Home About us Contact
|
Home About us Contact | ||
|
|
||
Independent Investigators (independent + investigator)
Selected AbstractsEfficacy of enamel matrix derivatives (Emdogain®) in treatment of replanted teeth , a systematic review based on animal studiesDENTAL TRAUMATOLOGY, Issue 5 2008Annette Wiegand A review of the published literature [search term: (Emdogain OR enamel matrix derivative OR enamel matrix protein] AND [avulsion OR replantation OR autotransplantation)] was conducted by two independent investigators according to defined selection criteria. For data extraction of the identified animal studies, the following histomorphometric findings were considered: (i) healed PDL, (ii) surface resorption, (iii) inflammatory resorption and (iv) replacement resorption. The heterogenity of data collection and the small amount of identified publications did not allow for statistical analysis. Four controlled trials (CT) conducted in animals, but no randomized controlled trials (RCT) or clinical controlled trials (CCT) could be received from the systematic search. From the selected studies, two CT gave evidence of EMD treatment to be effective in inducing healing of replanted teeth, while one CT found no differences between EMD treated teeth and controls. Finally, one CT compared EMD and sodium fluoride application, but revealed no differences between the treatments. The data of controlled trials available are limited and conflicting. No firm conclusion regarding the efficacy of EMD application on healing of replanted or autotransplanted permanent teeth can be drawn because of lack of RCT and CCT. [source] Localizing and Lateralizing Value of Behavioral Change in Childhood Partial SeizuresEPILEPSIA, Issue 1 2007András Fogarasi Summary:,Objective: To describe clinical characteristics as well as localizing and lateralizing value of behavioral change (BC) at the onset of childhood seizures. Methods: Five hundred forty-one videotaped seizures of 109 consecutive patients ,12 years with partial epilepsy and postoperatively seizure-free outcome were analyzed. Behavioral change (the first clinical feature of a certain seizure with a sudden change in the child's behavior) was evaluated by two independent investigators. Results: Thirty-three (30%) patients showed BC at least once during their seizures. Behavioral changes appeared in arrestive form in 19 and with affective activities in 18 children; four patients produced both kinds of BCs, separately. Arrest-type BC happened in 16 of 50 children with right- and 3 of 59 patients with left-sided seizure onset zone (p < 0.001). Affective-type BC was observed in 17 of 67 temporal lobe epilepsy patients while it happened in only 1 of 42 children with extratemporal lobe epilepsy (p = 0.001). Conclusions: Arrest-type BC lateralizes to the right hemisphere, while affective-type BC localizes to the temporal lobe in childhood partial seizures. Type of BCs can add important information to the presurgical evaluation of young children with refractory partial epilepsy. [source] MTHFR 677C>T and ACE D/I Polymorphisms in Migraine: A Systematic Review and Meta-AnalysisHEADACHE, Issue 4 2010Markus Schürks MD (Headache 2010;50:588-599) Background., Data on the association between the MTHFR 677C>T and ACE D/I polymorphisms and migraine including aura status are conflicting. Objective., The objective of this study is to perform a systematic review and meta-analysis on this topic. Methods., We searched for studies published until March 2009 using electronic databases (MEDLINE, EMBASE, Science Citation Index) and reference lists of studies and reviews on the topic. Assessment for eligibility of studies and extraction of data was performed by 2 independent investigators. For each study we calculated the odds ratios (OR) and 95% confidence intervals (CI) assuming additive, dominant, and recessive genetic models. We then calculated pooled ORs and 95% CIs. Results., Thirteen studies investigated the association between the MTHFR 677C>T polymorphism and migraine. The TT genotype was associated with an increased risk for any migraine, which only appeared for migraine with aura (pooled OR = 1.48, 95% CI 1.02-2.13), but not for migraine without aura. Nine studies investigated the association of the ACE D/I polymorphism with migraine. The II genotype was associated with a reduced risk for migraine with aura (pooled OR = 0.71, 95% CI 0.55-0.93) and migraine without aura (pooled OR = 0.84, 95% CI 0.70-0.99). Results for both variants were driven by studies in non-Caucasian populations. Results among Caucasians did not suggest an association. Extractable data did not allow investigation of gene,gene interactions. Conslusions., The MTHFR 677TT genotype is associated with an increased risk for migraine with aura, while the ACE II genotype is protective against both migraine with and without aura. Results for both variants appeared only among non-Caucasian populations. There was no association among Caucasians. [source] Barriers to physician adherence to nonsteroidal anti-inflammatory drug guidelines: a qualitative studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2008J. M. CAVAZOS Summary Background, Despite wide availability of physician guidelines for safer use of nonsteroidal anti-inflammatory drugs (NSAIDs) and widespread use of these drugs in the US, NSAID prescribing guidelines have been only modestly effective. Aim, To identify and describe comprehensively barriers to provider adherence to NSAID prescribing guidelines. Methods, We conducted interviews with 25 physicians, seeking to identify the major influences explaining physician non-adherence to guidelines. Interviews were standardized and structured probes were used for clarification and detail. All interviews were audio-taped and transcribed. Three independent investigators analysed the transcripts, using the constant-comparative method of qualitative analysis. Results, Our analysis identified six dominant physician barriers explaining non-adherence to established NSAID prescribing guidelines. These included (i) lack of familiarity with guidelines, (ii) perceived limited validity of guidelines, (iii) limited applicability of guidelines among specific patients, (iv) clinical inertia, (v) influences of prior anecdotal experiences and (vi) medical heuristics. Conclusions, A heterogeneous set of influences are barriers to physician adherence to NSAID prescribing guidelines. Suggested measures for improving guideline-concordant prescribing should focus on measures to improve physician education and confidence in guidelines, implementation of physician/pharmacist co-management strategies and expansion of guideline scope. [source] Evaluation by scanning acoustic microscopy (SAM) on glomerular lesion of IgA nephropathyNEPHROLOGY, Issue 2001H Kiyomoto IgA nephropathy (IgAN) is known to commonly cause of end-stage renal failure in Japan. The glomerular lesions of IgAN have histological variations. The determination of prognosis and therapeutic strategy should be carefully done by experts because morphological information from renal biopsies using ordinary optical microscopy is usually qualitative and subjective. Moreover, the histological items for the evaluation of glomerular lesions seems to be unsatisfactory for expression of the disease condition of IgAN. The beneficial properties of scanning acoustic microscopy (SAM) include not only observation of microstructure but also quantitative measurement of acoustic propagation speed (APS), indicating the tissue elasticity. In the present study we compared the APS of glomeruli with the pathological scores that were determined by ordinary light microscopy. We used stocked human renal biopsy specimens diagnosed as IgAN (n = 12) and normal/minimal changes (n = 5). All samples were taken by renal biopsy in Kagawa Medical University Hospital during 1997,2000 under informed consent of the patients. The obtained renal tissue were immersed in 10% formalin and embedded in paraffin. A fixed specimen was consecutively cut into 4 ,m slices. One of the deparaffinized 4 ,m-specimens was directly utilized for SAM without any staining, and the others were stained with haematoxylin-eosin and Masson Trichrome for counting cell number and evaluation of collagen accumulation. For the measurement of glomerular APS, the sample line was set on the equator of the glomerulus and then scanning of the X,Z axis was carried out to obtain the interference fringes that were analysed with a computer imaging software in order to calculate the APS. In light microscopic study, pathological scores were evaluated semiquantitatively by two independent investigators who were unaware of the sample number. Glomerular lesions were scored into five grades and glomerular cell number was also counted in individual glomerulus. The computer-assisted imaging analyser Win ROOF (Mitani, Fukui, Japan) was also used for the determination of glomerular collagen content in specimens stained by Masson Trichrome. A two-dimensional image (C-mode scanning) of SAM enabled imaging of glomerulus in renal biopsy specimen compatible with findings of ordinary light microscopy without staining dye. The glomerular APS in IgAN was significantly higher than in normal/minimal changes. This alteration of glomerular APS in IgAN was positively correlated to both semiquantitative pathological scores and glomerular collagen content determined by light microscopy. However, the cell number of glomelurus did not change between IgAN and normal/minimal change. As a result, we conclude that the glomerular lesion, especially matrix expansion in IgAN, was comparable with the absolute value among specimens. Therefore, it is suggested that SAM method is a novel and useful technique for quantitative evaluation of glomerular lesion in IgAN. [source] Prenatal PCB exposure and neurobehavioral development in infants and children: Can the Oswego study inform the current debate?PSYCHOLOGY IN THE SCHOOLS, Issue 6 2004Paul Stewart In the current paper we describe the methodology and results of the Oswego study, in light of D.V. Cicchetti, A.S. Kaufman, and S.S. Sparrow's (this issue) criticisms regarding the validity of the human health/behavioral claims in the PCB literature. The Oswego project began as a replication of the Lake Michigan Maternal Infant Cohort study. Beyond replication of the Michigan findings, the study sought to extend results and conclusions through more comprehensive behavioral assessment, and improved confounder control and analytic methodology. Results over the past 5 years have demonstrated a convincing replication of the Michigan findings. The Michigan cohort reported findings relating Great Lakes fish consumption to performance impairments on the Neonatal Behavioral Assessment Scale (J. Jacobson, S. Jacobson, P. Schwartz, G. Fein, & J. Dowler, 1984). These findings were also found in the Oswego cohort (E. Lonky, J. Reihman, T. Darvill, J. Mather, & H. Daly, 1996), and the Oswego study extended the association to cord blood PCBS (P.W. Stewart, J. Reihman, E. Lonky, and T. Darvill, 2000). The Michigan cohort reported an association between prenatal PCB exposure and poorer performance on the Fagan Test of Infant Intelligence (S.W. Jacobson, G.G. Fein, J.L. Jacobson, P.M. Schwartz, & J.K. Dowler, 1985). The Oswego cohort found similar results (T. Darvill, E. Lonky, J. Reihman, P. Stewart, & J. Pagano, 2000). The Michigan Cohort reported an association between prenatal PCB exposure and performance impairments on the McCarthy Scales of Children's abilities (J. Jacobson & S. Jacobson, 1997). The Oswego study also found PCB-related impairments on the McCarthy Scales (P.W. Stewart, J. Reihman, E. Lonky, T. Darvill, & J. Pagano, 2003). The Oswego results used the same exposure metric in every paper, employed conservative statistical design and analysis, and controlled for more than 40 potentially confounding variables. Moreover, while PCBs were related to all the behavioral endpoints outlined above, alternative candidates for effect, including lead, HCB, Mirex, DDE, and MeHg were not. Taken together, these results support the hypothesis that prenatal PCB exposure results in statistically significant predictors of small, but measurable, deficits in cognitive development from infancy through early childhood. Cicchetti et al. argue that these results, generated by independent investigators, be dismissed because they reflect a combination of measurement error, Type I error, and residual confounding. The evidence Cicchetti et al. present in support of their position fails to explain the nearly identical pattern of associations observed in the Oswego and Michigan Cohorts. In light of this replication, the extensive assessment of potential confounders, the effective elimination of alternative contaminants, and the conservative statistical approach employed in the Oswego study, we find that Cicchetti et al.'s claims are not substantiated. © 2004 Wiley Periodicals, Inc. Psychol Schs 41: 639,653, 2004. [source] Doppler sonographic findings in the long bicipital tendon sheath in patients with rheumatoid arthritis as compared with patients with degenerative diseases of the shoulderARTHRITIS & RHEUMATISM, Issue 7 2003Johannes Strunk Objective To compare power Doppler sonography (PDS) findings inside the bicipital tendon sheath in patients with rheumatoid arthritis (RA) and degenerative disorders of the shoulder, in order to evaluate the diagnostic value of PDS in distinguishing between inflammatory and noninflammatory shoulder pain. Methods The glenohumeral joints of 41 consecutive patients with shoulder pain were examined by ultrasound. Using ventral transverse and longitudinal scanning, the vascularity near and/or inside the bicipital tendon sheath was visualized by PDS. One fully trained and experienced examiner performed the sonography. Representative images were digitally stored and were read, under blinded conditions, by 2 independent investigators, who categorized the Doppler signals as being either inside or outside the tendon sheath. Results Biceps tendon sheath effusion, represented by the typical hypoechoic rim, was found in 95.8% of the RA patients (23 of 24) and in 58.8% of the patients with degenerative disorders (10 of 17). PDS signals were localized to inside the tendon sheath in 22 of the RA patients (91.7%) and in none of the patients with degenerative disorders. Although no PDS signal was found inside the tendon sheath in patients with degenerative disorders, in 9 of these patients (52.9%), signals could be localized to the environment of the tendon sheath. Conclusion PDS demonstrates vascularity in the long bicipital tendon sheath of patients with RA, but not in those with degenerative shoulder disorders. [source] Emergency department performance at a small rural hospital: An independent in-depth reviewAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2009Paul Tescher Abstract Objectives:,This study aims to provide a retrospective review of the recent performance of the emergency department of Cobram District Hospital, a small rural hospital located on the border of Victoria and New South Wales. Design:,Retrospective review. Setting:,Small rural accident and emergency department. Intervention:,All available data collected from the emergency department from the previous three financial years (July 2005 to June 2008) were compiled onto a computerised spreadsheet and analysed by two independent investigators. Main outcome measures:,Key performance indicators, including time for patient to be seen by a doctor and frequency of patient presentations to the emergency department. Results:,Cobram District Hospital has fewer than 5000 patients presenting to the emergency department each year. 12 p.m. to 12 a.m. accounts for 69% of all presentations, with three notable time periods that experience most presentations. Life-threatening emergencies represented <3% of all presentations to the emergency department. Patients in triage categories 1,3 did not met Australasian triage scale (ATS)-suggested time for maximum waiting timing, while categories 4 and 5 well exceeded ATS standards. Conclusion:,The small size and lack of dedicated emergency department staff place restrictions on the ability of an unfunded rural hospital to match the performance of major metropolitan emergency departments. ATS guidelines should be revised to improve clarity and reflect the different performance capabilities between metropolitan and rural centres. [source] Molecular linkage studies of bipolar disordersBIPOLAR DISORDERS, Issue 6 2001Wade H Berrettini Objectives: To review the reports of linkage findings for bipolar disorder. Methods: Literature review of published linkage findings in bipolar disorder. Results: There are several regions of the human genome that have been implicated repeatedly by independent investigators. These include 4p16, 12q24, 18q22, 18p11, 21q21 and 22q11. Two of these regions (18p11 and 22q11) are also implicated in genome scans of schizophrenia, suggesting that these two distinct nosological categories may share some genetic susceptibility. This hypothesis can only be tested when the underlying genes are identified. [source] | ||||||||||