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Inclusion Criterion (inclusion + criterion)

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Medical Sciences	100%

Selected Abstracts

Sleep staging and respiratory events in refractory epilepsy patients: Is there a first night effect?

EPILEPSIA, Issue 12 2008
Linda M. Selwa
Summary Purpose:, We performed this analysis of possible first night effects (FNEs) on sleep and respiratory parameters in order to evaluate the need for two serial night polysomnograms (PSGs) to diagnose obstructive sleep apnea (OSA) in epilepsy patients. Methods:, As part of a pilot multicenter clinical trial investigating the effects of treating sleep apnea in epilepsy, two nights of PSG recording were performed for 40 patients with refractory epilepsy and OSA symptoms. Sleep architecture was examined in detail, along with respiratory parameters including apnea/hypopnea index (AHI) and minimum oxygen saturation. Analysis included two-tailed t -tests, Wilcox sign rank analysis, and Bland Altman measures of agreement. Results:, Total sleep time differed between the two nights (night 1,363.8 min + 59.4 vs. 386.3 min + 68.6, p = 0.05). Rapid eye movement (REM) sleep and percentage of REM sleep were increased during night two (night 1: 12.3% + 5.9 vs. night 2: 15.5% + 6.2, p = 0.007), and the total minutes of slow-wave sleep (SWS) were increased (night 1: 35.6 + 60.7 vs. night 2: 46.4 + 68.1, p = 0.01). No other sleep or respiratory variables differed between the two nights. Given an AHI inclusion criterion of five apneas per hour, the first PSG identified all but one patient with OSA. Discussion:, Respiratory parameters showed little variability between the first and second nights. Sleep architecture was mildly different between the first and second PSG night. Performing two consecutive baseline PSGs to diagnose OSA may not be routinely necessary in this population. [source]

Smoking cessation interventions in chronic obstructive pulmonary disease and the role of the family: a systematic literature review

JOURNAL OF ADVANCED NURSING, Issue 6 2007
Karen A. Luker
Abstract Title.,Smoking cessation interventions in chronic obstructive pulmonary disease and the role of the family: a systematic literature review Aim., This paper is a report of a systematic review to assess the effectiveness of family-focused smoking cessation interventions for people with chronic obstructive pulmonary disease and to determine what data on families are documented in studies of smoking cessation interventions. Background., Chronic obstructive pulmonary disease is a major public health problem and cigarette smoking is the most important factor contributing to its development and progression. However, smoking cessation rates are low and relapse is common. The role of families in smoking cessation efforts has received little attention. Methods., All studies were included in the review that (i) addressed an evaluation of a psycho-social/educational smoking cessation intervention for people with chronic obstructive pulmonary disease, (ii) addressed some information on the family (i.e. living arrangements, marital status, smoking history of family members, support for quitting) and/or included the family as part of the intervention and (iii) were published between 1990 and 2006. Electronic data sources, existing systematic reviews of smoking cessation interventions and the grey literature were reviewed. Results., Seven studies were included. Six studies (11 papers) included data on marital status, smoking status of household members, support for quitting smoking and related variables. In two of the studies, the variable on the family was used to analyse smoking cessation outcomes. One additional study met the inclusion criterion of an evaluation of a smoking cessation intervention, which also included a family focus in the intervention. Conclusion., No conclusions about the effectiveness of a family-focused smoking cessation intervention could be drawn from this review. Further research is needed to determine if a more family-focused intervention, in conjunction with pharmacological and counselling approaches, would lead to improved smoking cessation outcomes. [source]

The relationship of stress and anxiety with chronic periodontitis

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2003
M.V. Vettore
Abstract Aim: This case,control study investigates the relationship of stress and anxiety with periodontal clinical characteristics. Method: Seventy-nine selected patients (mean age 46.8±8 years) were assigned to three groups in accordance with their levels of probing pocket depth (PPD): control group (PPD,3 mm, n=22), test group 1 (at least four sites with PPD ,4 mm and ,6 mm, n=27) and test group 2 (at least four sites with PPD >6 mm, n=30). An inclusion criterion of the study required that patients presented a plaque index (PI) with a value equal to or larger than 2 in at least 50% of dental surfaces. All subjects were submitted to stress and anxiety evaluations. Stress was measured by the Stress Symptom Inventory (SSI) and the Social Readjustment Rating Scale (SRRS), while the State,Trait Anxiety Inventory (STAI) was used to assess anxiety. Clinical measures such as PI, gingival index (GI), PPD and clinical attachment level (CAL) were collected. Patient's medical history and socioeconomic data were also recorded. Results: The mean clinical measures (PI, GI, PPD and CAL) obtained for the three groups, were: control group, 1.56±0.32, 0.68±0.49, 1.72±0.54 and 2.04±0.64 mm; group 1, 1.56±0.39, 1.13±0.58, 2.67±0.67 and 3.10±0.76 mm, group 2, 1.65±0.37, 1.54±0.46, 4.14±1.23 and 5.01±1.60 mm. The three groups did not differ with respect to percentage of clinical stress, scores of the SRRS, trait and state anxiety. Frequency of moderate CAL (4,6 mm) and moderate PPD (4,6 mm) were found to be significantly associated with higher trait anxiety scores after adjusting for socioeconomic data and cigarette consumption (p<0.05). Conclusions: Based on the obtained results, individuals with high levels of trait anxiety appeared to be more prone to periodontal disease. Zusammenfassung Die Beziehung von Stress und Angst bei chronischer Parodontitis Ziel: Diese Fall kontrollierte Studie untersuchte die Beziehung von Stress und Angst zu parodontal klinischen Charakteristika. Methoden: 79 ausgesuchte Patienten (mittleres Alter 46,8±8) wurden unter Berücksichtigung der Sondierungstiefen (PPD) in 3 Gruppen aufgeteilt: Kontrollgruppe (PPD,3 mm, n=22), Testgruppe 1 (mindestens 4 Flächen mit PPD,4 mm und 6 mm, n=27) und Testgruppe 2 (mindestens 4 Flächen mit PPD>6 mm, n=30). Ein Einschlusskriterium für die Studie erforderte, dass die Patienten einen Plaqueindex mit einem Wert gleich oder größer 2 an mindestens 50% der Zahnoberflächen hatten. Alle Personen wurden hinsichtlich Stress und Angst evaluiert. Stress wurde mit der Stress Symptom Aufnahme (SSI) und der sozialen Anpassungsrate Skala (SRRS) gemessen, während für die Erfassung der Angst der State Trait Anxiety Inventory (STAI) genutzt wurde. Die klinischen Messungen wie Plaque Index (PI), Gingivaindex (GI), PPD und klinisches Stützgewebeniveau (CAL) wurden aufgezeichnet. Die medizinische Anamnese der Patienten und die sozioökonomischen Daten wurden ebenso aufgezeichnet. Ergebnisse: Die mittleren klinischen Messungen (PI, GI, PPD und CAL) für die drei Gruppen waren: Kontrollgruppe 1,56±0,32, 0,68±0,49, 1,72±0,54 mm und 2,04± 0,64 mm; Gruppe 1 1,56±0,39, 1,13±0,58, 2,67±0,67 mm und 3,10±0,76 mm und Gruppe 2 1,65±0,37, 1,54±0,46, 4,14± 1,23 mm und 5,01±1,60 mm. Die drei Gruppen unterschieden sich nicht hinsichtlich der Prozentsätze für klinischen Stress, Werte des SRRS, Charakter- und Zustandsangst. Die Häufigkeit von moderatem CAL (4,6 mm) und moderaten PPD (4,6 mm) war signifikant verbunden mit höheren Charakterangst-Werten nach Adjustierung für sozio-ökonomische Daten und Zigarettenverbrauch (p<0,05). Zusammenfassung: Basierend auf den gewonnen Ergebnissen scheinen Individuen mit mehr Neigung zu parodontalen Erkrankungen höhere Werte von Charakterangst zu haben. Résumé Relation du stress et de l'anxiété avec la parodontite chronique Cette étude contrôle par cas a analysé la relation du stress et de l'anxiété avec les caractéristiques cliniques parodontales. Septante-neuf patients d'une moyenne d'âge de 46,8±8 ans ont été répartis en trois groupes suivant leur niveau de profondeur de poche au sondage (PPD) : groupe contrôle (PPD3 mm, n=22), groupe test 1 (au moins quatre sites avec PPD4 mm et 6 mm, n=27) et le groupe test 2 (au moins quatre sites avec PPD6 mm, n=30). Un critère d'inclusion dans cette étude exigeait que les patients montraient un indice de plaque d'une valeur égale ou supérieure à 2 sur au moins 50% des surfaces dentaires. Tous les sujets ont été soumis à des évaluations de stress et d'anxiété. Le stress a été mesuré par l'inventaire du symptôme de stress (SSI) et le niveau d'évaluation de réajustement social (SRRS), tandis que l'inventaire de l'état d'anxiété (STAI) était utilisé pour évaluer l'anxiété. Les mesures cliniques telles que l'indice de plaque (PlI), l'indice gingival (GI), PPD et le niveau d'attache clinique (CAL) ont été enregistrées. L'histoire médicale du patient et les données socio-économiques ont également été prises en considération. Les mesures cliniques moyennes (PlI, GI, PPD, CAL) obtenues pour les trois groupes étaient respectivement de : groupe contrôle 1,56±0,32, 0,68±0,49, 1,72± 0,54 mm et 2,04± 0,64 mm; groupe 1, 1,56± 0,39, 1,13±0,58, 2,67±0,67 mm et 3,10±0,76 mm et groupe 2, 1,65±0,37, 1,54±0,46, 4,14±1,23 mm et 5,01±1,60 mm. Les trois groupes ne différaient pas en ce qui concerne le pourcentage de stress clinique, des scores de SRRS, et le niveau d'anxiété. La fréquence de CAL modéré (4 à 6 mm) et de PPD modéré (4 à 6 mm) était constatée significativement en association avec les plus grands scores d'anxiété après l'ajustement pour les données socio-économiques et le tabagisme (p<0,05). Ces résultats indiquent que les individus avec de hauts niveaux d'anxiété semblent plus susceptibles à la maladie parodontale. [source]

A prepubertal and early adolescent bipolar disorder-I phenotype: review of phenomenology and longitudinal course

BIPOLAR DISORDERS, Issue 4 2003
James L Craney
Objective: Phenomenology, assessment, longitudinal, and psychosocial findings from an ongoing, controlled, prospective study of 93 subjects with a prepubertal and early adolescent bipolar disorder phenotype (PEA-BP) will be reviewed. Methods: Unlike adult-onset bipolar disorder, for which there were over 50 years of systematic investigations, there were a paucity of rigorous data and much controversy and skepticism about the existence and characteristics of prepubertal-onset mania. With this background, issues to address for investigation of child-onset mania included the following: (i) What to do about the differentiation of mania from attention-deficit hyperactivity disorder (ADHD). (ii) How to deal with the ubiquity of irritability as a presenting symptom in multiple child psychiatry disorders. (iii) Development of a research instrument to assess prepubertal manifestations of adult mania (i.e. children do not ,max out' credit cards or have four marriages). (iv) How to distinguish normal childhood happiness and expansiveness from pathologically impairing elated mood and grandiosity. Results: To address these issues, a PEA-BP phenotype was defined as DSM-IV mania with elated mood and/or grandiosity as one inclusion criterion. This criterion ensured that the diagnosis of mania was not made using only criteria that overlapped with those for ADHD, and that subjects had at least one of the two cardinal symptoms of mania (i.e. elated mood and grandiose behaviors). Subjects were aged 10.9 years (SD = 2.6) and age of onset of the current episode at baseline was 7.3 years (SD = 3.5). Validation of PEA-BP was shown by reliable assessment, 6-month stability, and 1- and 2-year diagnostic longitudinal outcome. PEA-BP resembled the severest form of adult-onset mania by presenting with a chronic, mixed mania, psychotic, continuously (ultradian) cycling picture. Conclusion: Counterintuitively, typical 7-year-old children with PEA-BP were more severely ill than typical 27 year olds with adult-onset mania. Moreover, longitudinal data strongly supported differentiation of PEA-BP from ADHD. [source]

Early Functional Loading of Brånemark Dental Implants: 5-Year Clinical Follow-up Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2000
Ingvar Ericsson DDS
ABSTRACT Background: Short-term clinical studies have indicated the possibility of one-stage surgery and early loading of machined titanium implants. However, long-term data comparing the outcome to the conventional two-stage technique are missing. Purpose: A clinical and radiographic study was performed to compare the outcome of oral rehabilitation of the endentulous mandible by fixed suprastructures connected to implants installed according to either (1) a one-stage surgical procedure and early loading (experimental group - EG) or (2) the original two-stage concept (reference group - RG). The EG and RG comprised 16 and 11 subjects, respectively. Materials and Methods: The following specific inclusion criterion were adopted: (1) all patients had to consider themselves to be in good general health, (2) the amount of bone had to enable the installation of five to six, at least 10-mm long fixtures (Mk II fixtures; Nobel Biocare AB, Göteborg, Sweden) between the mental foramina, and (3) the patients had to be available for the follow-up and maintenance program. A total of 88 implants were placed in the EG compared to 30 in the RG. In the EG, fixed appliances were connected to the implants within 20 days following implant installation while the fixed appliances in the RG were connected about 4 months following fixture installation. At delivery of the suprastructures, all patients were radiographically examined, an examination that was repeated at the 18- and 60-month follow-ups. Results: The analysis of the radiographs from the EG disclosed that during the observation period, between 18 and 60 months, the mean loss of bone support amounted to 0.2 mm (SD = 0.4). The corresponding value observed in the RG was 0.0 mm (SD = 0.5). During the 60-month observation period, no fixture was lost in any of the two groups examined. The implants under study as well as those in the reference material were at all observation intervals found to be clinically stable. Conclusions: This clinical study demonstrated that it is, at least based on a 5-year observation period, possible to successfully load via a permanent fixed rigid cross-arch suprastructure titanium dental implants soon after installation. However, such a treatment approach has to be strictly limited to the interforamina area of the endentulous mandible. Furthermore, the bone resorption was found to be within the same range around such implants as around implants installed and loaded according to the original two-stage protocal. [source]