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Selected AbstractsSerum IgG Concentrations after Intravenous Serum Transfusion in a Randomized Clinical Trial in Dairy Calves with Inadequate Transfer of Colostral ImmunoglobulinsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2010M. Chigerwe Background: Plasma transfusions have been used clinically in the management of neonates with failure of passive transfer. No studies have evaluated the effect of IV serum transfusions on serum IgG concentrations in dairy calves with inadequate transfer of passive immunity. Hypothesis: A commercially available serum product will increase serum immunoglobulin concentration in calves with inadequate transfer of colostral immunoglobulins. Animals: Thirty-two Jersey and Jersey-Holstein cross calves with inadequate colostral transfer of immunoglobulins (serum total protein <5.0 g/L). Methods: Thirty-two calves were randomly assigned to either control (n = 15) or treated (n = 17) groups. Treated calves received 0.5 L of a pooled serum product IV. Serum IgG concentrations before and after serum transfusion were determined by radial immunodiffusion. Results: Serum protein concentrations increased from time 0 to 72 hours in both control and transfused calves and the difference was significant between the control and treatment groups (P < .001). Mean pre- and posttreatment serum IgG concentrations in control and transfused calves did not differ significantly. Median serum IgG concentrations decreased from 0 to 72 hours by 70 mg/dL in control calves and increased over the same time interval in transfused calves by 210 mg/dL. The difference was significant between groups (P < .001). The percentage of calves that had failure of immunoglobulin transfer 72 hours after serum transfusion was 82.4%. Conclusions and Clinical Importance: Serum administration at the dosage reported did not provide adequate serum IgG concentrations in neonatal calves with inadequate transfer of colostral immunoglobulins. [source] Assessment of online continuing dental education in North CarolinaTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 2 2000Ms. Bonnie Francis RDH Abstract Background: Dental professionals are discovering the unique advantages of asynchronous lifelong learning through continuing dental education (CDE) opportunities offered online. The purpose of this study was to evaluate both the process and outcomes of online CDE in North Carolina. The assessment was designed to provide a better understanding of practicing dental professionals experiences with online CDE and to determine the effectiveness of this learning strategy. Methods: Dental professionals from four North Carolina Area Health Education Centers regions evaluated two pilot online CDE modules in 1998. Thirty-one participants were recruited and subsequently enrolled with 23 completing at least one module. Each module included objectives, a multiple-choice pretest, interactive core material, and a post-test. Participants completed three online surveys measuring individual demographics and computer skill level, module design, and use and overall reaction to online learning. Results: Most participants agreed that the modules were comprehensive, were pleasing in appearance, provided clear instructions, provided adequate feedback, and were easy to navigate. Most participants agreed that knowledge of the material increased. This was validated by a significant increase in mean pre- to post-test scores (p =.0001). Participants agreed that convenience was a definite advantage, and they would choose online courses again to meet their CDE needs. The least-liked aspects included technical and formatting issues. Implications: Participants were enthusiastic about online learning and learned effectively with this teaching strategy, but desired much more interactivity than existed in the current design. [source] Does Pregnancy Affect Otosclerosis?,THE LARYNGOSCOPE, Issue 10 2005William H. Lippy MD Abstract Objective: To evaluate the effect of pregnancy on the hearing of women with otosclerosis. Study Design: A retrospective study of women who had undergone stapedectomy. The women were equally divided into two groups: one group with children and a control group without children. Air and bone conduction, as well as discrimination, were measured before and after stapedectomy in both groups. Patients: Ninety-four women (47 with children and 47 without) were evaluated. Because many of the women had bilateral otosclerosis, the total number of ears studied was 128. Results: Mean pure tone air and bone conduction thresholds were not worse in women with children versus those women without children. In fact, mean pre- and postoperative pure tone air and bone conduction thresholds from 500 Hz through 4,000 Hz in women with children were slightly but significantly better than women without children. There was no difference in discrimination scores between groups. Within the group with children, no significant correlation was found between number of children and hearing loss. Also, no correlation was found between breastfeeding and the amount of hearing loss. Conclusion: We found no adverse effect on hearing in otosclerotic women who had children compared with women without children. Even with increasing numbers of pregnancies, no deleterious impact was noted. Air conduction, bone conduction, and discrimination were not worse in women with children versus childless women. No significant correlation was found between the number of children and hearing loss, and neither did breastfeeding affect the amount of hearing loss. [source] Safety of Completion Thyroidectomy Following Unilateral Lobectomy for Well-Differentiated Thyroid Cancer,THE LARYNGOSCOPE, Issue 7 2002Michael E. Kupferman MD Abstract Objectives When a diagnosis of thyroid cancer is returned following unilateral lobectomy, removal of the contralateral lobe is frequently necessary. Morbidity for completion thyroidectomy includes a reported 2% to 5% risk of recurrent laryngeal nerve (RLN) injury and an 8% to 15% incidence of hypoparathyroidism. In this study, to determine morbidity following completion thyroidectomy, we reviewed our results of reoperative surgery among patients with thyroid cancer. Study Design Retrospective chart review. Methods Between 1997 and 2000, 36 consecutive patients, 32 females and 4 males, with a mean age of 43.6 years (range, 19,59 y), underwent completion thyroidectomy. Preoperative fine-needle aspiration revealed follicular derived neoplasm in 32 patients (88.9%), indeterminate in 3 patients (8.3%), and Hürthle cell neoplasm in 1 patient (2.8%). The interval between the first and second operation was a mean of 43.3 days (range, 2,103 d). Results At the primary surgery, 29 patients (80.6%) had a follicular variant of papillary carcinoma, 6 (16.7%) had follicular carcinoma, and 1 (2.8%) had Hürthle cell carcinoma. Of these, 14 had multifocal disease. In the completion lobe, 20 patients (55.6%) had evidence of thyroid carcinoma. There was a 0% incidence of RLN injury, and the mean pre- and post-completion thyroidectomy serum calcium was 8.9 mg/dL and 8.6 mg/dL, respectively. There was one postoperative hematoma, requiring re-exploration. Five patients (13.9%) had a transient postoperative serum calcium (Ca) <8.0 mg/dL, with one being symptomatic. None required vitamin D or prolonged calcium supplementation. Conclusions When completion thyroidectomy is necessary for the treatment of thyroid malignancy, the procedure can be performed safely with low morbidity and is effective for diagnosing and removing occult disease in the remaining thyroid. [source] Assessing the responsiveness of measures of oral health-related quality of lifeCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 1 2004David Locker Abstract ,,, Objectives: This paper illustrates ways of assessing the responsiveness of measures of oral health-related quality of life (OHRQoL) by examining the sensitivity of the oral health impact profile (OHIP)-14 to change when used to evaluate a dental care program for the elderly. Methods: One hundred and sixteen elderly patients attending four municipally funded dental clinics completed a copy of the OHIP-14 prior to treatment and 1 month after the completion of treatment. The post-treatment questionnaire also included a global transition judgement that assessed subjects' perceptions of change in their oral health following treatment at the clinics. Change scores were calculated by subtracting post-treatment OHIP-14 scores from pre-treatment scores. The longitudinal construct validity of these change scores were assessed by means of their association with the global transition judgements. Measures of responsiveness included effect sizes for the change scores, the minimal important difference, and Guyatt's responsiveness index. An receiver operating characteristic (ROC) curve was constructed to determine the accuracy of the change scores in predicting whether patients had improved or not as a result of the treatment. Results: Based on the global transition judgements, 60.2% of subjects reported improved oral health, 33.6% reported no change, and only 6.2% reported that it was a little worse. These changes are reflected in mean pre- and post-treatment OHIP-14 scores that declined from 15.8 to 11.5 (P < 0.001). Mean change scores showed a consistent gradient in the expected direction across categories of the global transition judgement, but differences between the groups were not significant. However, paired t -tests showed no significant differences in the pre- and post-treatment scores of stable subjects, but showed significant declines for subjects who reported improvement. Analysis of data from stable subjects indicated that OHIP-14 had excellent test,retest reliability with an intraclass correlation coefficient (ICC) of 0.84. Effect size based on change scores for all subjects and subgroups of subjects were small to moderate. The ROC analysis indicated that OHIP-14 change scores were not good ,diagnostic tests' of improvement. The minimal important difference for the OHIP-14 was of 5-scale points, but detecting this difference would require relatively large sample sizes. Conclusions: OHIP-14 appeared to be responsive to change. However, the magnitude of change that it detected in the context described here was modest, probably because it was designed primarily as a discriminative measure. The psychometric properties of the global transition judgements that often provide the ,gold standard' for responsiveness studies need to be established. [source] |