
Are patient information leaflets contributing to informed consent for cataract surgery?
Authors: Brown H , Ramchandani M , Gillow J T , Tsaloumas M D 
Published: April 2004

Aim:To assess, against a checklist of specific areas of required information and using standard published criteria, to what extent leaflets given before cataract surgery provided patients with enough information to give adequately informed consent.Method:Twelve ophthalmology departments in the West Midlands region were asked to submit the cataract information leaflets given to their patients at the preoperative assessment for analysis. Using criteria published by the General Medical Council, British Medical Association, and Medical Defence Union the leaflets were assessed for their contribution to informed consent for patients considering cataract surgery. Leaflets were scored according to the information they provided on: diagnosis, prognosis, treatment options, costs to the patient, details about the procedure, its purpose, likely benefits, how to prepare for it, what to expect during and after the operation, and the common as well as serious complications that may occur. The readability of the information was also assessed.Results:All the units’ leaflets provided information on diagnosis, the lifestyle changes required postoperatively, and cost involved to the patient. Only five units had leaflets that mentioned the risks involved in cataract surgery. The other areas of information were covered by 50–75% of the leaflets. Fifty per cent of the leaflets included a diagram. The average SMOG readability score was high.Conclusion:Although present cataract information leaflets make some contribution to the process of informed consent, most do not address important areas outlined by the General Medical Council. Many of the areas of information that are required for informed consent could easily be covered, and should be borne in mind when designing patient information leaflets. Resources are available on the internet including toolkits, guides, and means of assessment for the production of patient information leaflets.
Should research samples reflect the diversity of the population?
Authors: Allmark P 
Published: April 2004

Recent research governance documents say that the body of research evidence must reflect population diversity. The response to this needs to be more sophisticated than simply ensuring minorities are present in samples.For quantitative research looking primarily at treatment effects of drugs and devices four suggestions are made. First, identify where the representation of minorities in samples matters—for example, where ethnicity may cause different treatment effects. Second, where the representation of a particular group matters then subgroup analysis of the results will usually be necessary. Third, ensuring representation and subgroup analysis will have costs; deciding on whether such representation is worthwhile will involve cost benefit analysis. Fourth, the representation of minorities should not be seen as mainly a locality issue.For qualitative research it is argued that the representation of diversity is often important. Given the small samples of many qualitative projects, however, the best way to ensure representation occurs is to allow a proliferation of such research, not to stipulate such representation in samples.
Coordinating the norms and values of medical research, medical practice and patient worlds—the ethics of evidence based medicine in orphaned fields of medicine
Authors: Vos R , Willems D , Houtepen R 
Published: April 2004

Evidence based medicine is rightly at the core of current medicine. If patients and society put trust in medical professional competency, and on the basis of that competency delegate all kinds of responsibilities to the medical profession, medical professionals had better make sure their competency is state of the art medical science. What goes for the ethics of clinical trials goes for the ethics of medicine as a whole: anything that is scientifically doubtful is, other things being equal, ethically unacceptable. This particularly applies to so called orphaned fields of medicine, those areas where medical research is weak and diverse, where financial incentives are lacking, and where the evidence regarding the aetiology and treatment of disease is much less clear than in laboratory and hospital based medicine. Examples of such orphaned fields are physiotherapy, psychotherapy, medical psychology, and occupational health, which investigate complex syndromes such as RSI, whiplash, chronic low back pain, and chronic fatigue syndrome.It appears that the primary ethical problem in this context is the lack of attention to the orphaned fields. Although we agree that this issue deserves more attention as a matter of potential injustice, we want to argue that, in order to do justice to the interplay of heterogeneous factors that is so typical of the orphaned fields, other ethical models than justice are required. We propose the coordination model as a window through which to view the important ethical issues which relate to the communication and interaction of scientists, health care workers, and patients.
The direction of mental health care for the elderly
Authors: Barker A 
Published: April 2004

Abstract
The way that mental health care for older people is developing in the UK is being shaped by a number of factors. These include demographic shifts, changes in the general population’s attitudes to health, alterations in professional practice, governmental policy, and medical and technological advances. This article summarises some key aspects of these changes and predicts the likely direction of growth of mental health services in response.
Use of diuretics in cardiovascular diseases: (1) heart failure
Authors: Shah S U , Anjum S , Littler W A 
Published: April 2004

Abstract
Diuretics are used extensively in hospitals and in community medical practice for the management of cardiovascular diseases. They are used frequently as the first line treatment for mild to moderate hypertension and are an integral part of the management of symptomatic heart failure. Although diuretics have been used for several decades, there is still some ambiguity and confusion regarding the optimal way of using these common drugs. In this paper, the classes and action of diuretics are reviewed, and the various indications, optimal doses, and recommendations on the effective use of these agents are discussed.
Effect of maternal antibiotics on breast feeding infants
Authors: Mathew J L 
Published: April 2004

Abstract
Antibiotic usage is fairly common among breastfeeding mothers and there is potential for transfer to infants through breast milk. While most medicines taken by lactating women cause no harm to their babies, at times it can result in serious consequences. This article reviews the principles governing tranfer of maternal antibiotics to breast milk, its clinical significance, and ways to minimise inadvertent infant exposure.
Can an information booklet on an ethnic minority increase the knowledge base of junior doctors?
Authors: Ward B , de Chazal P , Mayberry J F 
Published: April 2004

Abstract
Many doctors encounter people of different cultural backgrounds for the first time as patients. In Leicester a significant proportion of the area’s population comes from a Gujarati and Hindu background. In an attempt to better inform junior doctors about the views and beliefs of their patients, a group of clinicians and administrators developed an information booklet about the beliefs and practices of people from this community. The impact of this booklet on a group of 54 junior doctors’ knowledge was investigated over a period of one month. Such an information booklet was found to significantly increase awareness of the cultural background of patients from a minority community and this knowledge was maintained for at least one month after distribution. The study did not investigate impact on attitudes.
Effects of Amphetamine on Immune-Mediated Lung Inflammatory Response in Rats
Authors: Ligeiro-Oliveira A.P. , Fialho de Araújo A.M. , Lazzarini R. , Silva Z.L. , De Nucci G. , Muscará M.N. , Tavares de Lima W. , Palermo-Neto J. 
Published: April 2004

<i>Objective:</i> The present study analyzed the effects of acute amphetamine (AMPH) treatment on immune-mediated lung inflammatory response in rats. <i>Methods:</i> There were four experiments. In the first and second experiments, rats were treated with AMPH (1 mg/kg) or 0.9% NaCl, and locomotor activity (experiment 1) and serum AMPH concentrations (experiment 2) were measured 1 or 12 h after treatment. In the third experiment, rats which were immunized with ovalbumin (OVA) were treated 14 days later with 0.9% NaCl or AMPH (1 mg/kg). Twelve hours after these treatments, all animals were submitted to challenge by 1% OVA inhalation being analyzed afterwards for bronchoalveolar lavage fluid (BAL), peripheral blood and bone marrow cellularity. In the fourth and final experiment, rats were treated and studied as for experiment 3, except that half of the animals within each group were previously treated with metyrapone prior to the OVA challenge. <i>Results:</i> In the non- immunized rats, AMPH treatment induced an increase in locomotor activity synchronized to high serum AMPH concentrations 1 h after, but not 12 h after treatment. In OVA-challenged rats, AMPH treatment decreased the total number of inflammatory cells, recovered in both BAL and peripheral blood and increased the total number of bone marrow cells. These effects, observed 1 day after OVA challenge, were abrogated by previous metyrapone treatment. <i>Conclusion:</i> AMPH treatment changed HPA-axis responsiveness to the stress condition imposed by the OVA challenge decreasing lung and blood leukocytes cellularity most probably via corticosterone actions on bone marrow activity.
Role of Urinary Zinc and Copper on Calcium Oxalate Stone Formation
Authors: Ozgurtas Taner , Yakut Gurer , Gulec Mahir , Serdar Muhittin , Kutluay Turker 
Published: April 2004

<i>Introduction:</i> It is considered that many factors may play a role in urolithiasis. Experimental and clinical studies have shown that zinc has an inhibitory effect on urolithiasis. <i>Materials and Methods:</i> In this study, urinary zinc and copper were measured in 27 healthy controls and 30 calcium oxalate stone formers. <i>Results:</i> Urinary zinc excretion was significantly higher (p < 0.001) in stone formers than healthy controls (2,575 ± 274 and 960 ± 80 mg/day, respectively). There was no significant difference in urinary copper excretion between healthy controls and stone formers (32.3 ± 3.5 and 33.3 ± 3.2 µg/day, respectively). <i>Conclusions:</i> According to our results, the potent inhibitory effect of urinary zinc excretion on urolithiasis could be reviewed.
Serum Bactericidal Activity of Piperacillin/Tazobactam against <i>Staphylococcus aureus</i>, Piperacillin-Susceptible and Piperacillin-Resistant <i>Escherichia coli</i> and <i>Pseudomonas aeruginosa</i>
Authors: Lemmen S.W. , Zolldann D. , Klik S. , Lütticken R. , Kümmerer K. , Häfner H. 
Published: April 2004

<i>Background:</i> The serum bactericidal test measures the highest level of an antibiotic-containing serum dilution at which 99.9% of bacteria are killed. In this study the serum bactericidal activity of piperacillin/tazobactam was determined for bacteria often involved in severe infections. In earlier studies titres ≧1:8 in the serum bactericidal tests correlated well with clinical success in the treatment of endocarditis and osteomyelitis as well as bacterial eradication. <i>Methods:</i> Blood samples of 6 healthy volunteers were taken before and 1 and 4 h after piperacillin/tazobactam (4.5 g) administration. Serum concentrations and serum bactericidal activity were determined for 10 strains each of <i>Staphylococcus aureus</i>, <i>Pseudomonas aeruginosa</i> and <i>Escherichia coli</i>, both piperacillin-resistant and piperacillin-susceptible according to NCCLS guidelines. <i>Results:</i> 100% of <i>S. aureus</i> and piperacillin-susceptible <i>E. coli</i>, 90% of piperacillin-resistant <i>E. coli</i> and 80% of <i>P. aeruginosa</i> were killed 1 h after drug administration. 4 h after drug administration serum bactericidal activity decreased to 60% for <i>S. aureus</i>, 90% for piperacillin-susceptible <i>E. coli</i>, 80% for piperacillin-resistant <i>E. coli</i> and 30% for <i>P. aeruginosa</i>. <i>Conclusions:</i> Excellent serum bactericidal activity of piperacillin/tazobactam was recorded 1 h after drug administration for <i>S. aureus</i>, <i>E. coli</i> and <i>P. aeruginosa</i>. After 4 h limited killing rates for <i>P. aeruginosa</i> could be detected, which supports the idea of a combination therapy.
Critical Role of Platelet P-Selectin in the Response to Arterial Injury in Apolipoprotein-E–Deficient Mice
Authors: Manka David , Forlow S. Bradley , Sanders John M. , Hurwitz Debra , Bennett Daniel K. , Green Samuel A. , Ley Klaus , Sarembock Ian J. 
Published: April 2004

Objective—Mice deficient in apolipoprotein-E (apoE−/−) experience severe hypercholesterolemia that is exacerbated by a high-fat Western-type diet and atherosclerotic lesions spontaneously develop. In addition, we have reported that deficiency of P-selectin dramatically protects against neointimal lesion formation after arterial injury in apoE−/−mice. To define the mechanism, bone marrow transplantation (BMT) after lethal irradiation was used to generate apoE−/−chimeric mice deficient in platelet, but not endothelial, P-selectin.Methods and Results—Mice underwent vascular injury and were euthanized 4 weeks later. Absence of platelet P-selectin (pPS) expression in apoE−/−mice after BMT was confirmed by flow cytometry and Western blot analysis. Lack of pPS in apoE−/−mice resulted in a 62% reduction in neointimal area (45 000±27 000 versus 17 000±13 000 μm2,P<0.000001) and a 30% reduction (P<0.02) in macrophage infiltration, compared with control apoE−/−BMT. Absence of pPS was also associated with a reduction in plaque neovascularization as compared with pPS-competent controls (0/8 versus 3/8,P<0.05).Conclusions—Lack of pPS significantly attenuates macrophage recruitment and neointimal lesion formation, indicating that pPS on platelets lining the vessel wall plays a critical role in inflammation after wire-withdrawal injury of the carotid artery in apoE−/−mice.