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Abstract
Nickel is the most common metal to cause contact dermatitis in orthodontics. Nickel-containing metal alloys, such as nickel-titanium and stainless steel, are widely used in orthodontic appliances. Nickel-titanium alloys may have nickel content in excess of 50 per cent and can thus potentially release enough nickel in the oral environment to elicit manifestations of an allergic reaction. Stainless steel has a lower nickel content (8 per cent). However, because the nickel is bound in a crystal lattice it is not available to react. Stainless steel orthodontic components are therefore very unlikely to cause nickel hypersensitivity. This article discusses the diagnosis of nickel allergy in orthodontics and describes alternative products that are nickel free or have a very low nickel content, which would be appropriate to use in patients diagnosed with a nickel allergy.
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Miles A, Grey JE, Polychronis A, Price N, Melchiorri C. Current thinking in the evidence-based health care debate. J Eval Clin Pract 2003; 9:95-109. [PMID: 12787170 DOI: 10.1046/j.1365-2753.2003.00438.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mowatt L, Shun-Shin G, Price N. Ethnic differences in the demand incidence of retinal detachments in two districts in the West Midlands. Eye (Lond) 2003; 17:63-70. [PMID: 12579172 DOI: 10.1038/sj.eye.6700245] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
AIM To evaluate the epidemiological characteristics of rhegmatogenous retinal detachments (RRDs) in two defined populations in the West Midlands of England. METHODS A 5-year retrospective study of patients who underwent surgical repair of their RRD between April 1994 and March 1999. Statistical analysis was done by the Statistical Program for Social Sciences (SPSS) version 10.0. RESULTS The total demand incidence of RRD was 11.3 and 6.3 per 100,000 in Wolverhampton and Walsall, respectively. The Asian subgroup had a low demand incidence of 4.6 and 2.0 per 100,000 in each area, respectively. In Wolverhampton the highest age-specific demand incidence was in the 70 to 79-year age group at 29.1 per 100,000, whereas in Walsall it was 98.6 per 100,000 in the 85+ age group. Nontraumatic phakic detachments had the highest demand incidence of 9.7 per 100,000, whereas nontraumatic pseudophakic and aphakic R/D were much lower at 1.2 and 0.3 per 100,000, respectively. There was a 1 : 1.5 female-to-male ratio, with a mean age of 57.8 years (95% CI 54.7-61.0) in females and 55.5 years (95% CI 53.1-57.9) for males. A total of 41.6% (142) of patients presented initially to the Wolverhampton Eye Infirmary Accident and Emergency Department (A&E). CONCLUSION This is the first UK-based study. The demand incidence in Caucasians is similar to worldwide figures. Asians have a three times lower incidence of retinal detachments. The demand incidence increases with age. Females have a higher mean age than males. Males (89.5%) were more likely to suffer from traumatic detachments. Younger patients were more likely to present to the optometrist initially. Less than half of the patients will present initially to the eye A&E.
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Price N. Health professionals standing committee. Ann Rheum Dis 2002; 61:1116. [PMID: 12429551 PMCID: PMC1753965 DOI: 10.1136/ard.61.12.1116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Johny AA, Clark A, Price N, Carrington D, Oakhill A, Marks DI. The use of zanamivir to treat influenza A and B infection after allogeneic stem cell transplantation. Bone Marrow Transplant 2002; 29:113-5. [PMID: 11850704 DOI: 10.1038/sj.bmt.1703343] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2001] [Accepted: 10/08/2001] [Indexed: 11/09/2022]
Abstract
The use of zanamivir in seven patients with influenza (three A and four B) post allograft is described. Inhaled zanamivir (10 mg twice daily) was continued from the diagnosis of influenza until excretion of virus ceased (median duration 15 days, range 5 to 44 days). There was no toxicity attributable to zanamivir and rapid resolution of influenza symptoms was seen. There was no mortality due to influenza in the seven patients. The good outcome of 30 previous patients with influenza post transplant is described. A randomised multicentre study would be required to demonstrate efficacy.
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Mensinger AF, Stephenson KA, Pollema SL, Richmond HE, Price N, Hanlon RT. Mariculture of the toadfish Opsanus tau. THE BIOLOGICAL BULLETIN 2001; 201:282-283. [PMID: 11687425 DOI: 10.2307/1543367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Price N. The performance of social marketing in reaching the poor and vulnerable in AIDS control programmes. Health Policy Plan 2001; 16:231-9. [PMID: 11527863 DOI: 10.1093/heapol/16.3.231] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The article reviews evidence on the impact and effectiveness of condom social marketing programmes (CSMPs) in reaching the poor and vulnerable with information, services and products in the context of HIV/AIDS/STD prevention and control. Ideally, the success of CSMPs would be judged by whether they contribute to sustained improvements in sexual health outcomes at the population level. Given methodological and attribution difficulties, intermediary criteria are employed to assess effectiveness and impact, focusing on changes in behaviour (including condom use) among poor and vulnerable groups, and access by the poor and vulnerable to condoms, services and information. It remains difficult to reach definitive conclusions about the extent to which CSMPs meet the sexual health needs of the poor and vulnerable, due largely to reliance on sales data for CSMP monitoring and evaluation. CSMPs (like many health programme strategies) have traditionally collected little information on client profiles, health-seeking behaviour, condom use effectiveness, and supply-side issues. Recent data indicate that CSMPs are unlikely to be pro-poor in their early stages, in terms of the distribution of benefits, but as CSMPs mature, then inequities in access diminish, followed by reduced inequities in condom use. The paper assesses the extent to which social marketing is effective in improving access for the poor and vulnerable using a number of variables. In terms of economic access, it is evident that low-income groups are particularly sensitive to CSMP price increases, and that a cost-recovery focus excludes the poorest. Convenience is significantly improved for those who can afford to pay, and CSMPs appear to be addressing social and regulatory constraints to access. Conventional CSMP monitoring systems make it difficult to assess the effectiveness of behavioural change IEC strategies, although data on this dimension of the social marketing approach are beginning to emerge.
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Anderson H, Espinosa E, Lofts F, Meehan M, Hutchinson G, Price N, Heyes A. Evaluation of the chemotherapy patient monitor: an interactive tool for facilitating communication between patients and oncologists during the cancer consultation. Eur J Cancer Care (Engl) 2001; 10:115-23. [PMID: 11829044 DOI: 10.1046/j.1365-2354.2001.00257.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Effective communication between oncologists and patients with cancer is of paramount importance. The Chemotherapy Patient Monitor (CPM) is a novel tool designed to assist doctor-patient communication regarding patient concerns and side-effects. Initially, the CPM was assessed in a primary evaluation study of its use during consultations with 26 patients with advanced colorectal cancer (one consultation without, followed by two with, the CPM per patient). This led to a further dissemination/audit of 34 patients attending oncology centres in the UK, who had completed the survey prior to three consultations. The CPM contains a checklist of common side-effects of chemotherapy regimens used in advanced colorectal cancer, and other common concerns of patients with advanced colorectal cancer. The CPM records the presence of side-effects/concerns, the distress caused, whether patients wish to discuss them further, and actions taken as a result. Questionnaires explored the views of patients and oncologists in the UK and Spain regarding the effectiveness of consultations during a baseline visit conducted without the CPM, and then with the CPM in subsequent visits. These data were then complemented by the dissemination/audit study of the CPM across nine centres in the UK. All patients understood the CPM. The CPM was rated as useful by oncologists in 83% of consultations, and did not lengthen 82% of visits. Patients felt it had improved the visit in 95% of cases. Responses from patients (100%) and oncologists (84%) indicated willingness to use the CPM for at least some consultations in the future. The results of the dissemination/audit study supported these conclusions. We conclude that the CPM appears to be a useful new tool for improving patient-doctor communication during cancer consultations.
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Meier-Ewert HK, Ridker PM, Rifai N, Price N, Dinges DF, Mullington JM. Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects. Clin Chem 2001; 47:426-30. [PMID: 11238292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND The concentration of C-reactive protein (CRP) in otherwise healthy subjects has been shown to predict future risk of myocardial infarction and stroke. CRP is synthesized by the liver in response to interleukin-6, the serum concentration of which is subject to diurnal variation. METHODS To examine the existence of a time-of-day effect for baseline CRP values, we determined CRP concentrations in hourly blood samples drawn from healthy subjects (10 males, 3 females; age range, 21-35 years) during a baseline day in a controlled environment (8 h of nighttime sleep). RESULTS Overall CRP concentrations were low, with only three subjects having CRP concentrations >2 mg/L. Comparison of raw data showed stability of CRP concentrations throughout the 24 h studied. When compared with cutoff values of CRP quintile derived from population-based studies, misclassification of greater than one quintile did not occur as a result of diurnal variation in any of the subjects studied. Nonparametric ANOVA comparing different time points showed no significant differences for both raw and z-transformed data. Analysis for rhythmic diurnal variation using a method fitting a cosine curve to the group data was negative. CONCLUSIONS Our data show that baseline CRP concentrations are not subject to time-of-day variation and thus help to explain why CRP concentrations are a better predictor of vascular risk than interleukin-6. Determination of CRP for cardiovascular risk prediction may be performed without concern for diurnal variation.
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Lamberti JS, Weisman RL, Schwarzkopf SB, Price N, Ashton RM, Trompeter J. The mentally ill in jails and prisons: towards an integrated model of prevention. Psychiatr Q 2001; 72:63-77. [PMID: 11293202 DOI: 10.1023/a:1004862104102] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Jails and prisons have become a final destination for persons with severe mental illness in America. Addiction, homelessness, and fragmentation of services have contributed to the problem, and have underscored the need for new models of service delivery. Project Link is a university-led consortium of five community agencies in Monroe County, New York that spans healthcare, social service and criminal justice systems. The program features a mobile treatment team with a forensic psychiatrist, a dual diagnosis treatment residence, and culturally competent staff. This paper discusses the importance of service integration in preventing jail and hospital recidivism, and describes steps that Project Link has taken towards integrating healthcare, criminal justice, and social services. Results from a preliminary evaluation suggest that Project Link may be effective in reducing recidivism and in improving community adjustment among severely mentally ill patients with histories of arrest and incarceration.
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Miles A, Charlton B, Bentley P, Polychronis A, Grey J, Price N. New perspectives in the evidence-based healthcare debate. J Eval Clin Pract 2000; 6:77-84. [PMID: 10970001 DOI: 10.1046/j.1365-2753.2000.00255.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Price N, Gottfried MR, Clary E, Lawson DC, Baillie J, Mergener K, Westcott C, Eubanks S, Pappas TN. Safety and efficacy of India ink and indocyanine green as colonic tattooing agents. Gastrointest Endosc 2000; 51:438-42. [PMID: 10744816 DOI: 10.1016/s0016-5107(00)70445-7] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Controversy exists concerning the safety and efficacy of colonic tattooing for the intraoperative identification of polypectomy sites. The purpose of this study was to determine (1) the concentrations of India ink and indocyanine green that resulted in high-visibility tattoos without significant tissue inflammation and (2) the India ink injection volume that produces best visibility at colonoscopy, laparoscopy, and laparotomy. METHODS Twenty-two New Zealand white rabbits (2 kg) were anesthetized and injected with India ink (undiluted 1:10, 1:50, 1:100, 1:1000, 1:10,000) and indocyanine green as an undiluted, concentrated formulation (25 mL/2 mL solvent) or in a diluted form (25 mg/5 mL solvent) at various concentrations (1:10, 1:50, 1:100). Tuberculin syringes were used to create a 0.1 mL serosal bleb at two injection sites 2 cm apart. Laparotomy was repeated at days 1, 3, and 7 after injection. Additionally, 16 rabbits were injected with India ink at laparotomy and re-explored at 1 and 5 months. Twelve mongrel dogs (20 kg) were injected with 1.0 mL volumes. Re-exploration by colonoscopy, laparoscopy, and laparotomy was done at 7 days and 1 month. Tattoo visibility at re-exploration in both animal models was graded on a scale (0 = agent not seen, 1 = seen with difficulty, 2 = easily seen). Histology in the rabbit was judged by degrees of inflammation (0 = no inflammation, 2 = mild inflammation, 4 = moderate inflammation, 6 = severe inflammation). RESULTS The concentrated indocyanine green solution was easily visible only on day 1 in the rabbit. Injections of both concentrated and diluted indocyanine green caused mucosal ulceration and moderate to severe inflammation. India ink studied at 7 days, 1 month, and 5 months after injection in the rabbit model was visible at all concentrations. The undiluted and 1:10 concentrations were easily seen and showed evidence of mucosal ulceration. Tattoos produced with all other India ink concentrations were visible without gross inflammation. India ink was also studied at 7 days and 1 month in dogs. The tattoo with the 1:100 concentration at 0.5 mL was seen consistently at colonoscopy, laparoscopy, and laparotomy with only a mild submucosal reaction at 7 days. The tattoos produced with the 1:100 and 1:1000 concentrations at 0.5 mL and 1.0 mL injection volumes were easily seen by all methods of intraabdominal visualization at 1 month with similar histology. CONCLUSION Indocyanine green was an ineffective colonic tattooing agent. India ink was an effective colonic tattooing agent. Dilute concentrations that caused little to no inflammation could be visualized at 7 days and 1 month in rabbits and dogs and at 5 months in rabbits. India ink, at appropriated concentrations, appears to be a safe short- and long-term colonic tattooing agent.
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Price N, Tscharke DC, Hollinshead M, Smith GL. Vaccinia virus gene B7R encodes an 18-kDa protein that is resident in the endoplasmic reticulum and affects virus virulence. Virology 2000; 267:65-79. [PMID: 10648184 DOI: 10.1006/viro.1999.0116] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This paper presents a characterisation of vaccinia virus (VV) gene B7R that was predicted to encode a polypeptide of 182 amino acids with an N-terminal signal peptide. In vitro transcription and translation analysis showed the B7R gene product was a 21-kDa protein that, in the presence of microsomes, was processed into an 18-kDa mature form. The 18-kDa form associated with the microsomal membranes and was within the lumen of the vesicle where it was inaccessible to exogenous protease or an antibody raised against the B7R C terminus. Within VV-infected cells, the 18-kDa form of B7R was detected late during infection in the endoplasmic reticulum where it colocalised with protein disulphide isomerase. The B7R protein was detected neither in the culture supernatant nor associated with virus particles. A virus deletion mutant lacking the B7R gene and a revertant virus were constructed. Compared to wild-type and revertant viruses, the deletion mutant replicated normally in cell culture and had unaltered virulence in a murine intranasal model of infection. However, the deletion mutant was attenuated in a murine intradermal model where it induced a smaller lesion than the control viruses.
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Price N. The role of the research sister in MRI/oncology. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)80591-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Price N, Hunt NP, Lewis MP. Expression of an embryonic fibronectin splicing variant in human masseter muscle. Arch Oral Biol 1998; 43:911-5. [PMID: 9821515 DOI: 10.1016/s0003-9969(98)00076-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Fibronectin is an extracellular matrix protein that is a key constituent of all skeletal muscles. Its deposition increases in a number of pathological conditions, including some muscular dystrophies in which a progressive increase in lower-face height is often noted. It has been shown in other organ systems that increased deposition of fibronectin is associated with changes in the expression of differentially spliced isoforms of the molecule. This investigation documents the expression of mRNA coding for fibronectin and its splicing variants, EIIIA and EIIIB, in biopsies of masseter muscle from normal and long-face patients, using reverse transcriptase-polymerase chain reaction. Expression was compared with that occurring in anatomically and embryologically differing somatic skeletal muscle. Masseter expressed fibronectin mRNA containing the EIIIA but not the EIIIB splicing variant. Conversely, somatic skeletal muscle expressed neither the EIIIA nor EIIIB variants. There were no differences between expression of fibronectin containing the EIIIA splicing variants in masseter from normal and long faces. These results suggest that variations in fibronectin expression reflect the differing functional demands of muscles from different anatomical locations and indicate that jaw and somatic muscle belong to different allotypes.
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Miles A, Bentley P, Polychronis A, Grey J, Price N. Recent progress in health services research: on the need for evidence-based debate. J Eval Clin Pract 1998; 4:257-65. [PMID: 9927236 DOI: 10.1111/j.1365-2753.1998.tb00084.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lip PL, Jones AF, Price N, Headon M, Beevers DG, Lip GY. Do intraocular angiotensin II levels, plasma prothrombotic factors and endothelial dysfunction contribute to proliferative diabetic retinopathy? ACTA OPHTHALMOLOGICA SCANDINAVICA 1998; 76:533-6. [PMID: 9826034 DOI: 10.1034/j.1600-0420.1998.760504.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate whether diabetic retinopathy (DR) is associated with abnormalities in: (i) aqueous humour Angiotensin I (Ang I) and Angiotensin II (Ang II) levels; and (ii) plasma Ang I, soluble P-selectin, lipoprotein (a) (Lp(a)), endothelial markers and haemorheological abnormalities. METHODS Cross-sectional study of diabetic patients and healthy controls undergoing cataract surgery. RESULTS 21 diabetic patients (12 males; mean age 67.0 years) were studied. Plasma levels of Ang II were lower in diabetics compared with controls (p<0.05). There were no differences in mean aqueous Ang I and Ang II levels in diabetics with or without proliferative DR compared with controls. Mean systolic blood pressure was higher in Group 1 patients (p=0.02). Patients with DR also demonstrated high Lp (a) and abnormal haemorheological factors (fibrinogen, white cell count). CONCLUSION Ang I and Ang II do not significantly contribute to the pathogenesis of DR. Patients with DR also had abnormal Lp (a) and haemorheological factors. The role of hypertension in the pathogenesis of DR needs further evaluation.
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Doorey A, Patel S, Reese C, O'Connor R, Geloo N, Sutherland S, Price N, Gleasner E, Rodrigue R. Dangers of delay of initiation of either thrombolysis or primary angioplasty in acute myocardial infarction with increasing use of primary angioplasty. Am J Cardiol 1998; 81:1173-7. [PMID: 9604940 DOI: 10.1016/s0002-9149(98)00160-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We observed treatment delays and suboptimal outcomes when beginning to treat patients with acute myocardial infarction (AMI) with primary angioplasty. Of the 37 patients treated during a 12-month period, 12 (32%) required either emergency bypass surgery or died. Delayed time intervals to balloon reperfusion (mean 134 minutes) probably contributed to these adverse outcomes, with hemodynamic instability requiring pressors or intra-aortic balloon pumping in 15 patients, 12 (75%) before the first balloon inflation. Eleven of the 12 patients with significant adverse outcomes required such intervention. As angioplasty use increased, time intervals to thrombolysis in those not treated with angioplasty increased from an average of 29 minutes (53% treated less than the national standard of 30 minutes) to 39 minutes (32% treated <30 minutes, p <0.001). During the last 2 months of the study period, the time intervals had increased to 48 minutes (14% treated <30 minutes, p <0.0001). There was no change in thrombolytic time intervals at a local community hospital that did not offer primary angioplasty. Emergency Department physician confusion about the best therapy (angioplasty or thrombolysis) was documented in the medical records in 42% of cases (53 of 127). Confusion regarding therapy of AMI led to unacceptable delays in the administration of thrombolytic agents and probably contributed to the adverse outcomes in patients receiving primary angioplasty.
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Price N, Bendall SP, Frondoza C, Jinnah RH, Hungerford DS. Human osteoblast-like cells (MG63) proliferate on a bioactive glass surface. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 1997; 37:394-400. [PMID: 9368144 DOI: 10.1002/(sici)1097-4636(19971205)37:3<394::aid-jbm10>3.0.co;2-c] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Bioglass, a resorbable glass, previously has been evaluated as a bone graft substitute using cells of animal origin. Limited information is available on its effect on human cells. The objective of this study was to test the hypothesis that Bioglass supports viability and proliferation of human bone cells. As a prototype of human bone cells, the osteoblast cell line MG63 was used and propagated on Bioglass disks. MG63 cells also were seeded onto disks made of titanium (Ti-6Al-4V) and of cobalt chrome (Co-Cr-Mo) alloys. The number of viable cells recovered was similar for Bioglass, titanium, and polystyrene control surfaces. Significantly fewer cells were recovered from CoCr (P < 0.05) compared to Bioglass, Ti-6 Al-4v, and polystyrene surfaces. The proportion of cells undergoing DNA synthesis, estimated by thymidine uptake, was significantly greater on Bioglass and titanium surfaces (P < 0.05) than on the CoCr surface. There were detectable differences in cell morphology on these biomaterials. Functional capacity was tested by assay of osteocalcin production and no differences were detectable among the different biomaterials. This study supports the hypothesis that 45S5 Bioglass provides a favorable environment for human osteoblast proliferation and function. Bioglass may have clinical potential as a bone graft substitute, a bioactive grout, or an implant coating for promoting bony ingrowth in uncemented prostheses.
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Miles A, Bentley P, Polychronis A, Price N, Grey J. Goals and methods of audit should be reappraised. Pragmatic methods need to be developed. BMJ (CLINICAL RESEARCH ED.) 1996; 313:497. [PMID: 8776346 PMCID: PMC2351888 DOI: 10.1136/bmj.313.7055.497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
It is increasingly recognized that the repeated rhetorical emphasis from 1989 to date on achieving measurable benefits to patients from audit, in the face of inattention to the development of methodologies with which to realize such benefits in operational practice, has represented a serious deficiency in strategic planning and direction and a consequent failure to establish functional clinical audit within the NHS. A grand revision of strategy is therefore necessary, and this should begin with the development of a research-based method of audit, the training of clinicians and audit support staff in its use and a subsequent trial of its effectiveness prior to its implementation within the NHS. Only then will measurable improvements become possible, value for money be assured and clinicians' attitudes to audit change.
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Miles A, Bentley P, Price N, Polychronis A, Grey J, Asbridge J. The Total Health Care Audit System: a systematic methodology for clinical practice evaluation and development in NHS provider organizations. J Eval Clin Pract 1996; 2:37-64. [PMID: 9238575 DOI: 10.1111/j.1365-2753.1996.tb00027.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Writing in Medical Education in 1982, Fowkes (1982) noted the lack of general agreement within the medical profession on methods of audit, a deficiency previously articulated by Shaw (1980) and later emphasized by McIntyre (1985). More recently, a study by Black & Thompson (1993) of consultant and junior medical staff in four London district general hospitals revealed that 'many doctors did not understand how to undertake audit', and major research by both Hopkins (1993, 1994) and Buttery et al. (1994) described a multiplicity of methodological deficiencies in the general approaches to audit adopted by clinicians since the promulgation of the White Paper definition in 1989. Soundness of methodological approach is fundamental to securing the success of clinical audit within Provider organizations and is thus central to the generation of measurable improvements in the quality of clinical care being delivered to patients. It is therefore disturbing that methodological deficiencies may still be observed in general approaches to audit (Buttery et al. 1994), with no author yet recommending a formal system for critical inquiry into clinical practice. It was the recognition of the unsatisfactory nature of this situation which led us to develop a system aimed at assessing, in a critical fashion, the quality of the totality of care dispensed within NHS provider organizations. The system is presented here for the first time.
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Price N. The changing value of children among the Kikuyu of Central Province, Kenya. AFRICA : JOURNAL OF THE INTERNATIONAL INSTITUTE OF AFRICAN LANGUAGES AND CULTURES 1996; 66:411-436. [PMID: 12348071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
"This article describes and analyses recent changes in the social institutions and cultural practices which have traditionally supported high fertility among the Kikuyu of Central Province, Kenya, and assesses the extent to which such institutions and practices retain their significance in the context of the changing value of children. The material and symbolic value of children to the Kikuyu is analysed, using methods and concepts derived from social anthropology.... After briefly profiling each of the communities of study, the article is organised around three themes which correspond to the key social institutions that shape fertility motives: marriage, kinship and religion. A fourth theme which runs throughout the article is the changing strategic role played by these same institutions in regulating or enhancing fertility." (SUMMARY IN FRE)
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