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Second Visit (second + visit)
Selected AbstractsThe importance of dental beliefs for the outcome of dental-fear treatmentEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 2 2003Kajsa Henning Abrahamsson This study investigated the importance of dental beliefs and the predictive value of the Dental Belief Survey (DBS) in dental-fear treatment. The sample comprised 117 adult patients seeking treatment at a dental-fear clinic. Pretreatment data were collected during a screening procedure, including two visits to the dentist. Outcome measurements were completed after treatment. The dentist rated successful/unsuccessful treatment outcome. Patients unsuccessful in treatment (n = 48) reported more initial negative dental beliefs, while patients successful in treatment (n = 69) showed a larger decrease in negative beliefs between the first and second visit to the dentist. However, these differences were small. There was a significant difference between the groups at visit two. Thus, patients unsuccessful in treatment reported more negative beliefs about how dentists communicate. Regression analyses showed that improved dental beliefs during the first two visits to the dentist predicted dental-fear reduction, while longer avoidance time, female gender, low engagement in treatment, and depressed mood increased the risk of unsuccessful treatment outcome. Our results suggest that the DBS provides valuable information, and that patients' subjective perceptions about how dentists communicate are important for treatment outcome. However, initial dental beliefs were not found to predict clinical treatment outcome. [source] Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesionsINTERNATIONAL ENDODONTIC JOURNAL, Issue 1 2002L. B. Peters Abstract Aim The aim of this study was to evaluate the fate of microorganisms in root canals of teeth with infected pulps and periapical bone lesions with and without the use of calcium hydroxide medication. Methodology Endodontic samples were cultured and microorganisms were counted and identified in 43 teeth before (sample 1) and after (sample 2) treatment during the first visit and before (sample 3) and after (sample 4) treatment during the second visit. In the first visit teeth were instrumented and half of the teeth were filled with a thick slurry of calcium hydroxide in sterile saline. The other teeth were obturated with gutta-percha and AH-26 sealer. After 4 weeks the teeth with calcium-hydroxide were accessed again and after microbiological sampling they were obturated with gutta-percha and AH-26 sealer. Results The mean total colony forming unit (CFU) counts of positive samples dropped significantly as a result of canal preparation during the first visit from 1.0 × 106 to 1.8 × 103 (between samples 1 and 2) but increased to 9.3 × 103 in the period between the two visits (sample 2 and 3). There was no difference in mean total CFU counts of positive samples between the end of the first (sample 2) and the end of the second visit (sample 4). The most frequently isolated species were Prevotella intermedia, Capnocytophaga spp., Actinomyces odontolyticus, Propionibacterium acnes and Peptostreptococcus micros. Conclusions Although a calcium hydroxide paste was placed in the prepared canals, the number of positive canals had increased in the period between visits. However, the number of microorganisms had only increased to 0.93% of the original number of CFU (sample 1). It is concluded that a calcium hydroxide and sterile saline slurry limits but does not totally prevent regrowth of endodontic bacteria. [source] Smoking cessation advice provided in 53 Norwegian pharmaciesINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2004Dr. Anne G. Granas Director of research Objective To investigate the quality of the smoking cessation advice on over-the-counter (OTC) nicotine replacement treatment (NRT) provided by community and hospital pharmacies in Norway and to assess any change in customer services and pharmaceutical smoking cessation advice after a change in legislation deregulating NRT from pharmacy-only to general sale. Method A mystery shopper made 106 visits to 53 pharmacies in Oslo, Norway. The first visit was when NRT was a pharmacy-only medicine and the second when it had become available from any outlet as a general sales product. The pharmacies were scored on 12 observation parameters regarding customer service and pharmaceutical advice (score 0,4, total possible score was 48). Key findings There was considerable inter- and intra-pharmacy variation in scores. The pharmacies' total score ranged from 3 to 45. On only 14.2% of the visits was the service categorised as ,Good'. There was no statistically significant difference in total score between the two test periods (P = 0.56), and hence no measurable difference in customer services and pharmaceutical advice as a result of increased competition after the switch to general sale. A scatter plot showed no relationship between the individual pharmacies' total score at the two visits. Conclusions Pharmacies' scores for the quality of their smoking cessation advice were generally low. There was no measurable change in pharmacies' customer service and pharmaceutical advice following the deregulation of NRT. There was little consistency in the total score between the first and the second visit to the same pharmacy. Improvement is needed in the smoking cessation advice provided by Norwegian pharmacies. [source] Progression of dysprosody in Parkinson's disease over time,A longitudinal study,MOVEMENT DISORDERS, Issue 5 2009Sabine Skodda MD Abstract Parkinsonian speech or hypokinetic dysarthria results from a multidimensional impairment of phonation, articulation, and prosody. Although the dysprosody in Parkinson's disease (PD) is well described (alterations in speech rate and pause time, speech intensity and pitch variation), little is known about alterations of these single prosodic parameters over a longer time course. The objective of this study is to analyze changes of speech rate and pitch variation in patients with PD over time and to compare these findings with healthy controls. Patients with PD (N = 50; 27 male and 23 female) and n = 50 age-matched healthy controls (25 male, 25 female) were tested and retested after at least 7 months (mean: 25.02; median: 21; SD: 17.44; range: 7,79 months). In the PD group, motor impairment according to UPDRS motor score was similar at first and second visit. The participants had to accomplish a standardized four sentence reading task. The acoustical analysis was performed using a standard head-worn microphone for voice recordings and commercial audio software (WaveLab®). For the determination of intonation based upon fundamental frequency (F0) variation, we used a computer analysis program (Praat®). Articulatory velocity was determined by measurement of syllable rate and pause ratios. In the PD group, total speech rate (syllables per second related to total speech time/TSR) and net speech rate declined from first to second examination, especially in the male patients, but showed no significant differences to the control group. The course of pitch variation revealed some gender particularities. Whereas female patients' pitch variability declined over time, male patients' intonation variability remained relatively stable. F0 variation in male and female patients with PD were significantly reduced compared with the control group in the first examination and the follow up as well. Progression of prosodic impairment over time showed no correlation to disease duration or UPDRS motor score. Some aspects of dysprosody in PD show characteristic changes over time, but show no clear correlation with general motor impairment as assessed by UPDRS motor score. Therefore, we suspect that the underlying mechanism could be independent from dopaminergic deficits. © 2008 Movement Disorder Society [source] Tiagabine in treatment refractory bipolar disorder: a clinical case seriesBIPOLAR DISORDERS, Issue 5 2002Trisha Suppes Objectives:, Anticonvulsants have provided major treatment advances for patients with bipolar disorder. Many of these drugs, including several with proven efficacy in bipolar mania or depression, enhance the activity of the ,-amino butyric acid (GABA) neurotransmitter system. A new anticonvulsant, tiagabine, has selective GABAergic activity and is approved for patients with partial epilepsy. Few reports of its potential effectiveness in bipolar disorder, however, have been published. We sought to evaluate the effectiveness of tiagabine added to ongoing medication regimens in patients with bipolar disorder inadequately responsive to or intolerant of usual treatments. Methods:, Seventeen treatment-refractory patients participating in the Stanley Foundation Bipolar Network (SFBN) long-term follow-up study were offered open treatment with add-on tiagabine after discussion of the risks, benefits, other treatment options and giving informed consent. Patients' clinical symptoms and somatic complaints were closely monitored with SFBN longitudinal and cross-sectional ratings. Four patients discontinued low-dose tiagabine prior to the second visit and were excluded from data analysis. Results:, Thirteen patients received a mean of 38 days of treatment at a mean dose of 8.7 mg/day of tiagabine. On the Clinical Global Impression Scale for Bipolar Disorder Overall category, three (23%) patients showed much or very much improvement and 10 (77%) patients showed no change or worsening. Three significant adverse events were noted, including two presumptive seizures. Conclusions:, Open add-on tiagabine for treatment-refractory patients with bipolar disorder demonstrated limited efficacy with the majority of patients showing no change or worsening of clinical symptoms. In addition, patients experienced serious side-effects attributed as likely due to the medication, which resolved without lasting consequence when tiagabine was discontinued. [source] An unplanned delay between control visits influences the metabolic status in children with diabetes: an observational studyACTA PAEDIATRICA, Issue 5 2010P-E Kofoed Abstract Aim:, To evaluate whether the metabolic status had been influenced by the longer interval between visits because of a strike at the diabetes outpatient clinic. Methods:, During the strike from April 16 to June 15, 2008 all routine visits were cancelled. The HbA1c values from the last two visits prior to and the first two visits after the strike were compared with the values from the same periods the previous year. Danish speaking patients answered a questionnaire. Results:, For 155 children included, the mean HbA1c values before the strike were 8.1 and 8.1 (p = 0.39), while the value increased to 8.5 at the first visit (p < 0.0001) and 8.4 at the second visit following the strike (p = 0.14). No differences were found between any of the HbA1c values measured in 2007 (p > 0.05). Of the 152 questionnaires handed out, 113 (74.3%) were returned. Of these, 48 (42.5%) stated to have needed help, and 49 (43.3%) that their children's diabetes had deteriorated because of the strike. Conclusions:, In this unplanned study, the increase of 0.4% in mean HbA1c supports previous findings that the interval between visits at a diabetic clinic is important for ensuring an acceptable metabolic control in children with diabetes. [source] Topical anaesthesia before nasendoscopy: a randomized controlled trial of co-phenylcaine compared with lignocaineCLINICAL OTOLARYNGOLOGY, Issue 1 2006R. Douglas Objective:, To evaluate the relative effectiveness of co-phenylcaine (lignocaine 5% with phenylephrine) and lignocaine 5% sprays when administered prior to rigid nasendoscopy. Design:, Randomized, double blind controlled study. Setting:, Teaching hospital otolaryngology unit. Participants:, Thirty patients requiring routine outpatient rigid nasendoscopy were administered five puffs of either co-phenylcaine or lignocaine 5% spray which had been randomly assigned to either the first or the second visit. Ten minutes later nasendoscopy was performed. Immediately after nasendoscopy the ease of performance of the procedure and the quality of the view achieved was rated on a visual analogue scale by the endoscopist and the patients recorded the level of pain experienced on a visual analogue scale. Two weeks later, the patients returned for a repeat nasendoscopy, receiving the alternate spray. Main outcomes measures:, Ease of performance and quality of view of achieved by endoscopists and pain experienced by patients, both measured with visual analogue scales. Results:, The ease of passage of the endoscope and quality of the view obtained was found to be greater after the administration of co-phenylcaine [visual analogue scores 84 (95% CI: 80,89) than after lignocaine and 77 (95% CI: 73,81) (P < 0.01)]. The two sprays produced similar levels of topical anaesthesia. Conclusions:, Nasendoscopy can be performed with minimal discomfort after the administration of either co-phenylcaine or lignocaine 5% sprays. The vasoconstricting action of co-phenylcaine increases the ease of passage of the endoscope and quality of the view obtained by the endoscopist. [source] | ||||||||||