R. Newcombe | Cardiff University (original) (raw)

Papers by R. Newcombe

Research paper thumbnail of Toothpastes containing 0.3% and 0.5% triclosan. II. Effects of single brushings on salivary bacterial counts

American journal of dentistry, 1989

For antimicrobials such as chlorhexidine antiplaque activity appears due to persistence of consid... more For antimicrobials such as chlorhexidine antiplaque activity appears due to persistence of considerable antimicrobial action in the mouth. The substantivity of antimicrobial compounds can be evaluated by measuring the magnitude and duration of salivary bacterial counts following a single exposure. Such data has been shown to correlate with plaque inhibitory properties of antimicrobial compounds. This study measured the effects of single brushings with 0.3% and 0.5% triclosan with or without PVM/MA copolymer in toothpastes on salivary bacterial counts in 14 young adults. The results were compared with single rinsing with a 0.2% chlorhexidine solution, water and a single brushing with a commercial fluoride toothpaste. The study was a 7 cell cross-over design, randomized using a 7x7 latin square design. Chlorhexidine produced large and significant reductions which persisted to the 7 hour measurement time with no indication of count recovery at this time. The triclosan pastes containing...

Research paper thumbnail of Predictors of non-sentinel lymph node metastasis in breast cancer patients

European Journal of Cancer, 2004

In many patients, the sentinel lymph node (SLN) is the sole site of regional nodal metastasis. Th... more In many patients, the sentinel lymph node (SLN) is the sole site of regional nodal metastasis. This subgroup of patients would not be expected to benefit from completion axillary lymph node dissection (CALND). This study evaluated the factors that may determine the likelihood of additional positive nodes in the axilla in the presence of sentinel node metastasis. A total of 618 breast cancer patients underwent SLN biopsy based on lymphoscintigraphy, intraoperative gamma probe detection, and blue dye mapping using 99mTc-nanocolloid and Patent Blue V injected peritumourally. This was followed by standard axillary node clearance at the same operation. Of the 201 patients with a positive SLN, 105 (52%) patients had no further positive nodes in the axilla, 96 (48%) patients had additional metastasis in non-sentinel lymph nodes (NSLN) upon CALND. In patients with a positive SLN, increasing tumour size and tumour grade significantly increased the frequency of additional positive nodes on univariate analysis. The number of SLNs removed and the number of negative SLNs were significant negative predictors. Increasing tumour burden in the sentinel nodes (determined by the number of positive SLNs) was significantly associated with increasing likelihood of positive NSLNs. Multivariate analysis revealed that the rest of the axilla is more likely to be positive if there are more positive than negative SLNs removed and more likely to be negative otherwise. A group of cases from one centre (Cardiff) were subjected to further detailed analysis. Tumour burden in the positive SLN was assessed by measuring the size of metastasis, percentage replacement of the SLN by tumour and by documenting extracapsular extension (ECE) around the SLN. Of the 64 patients with a positive SLN, 34 (53%) patients had no further positive nodes in the axilla, 30 patients (47%) had additional metastasis in NSLNs upon CALND. Increasing tumour burden in the SLN was associated with additional positive nodes in the axilla. Multivariate analysis revealed that size of the SLN metastasis is the most important predictor of involvement of only the SLN. Overall, in patients with a positive SLN, the difference in the number of positive and negative SLNs removed and size of the metastasis in the SLN, all predicted the frequency of additional positive nodes.

Research paper thumbnail of Effectiveness of preoperative staging in rectal cancer: digital rectal examination, endoluminal ultrasound or magnetic resonance imaging?

British Journal of Cancer, 2004

Research paper thumbnail of Comparison of an herbal toothpaste with a fluoride toothpaste on plaque and gingivitis

Clinical preventive dentistry

An herbal/bicarbonate toothpaste has received some attention from the public and profession follo... more An herbal/bicarbonate toothpaste has received some attention from the public and profession following a number of studies which have reported beneficial effects of the paste on both plaque and gingivitis. The present study, one of several ongoing clinical trials, evaluated the toothpaste in mouthrinse form using a 19-day, no oral hygiene, triple-crossover design in which it was compared with a commercial fluoride toothpaste rinse and the antiplaque mouthrinse chlorhexidine. Over the three periods of the study an increase in plaque and gingivitis was seen for all three products. However, while significant reductions in both parameters were seen with chlorhexidine compared to the toothpastes, there were no significant differences between the herbal and fluoride toothpaste. From these findings it can be concluded that in the long term, the herbal/bicarbonate toothpaste may not exert significant therapeutic effects on plaque and gingivitis beyond that of a conventional commercial paste....

Research paper thumbnail of A clinical study to assess the ability of a powered toothbrush to remove chlorhexidine/tea dental stain

Journal of Clinical Periodontology, 2004

A single-center, single-blind, two-way crossover study was performed to compare the effects of an... more A single-center, single-blind, two-way crossover study was performed to compare the effects of an electric powered toothbrush with a conventional manual toothbrush at removing chlorhexidine/tea tooth staining. This study used 24 subjects. During the week before the study, the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the Monday of the following week, subjects returned to the clinic to receive a further prophylaxis. Under direct supervision, they then rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. Throughout this period, volunteers omitted all other forms of oral hygiene except rinsing with the chlorhexidine mouthwash. On the Friday, the level of stain was assessed both prior to and immediately after brushing with the allocated brush with toothpaste for 1 min. This was done in an adjoining room (out of sight of the clinical scorer). Subjects were then instructed to use the toothbrush at home according to their normal oral hygiene practices. On the following Friday, subjects returned to the clinic when the stain present was re-assessed. Each subject received a thorough prophylaxis to remove all plaque calculus and staining before starting the second period of the study and again on completion of the study. The study showed relatively little difference between the ability of the two brushes to remove stain at a single test brushing. However, there was some evidence that the powered brush was more effective than the manual brush in minimising stain level during the home use period, overall and in particular for gingival crescent sites. This study has suggested that the powered brush may become more effective at reducing dental stain, the longer the brush is used under normal home conditions.

Research paper thumbnail of Studies on the effect of toothpaste rinses on plaque regrowth. (II). Triclosan with and without zinc citrate formulations

Journal of Clinical Periodontology, 1989

Research paper thumbnail of Preventing fractures among older people living in institutional care: a pragmatic randomised double blind placebo controlled trial of vitamin D supplementation

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2007

Osteoporotic fractures in older people are a major and increasing public health problem. We exami... more Osteoporotic fractures in older people are a major and increasing public health problem. We examined the effect of vitamin D supplementation on fracture rate in people living in sheltered accommodation. In a pragmatic double blind randomised controlled trial of 3 years duration, we examined 3,440 people (2,624 women and 816 men) living in residential or care home. We used four-monthly oral supplementation using 100,000 IU vitamin D(2) (ergocalciferol). As a main outcome measure, we used the incidence of first fracture using an intention to treat analysis. This was a multicentre study in 314 care homes or sheltered accommodation complexes in South Wales, UK. The vitamin D and placebo groups had similar baseline characteristics. In intention-to-treat analysis, 205 first fractures occurred in the intervention group during a total of 2,846 person years of follow-up (7 fractures per 100 people per year of follow-up), with 218 first fractures in the control group over 2,860 person years o...

Research paper thumbnail of Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II

Bmj, 1994

Objectives: To define relation between mood and concentrations of progesterone and cortisol durin... more Objectives: To define relation between mood and concentrations of progesterone and cortisol during perinatal period to test hypothesis that rapid physiological withdrawal of steroid hormones after delivery is associated with depression. ... Design: Prospective study of primiparous ...

Research paper thumbnail of Carrier Detection Of Haemophilia A In Pregnancy By Measurement Of Factor VIIIc/Rag And VIIICAg/RAg Ratios

VIIIth International Congress on Thrombosis and Haemostasis

The 1977 WHO Memorandum on carrier detection highlighted the need to test the methods in pregnanc... more The 1977 WHO Memorandum on carrier detection highlighted the need to test the methods in pregnancy, when plasma modalities of facor VIII are augmented. At KCH blood was taken into citrate from 21 pregnant obligate carriers of severe haemophilia A and 28 pregnant women from unaffected families, matched for age and period of gestation. The women, who were basal after a night’s rest, were tested prior to prenatal diagnosis of haemophilia or other conditions, or to undergoing termination of pregnancy for unrelated causes.One-stage factor VIIIC assays were done immediately; VIIIRAg (Laurell) after -40°C storage within 6 days; and VIIICAg immunoradiometrically in Cardiff on the remainder after varying intervals. Careful standardization was ensured between both laboratories.At 17-22 weeks, VIIIRAg was elevated both in pregnant controls & carriers]; VIIIC & VIIICAg levels were also raised, though less, in the controls (values in units/dl)In pregnant carriers, VIIIC & VIIICAg are both lower ...

Research paper thumbnail of Relative value of blue dye and isotope in sentinel node localization for breast cancer in a multicentre trial

European Journal of Cancer Supplements

Research paper thumbnail of Taurolin as an oral rinse. I. Antimicrobial effects in vitro and in vivo

Clinical preventive dentistry

Taurolin, a synthetic antimicrobial agent, has been suggested to be of potential value as an inhi... more Taurolin, a synthetic antimicrobial agent, has been suggested to be of potential value as an inhibitor of dental plaque. Although data on the antibacterial activity of Taurolin are available there is a dearth of information for effects on oral bacterial isolates and antibacterial activity in the mouth. This study assessed the in vivo and in vitro antibacterial properties of a Taurolin rinse by a) determining the MID values against seven oral isolates and b) measuring salivary bacterial counts following a single rinse. By comparing activity with chlorhexidine, it was hoped to determine substantivity and predict the relative ability of Taurolin to inhibit plaque through an antimicrobial effect. For Taurolin, MID values against the test organisms were found to range between 1:20 and 1:80, while for chlorhexidine, values between 1:320 to 1:640 were obtained. The effects on salivary bacterial counts revealed that Taurolin significantly reduced salivary bacterial counts compared to saline...

Research paper thumbnail of Severe Postherpetic Neuralgia and Other Neuropathic Pain Syndromes Alleviated by Topical Gabapentin

The British journal of dermatology, Jan 18, 2014

Herpes zoster reactivation, shingles, affects 0.2% of the population (1) and complications includ... more Herpes zoster reactivation, shingles, affects 0.2% of the population (1) and complications include: secondary bacterial infection, postherpetic neuralgia (PHN), ulceration and scarring, pneumonitis, hepatitis, Ramsey-Hunt syndrome, meningoencephalitis and paralysis. PHN occurs in 10 -15% of patients following an episode of shingles, with the greatest risk in the elderly.The risk of PHN can be reduced by early treatment at the onset of the cutaneous eruption with antivirals, amitriptyline, opioid analgesics or oral gabapentin. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Clinical studies to determine the effectiveness of a whitening toothpaste at reducing stain (using a forced stain model)

International journal of dental hygiene, 2005

Two single centre, randomized single-blind, crossover studies were performed, to compare the effe... more Two single centre, randomized single-blind, crossover studies were performed, to compare the effect of a test toothpaste with a conventional fluoride paste in the inhibition and removal of extrinsic dental stain promoted by repeated chlorhexidine/tea rinses. These studies used 24 subjects in each of two separate clinical trials. On the Friday before each trial period, the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the following Monday, subjects were checked whether they were stain free and then under direct supervision they rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. In addition subjects also received daily a single toothpaste slurry rinse or control water rinse in the morning and lunchtime. No other form of oral hygiene was permitted during this period. On the Friday, ...

Research paper thumbnail of Challenging the pressure sore paradigm

Journal of wound care, 1999

This study determines the effectiveness of a new low-unit-cost support system in patients at very... more This study determines the effectiveness of a new low-unit-cost support system in patients at very high risk of developing pressure sores. In a prospective randomised controlled trial, a low-pressure inflatable mattress and cushion system (Repose) was compared to a dynamic support mattress (Nimbus II) used in conjunction with an alternating-pressure cushion (Alpha TranCell) in 80 patients with fractured neck of femur and high scores on a pressure sore risk assessment scale. All patients received best standard care, including turning at regular intervals. Skin condition was assessed in 17 locations on admission, preoperatively, and seven and 14 days postoperatively. No difference was found between the groups in skin condition or the occurrence and severity of pressure sores at any time point.

Research paper thumbnail of The frequency of bleeding and height of adolescent haemophiliacs

Thrombosis and haemostasis, Jan 23, 1979

The relation between the height of adolescent haemophiliacs and their bleeding frequency has been... more The relation between the height of adolescent haemophiliacs and their bleeding frequency has been studied. 45 haemophiliacs aged 10--19 years were divided into 3 groups: small, medium and tall, using a Height Standard Deviation Score. The average bleeding frequency per 100 days in the group of small haemophiliacs was 8.71 +/- SD 4.47, in the medium height group 10.18 +/- SD 6.71, while the tall individuals bled in average 15.97 +/- SD 3.15 every 100 days. There was no relationship between age and bleeding frequency.

Research paper thumbnail of Accuracy of ambulance staff diagnosis of acute cardiogenic pulmonary oedema: A prospective diagnostic study of 1334 patients

Research paper thumbnail of Toward Minimum Standards for Certifying Patient Decision Aids: A Modified Delphi Consensus Process

Medical Decision Making, 2013

Objective. The IPDAS Collaboration has developed a checklist and an instrument (IPDASi v3.0) to a... more Objective. The IPDAS Collaboration has developed a checklist and an instrument (IPDASi v3.0) to assess the quality of patient decision aids (PDAs) in terms of their development process and shared decision-making design components. Certification of PDAs is of growing interest in the US and elsewhere. We report a modified Delphi consensus process to agree on IPDASi (v3.0) items that should be considered as minimum standards for PDA certification, for inclusion in the refined IPDASi (v4.0). Methods. A 2-stage Delphi voting process considered the inclusion of IPDASi (v3.0) items as minimum standards. Item scores and qualitative comments were analyzed, followed by expert group discussion. Results. One hundred and one people voted in round 1; 87 in round 2. Forty-seven items were reduced to 44 items across 3 new categories: 1) qualifying criteria, which are required in order for an intervention to be considered a decision aid (6 items); 2) certification criteria, without which a decision ...

Research paper thumbnail of Comparative effects of toothpaste brushing and toothpaste rinsing on salivary bacterial counts

Journal of Periodontal Research, 1990

Research paper thumbnail of A model protocol evaluating the introduction of genetic assessment for women with a family history of breast cancer

Journal of Medical Genetics, 2000

Randomised controlled trials allow comparisons to be made between diVerent models of service deli... more Randomised controlled trials allow comparisons to be made between diVerent models of service delivery, but have not been used in the field of clinical genetics. With the advent of clinical governance, the evidence provided by such trials will be increasingly important in informing and shaping clinical genetics practice. The TRACE project (Trial of genetic assessment in breast cancer) is a randomised controlled trial of genetic assessment for women who are at increased risk of breast cancer because of their family history. The absence of cancer genetics service provision in Wales before this study gave a window of opportunity in which this important trial could be conducted. The present paper describes how TRACE will provide crucial evidence regarding the psychosocial as well as resource implications of adding individualised genetic assessment, genetic counselling, and (where appropriate) gene testing to typical advice and surveillance from a hospital breast clinic. In addition, it is anticipated that TRACE will represent a model for future trials of service delivery in the increasing number of complex genetic disorders where evidence on the economic implications of screening and management is currently limited.

Research paper thumbnail of Triclosan and sodium lauryl sulphate mouthwashes. (I). Effects on salivary bacterial counts

Journal of Clinical Periodontology, 1991

Research paper thumbnail of Toothpastes containing 0.3% and 0.5% triclosan. II. Effects of single brushings on salivary bacterial counts

American journal of dentistry, 1989

For antimicrobials such as chlorhexidine antiplaque activity appears due to persistence of consid... more For antimicrobials such as chlorhexidine antiplaque activity appears due to persistence of considerable antimicrobial action in the mouth. The substantivity of antimicrobial compounds can be evaluated by measuring the magnitude and duration of salivary bacterial counts following a single exposure. Such data has been shown to correlate with plaque inhibitory properties of antimicrobial compounds. This study measured the effects of single brushings with 0.3% and 0.5% triclosan with or without PVM/MA copolymer in toothpastes on salivary bacterial counts in 14 young adults. The results were compared with single rinsing with a 0.2% chlorhexidine solution, water and a single brushing with a commercial fluoride toothpaste. The study was a 7 cell cross-over design, randomized using a 7x7 latin square design. Chlorhexidine produced large and significant reductions which persisted to the 7 hour measurement time with no indication of count recovery at this time. The triclosan pastes containing...

Research paper thumbnail of Predictors of non-sentinel lymph node metastasis in breast cancer patients

European Journal of Cancer, 2004

In many patients, the sentinel lymph node (SLN) is the sole site of regional nodal metastasis. Th... more In many patients, the sentinel lymph node (SLN) is the sole site of regional nodal metastasis. This subgroup of patients would not be expected to benefit from completion axillary lymph node dissection (CALND). This study evaluated the factors that may determine the likelihood of additional positive nodes in the axilla in the presence of sentinel node metastasis. A total of 618 breast cancer patients underwent SLN biopsy based on lymphoscintigraphy, intraoperative gamma probe detection, and blue dye mapping using 99mTc-nanocolloid and Patent Blue V injected peritumourally. This was followed by standard axillary node clearance at the same operation. Of the 201 patients with a positive SLN, 105 (52%) patients had no further positive nodes in the axilla, 96 (48%) patients had additional metastasis in non-sentinel lymph nodes (NSLN) upon CALND. In patients with a positive SLN, increasing tumour size and tumour grade significantly increased the frequency of additional positive nodes on univariate analysis. The number of SLNs removed and the number of negative SLNs were significant negative predictors. Increasing tumour burden in the sentinel nodes (determined by the number of positive SLNs) was significantly associated with increasing likelihood of positive NSLNs. Multivariate analysis revealed that the rest of the axilla is more likely to be positive if there are more positive than negative SLNs removed and more likely to be negative otherwise. A group of cases from one centre (Cardiff) were subjected to further detailed analysis. Tumour burden in the positive SLN was assessed by measuring the size of metastasis, percentage replacement of the SLN by tumour and by documenting extracapsular extension (ECE) around the SLN. Of the 64 patients with a positive SLN, 34 (53%) patients had no further positive nodes in the axilla, 30 patients (47%) had additional metastasis in NSLNs upon CALND. Increasing tumour burden in the SLN was associated with additional positive nodes in the axilla. Multivariate analysis revealed that size of the SLN metastasis is the most important predictor of involvement of only the SLN. Overall, in patients with a positive SLN, the difference in the number of positive and negative SLNs removed and size of the metastasis in the SLN, all predicted the frequency of additional positive nodes.

Research paper thumbnail of Effectiveness of preoperative staging in rectal cancer: digital rectal examination, endoluminal ultrasound or magnetic resonance imaging?

British Journal of Cancer, 2004

Research paper thumbnail of Comparison of an herbal toothpaste with a fluoride toothpaste on plaque and gingivitis

Clinical preventive dentistry

An herbal/bicarbonate toothpaste has received some attention from the public and profession follo... more An herbal/bicarbonate toothpaste has received some attention from the public and profession following a number of studies which have reported beneficial effects of the paste on both plaque and gingivitis. The present study, one of several ongoing clinical trials, evaluated the toothpaste in mouthrinse form using a 19-day, no oral hygiene, triple-crossover design in which it was compared with a commercial fluoride toothpaste rinse and the antiplaque mouthrinse chlorhexidine. Over the three periods of the study an increase in plaque and gingivitis was seen for all three products. However, while significant reductions in both parameters were seen with chlorhexidine compared to the toothpastes, there were no significant differences between the herbal and fluoride toothpaste. From these findings it can be concluded that in the long term, the herbal/bicarbonate toothpaste may not exert significant therapeutic effects on plaque and gingivitis beyond that of a conventional commercial paste....

Research paper thumbnail of A clinical study to assess the ability of a powered toothbrush to remove chlorhexidine/tea dental stain

Journal of Clinical Periodontology, 2004

A single-center, single-blind, two-way crossover study was performed to compare the effects of an... more A single-center, single-blind, two-way crossover study was performed to compare the effects of an electric powered toothbrush with a conventional manual toothbrush at removing chlorhexidine/tea tooth staining. This study used 24 subjects. During the week before the study, the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the Monday of the following week, subjects returned to the clinic to receive a further prophylaxis. Under direct supervision, they then rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. Throughout this period, volunteers omitted all other forms of oral hygiene except rinsing with the chlorhexidine mouthwash. On the Friday, the level of stain was assessed both prior to and immediately after brushing with the allocated brush with toothpaste for 1 min. This was done in an adjoining room (out of sight of the clinical scorer). Subjects were then instructed to use the toothbrush at home according to their normal oral hygiene practices. On the following Friday, subjects returned to the clinic when the stain present was re-assessed. Each subject received a thorough prophylaxis to remove all plaque calculus and staining before starting the second period of the study and again on completion of the study. The study showed relatively little difference between the ability of the two brushes to remove stain at a single test brushing. However, there was some evidence that the powered brush was more effective than the manual brush in minimising stain level during the home use period, overall and in particular for gingival crescent sites. This study has suggested that the powered brush may become more effective at reducing dental stain, the longer the brush is used under normal home conditions.

Research paper thumbnail of Studies on the effect of toothpaste rinses on plaque regrowth. (II). Triclosan with and without zinc citrate formulations

Journal of Clinical Periodontology, 1989

Research paper thumbnail of Preventing fractures among older people living in institutional care: a pragmatic randomised double blind placebo controlled trial of vitamin D supplementation

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2007

Osteoporotic fractures in older people are a major and increasing public health problem. We exami... more Osteoporotic fractures in older people are a major and increasing public health problem. We examined the effect of vitamin D supplementation on fracture rate in people living in sheltered accommodation. In a pragmatic double blind randomised controlled trial of 3 years duration, we examined 3,440 people (2,624 women and 816 men) living in residential or care home. We used four-monthly oral supplementation using 100,000 IU vitamin D(2) (ergocalciferol). As a main outcome measure, we used the incidence of first fracture using an intention to treat analysis. This was a multicentre study in 314 care homes or sheltered accommodation complexes in South Wales, UK. The vitamin D and placebo groups had similar baseline characteristics. In intention-to-treat analysis, 205 first fractures occurred in the intervention group during a total of 2,846 person years of follow-up (7 fractures per 100 people per year of follow-up), with 218 first fractures in the control group over 2,860 person years o...

Research paper thumbnail of Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II

Bmj, 1994

Objectives: To define relation between mood and concentrations of progesterone and cortisol durin... more Objectives: To define relation between mood and concentrations of progesterone and cortisol during perinatal period to test hypothesis that rapid physiological withdrawal of steroid hormones after delivery is associated with depression. ... Design: Prospective study of primiparous ...

Research paper thumbnail of Carrier Detection Of Haemophilia A In Pregnancy By Measurement Of Factor VIIIc/Rag And VIIICAg/RAg Ratios

VIIIth International Congress on Thrombosis and Haemostasis

The 1977 WHO Memorandum on carrier detection highlighted the need to test the methods in pregnanc... more The 1977 WHO Memorandum on carrier detection highlighted the need to test the methods in pregnancy, when plasma modalities of facor VIII are augmented. At KCH blood was taken into citrate from 21 pregnant obligate carriers of severe haemophilia A and 28 pregnant women from unaffected families, matched for age and period of gestation. The women, who were basal after a night’s rest, were tested prior to prenatal diagnosis of haemophilia or other conditions, or to undergoing termination of pregnancy for unrelated causes.One-stage factor VIIIC assays were done immediately; VIIIRAg (Laurell) after -40°C storage within 6 days; and VIIICAg immunoradiometrically in Cardiff on the remainder after varying intervals. Careful standardization was ensured between both laboratories.At 17-22 weeks, VIIIRAg was elevated both in pregnant controls & carriers]; VIIIC & VIIICAg levels were also raised, though less, in the controls (values in units/dl)In pregnant carriers, VIIIC & VIIICAg are both lower ...

Research paper thumbnail of Relative value of blue dye and isotope in sentinel node localization for breast cancer in a multicentre trial

European Journal of Cancer Supplements

Research paper thumbnail of Taurolin as an oral rinse. I. Antimicrobial effects in vitro and in vivo

Clinical preventive dentistry

Taurolin, a synthetic antimicrobial agent, has been suggested to be of potential value as an inhi... more Taurolin, a synthetic antimicrobial agent, has been suggested to be of potential value as an inhibitor of dental plaque. Although data on the antibacterial activity of Taurolin are available there is a dearth of information for effects on oral bacterial isolates and antibacterial activity in the mouth. This study assessed the in vivo and in vitro antibacterial properties of a Taurolin rinse by a) determining the MID values against seven oral isolates and b) measuring salivary bacterial counts following a single rinse. By comparing activity with chlorhexidine, it was hoped to determine substantivity and predict the relative ability of Taurolin to inhibit plaque through an antimicrobial effect. For Taurolin, MID values against the test organisms were found to range between 1:20 and 1:80, while for chlorhexidine, values between 1:320 to 1:640 were obtained. The effects on salivary bacterial counts revealed that Taurolin significantly reduced salivary bacterial counts compared to saline...

Research paper thumbnail of Severe Postherpetic Neuralgia and Other Neuropathic Pain Syndromes Alleviated by Topical Gabapentin

The British journal of dermatology, Jan 18, 2014

Herpes zoster reactivation, shingles, affects 0.2% of the population (1) and complications includ... more Herpes zoster reactivation, shingles, affects 0.2% of the population (1) and complications include: secondary bacterial infection, postherpetic neuralgia (PHN), ulceration and scarring, pneumonitis, hepatitis, Ramsey-Hunt syndrome, meningoencephalitis and paralysis. PHN occurs in 10 -15% of patients following an episode of shingles, with the greatest risk in the elderly.The risk of PHN can be reduced by early treatment at the onset of the cutaneous eruption with antivirals, amitriptyline, opioid analgesics or oral gabapentin. This article is protected by copyright. All rights reserved.

Research paper thumbnail of Clinical studies to determine the effectiveness of a whitening toothpaste at reducing stain (using a forced stain model)

International journal of dental hygiene, 2005

Two single centre, randomized single-blind, crossover studies were performed, to compare the effe... more Two single centre, randomized single-blind, crossover studies were performed, to compare the effect of a test toothpaste with a conventional fluoride paste in the inhibition and removal of extrinsic dental stain promoted by repeated chlorhexidine/tea rinses. These studies used 24 subjects in each of two separate clinical trials. On the Friday before each trial period, the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the following Monday, subjects were checked whether they were stain free and then under direct supervision they rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. In addition subjects also received daily a single toothpaste slurry rinse or control water rinse in the morning and lunchtime. No other form of oral hygiene was permitted during this period. On the Friday, ...

Research paper thumbnail of Challenging the pressure sore paradigm

Journal of wound care, 1999

This study determines the effectiveness of a new low-unit-cost support system in patients at very... more This study determines the effectiveness of a new low-unit-cost support system in patients at very high risk of developing pressure sores. In a prospective randomised controlled trial, a low-pressure inflatable mattress and cushion system (Repose) was compared to a dynamic support mattress (Nimbus II) used in conjunction with an alternating-pressure cushion (Alpha TranCell) in 80 patients with fractured neck of femur and high scores on a pressure sore risk assessment scale. All patients received best standard care, including turning at regular intervals. Skin condition was assessed in 17 locations on admission, preoperatively, and seven and 14 days postoperatively. No difference was found between the groups in skin condition or the occurrence and severity of pressure sores at any time point.

Research paper thumbnail of The frequency of bleeding and height of adolescent haemophiliacs

Thrombosis and haemostasis, Jan 23, 1979

The relation between the height of adolescent haemophiliacs and their bleeding frequency has been... more The relation between the height of adolescent haemophiliacs and their bleeding frequency has been studied. 45 haemophiliacs aged 10--19 years were divided into 3 groups: small, medium and tall, using a Height Standard Deviation Score. The average bleeding frequency per 100 days in the group of small haemophiliacs was 8.71 +/- SD 4.47, in the medium height group 10.18 +/- SD 6.71, while the tall individuals bled in average 15.97 +/- SD 3.15 every 100 days. There was no relationship between age and bleeding frequency.

Research paper thumbnail of Accuracy of ambulance staff diagnosis of acute cardiogenic pulmonary oedema: A prospective diagnostic study of 1334 patients

Research paper thumbnail of Toward Minimum Standards for Certifying Patient Decision Aids: A Modified Delphi Consensus Process

Medical Decision Making, 2013

Objective. The IPDAS Collaboration has developed a checklist and an instrument (IPDASi v3.0) to a... more Objective. The IPDAS Collaboration has developed a checklist and an instrument (IPDASi v3.0) to assess the quality of patient decision aids (PDAs) in terms of their development process and shared decision-making design components. Certification of PDAs is of growing interest in the US and elsewhere. We report a modified Delphi consensus process to agree on IPDASi (v3.0) items that should be considered as minimum standards for PDA certification, for inclusion in the refined IPDASi (v4.0). Methods. A 2-stage Delphi voting process considered the inclusion of IPDASi (v3.0) items as minimum standards. Item scores and qualitative comments were analyzed, followed by expert group discussion. Results. One hundred and one people voted in round 1; 87 in round 2. Forty-seven items were reduced to 44 items across 3 new categories: 1) qualifying criteria, which are required in order for an intervention to be considered a decision aid (6 items); 2) certification criteria, without which a decision ...

Research paper thumbnail of Comparative effects of toothpaste brushing and toothpaste rinsing on salivary bacterial counts

Journal of Periodontal Research, 1990

Research paper thumbnail of A model protocol evaluating the introduction of genetic assessment for women with a family history of breast cancer

Journal of Medical Genetics, 2000

Randomised controlled trials allow comparisons to be made between diVerent models of service deli... more Randomised controlled trials allow comparisons to be made between diVerent models of service delivery, but have not been used in the field of clinical genetics. With the advent of clinical governance, the evidence provided by such trials will be increasingly important in informing and shaping clinical genetics practice. The TRACE project (Trial of genetic assessment in breast cancer) is a randomised controlled trial of genetic assessment for women who are at increased risk of breast cancer because of their family history. The absence of cancer genetics service provision in Wales before this study gave a window of opportunity in which this important trial could be conducted. The present paper describes how TRACE will provide crucial evidence regarding the psychosocial as well as resource implications of adding individualised genetic assessment, genetic counselling, and (where appropriate) gene testing to typical advice and surveillance from a hospital breast clinic. In addition, it is anticipated that TRACE will represent a model for future trials of service delivery in the increasing number of complex genetic disorders where evidence on the economic implications of screening and management is currently limited.

Research paper thumbnail of Triclosan and sodium lauryl sulphate mouthwashes. (I). Effects on salivary bacterial counts

Journal of Clinical Periodontology, 1991