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  1. Article: Implementing a Prenatal Oral Health Program for Dental Students: Lessons Learned.

    Brame, Jennifer L / Quinonez, Rocio B / Ciszek, Brittney P / Weintraub, Jane A

    Health promotion practice

    2023  , Page(s) 15248399231207070

    Abstract: The Prenatal Oral Health Program (pOHP) was developed to educate dental students on prenatal oral health and promote access to dental care for pregnant women. Program advancement has occurred in support of quality improvement. This mixed-methods design ... ...

    Abstract The Prenatal Oral Health Program (pOHP) was developed to educate dental students on prenatal oral health and promote access to dental care for pregnant women. Program advancement has occurred in support of quality improvement. This mixed-methods design combined quantitative data from fourth-year dental students who participated the pOHP (N = 81) and qualitative data from a student-faculty-staff focus group discussion (N = 7). Different clinical structures, appropriate leveling in the curriculum, management with a patient care coordinator, and inclusion of interprofessional learning experiences (IPE) were compared. The survey response rate was 96.4% (N = 81). Trends were noted between students who provided clinical care for a pregnant patient (31%) versus those who did not. Results indicated that an integrated clinic was preferred, though students who had treated a pOHP patient showed greater support for a standalone clinic model. Survey and focus group data agreed that pOHP should occur during the third-year dental school training; however, students with patient experience favored second-year placement. Survey and focus group data emphasize the importance of a patient care coordinator for clinical management and IPE as an essential learning element. Innovating new clinical models requires a period of evolution to determine preferred and sustainable infrastructure. Results reveal the advantages and disadvantages of various program implementation models and demonstrate that student perceptions were influenced by their clinical experiences. Study findings will inform implementation and guide other programs as they create and modify existing curricula to enhance prenatal oral health.
    Language English
    Publishing date 2023-10-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2036801-X
    ISSN 1552-6372 ; 1524-8399
    ISSN (online) 1552-6372
    ISSN 1524-8399
    DOI 10.1177/15248399231207070
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Retrospective Study of Prenatal and Postnatal Gaps in Oral Health Care Utilization: Medicaid Policy Implications.

    Puett, Savannah / Tellez, Montserrat / Byrd, Gentry / Weintraub, Jane A / Ciszek, Brittney / Phillips, Ceib / Boggess, Kim / Quinonez, Rocio

    Maternal and child health journal

    2022  Volume 26, Issue 3, Page(s) 642–648

    Abstract: Objective: To assess the frequency and timing of dental treatment completion among pregnant and post-partum women served through the University of North Carolina at Chapel Hill (UNC-CH) Prenatal Oral Health Program (pOHP) dental clinic in the context of ...

    Abstract Objective: To assess the frequency and timing of dental treatment completion among pregnant and post-partum women served through the University of North Carolina at Chapel Hill (UNC-CH) Prenatal Oral Health Program (pOHP) dental clinic in the context of North Carolina (NC) dental Medicaid policies.
    Methods: We completed a retrospective chart review of pregnant women referred to the program between May 2015 and May 2019. Data were collected from the time of referral until up to 2 years after their estimated due date (EDD). We assessed pre- and post-delivery dental appointment timing and dental treatment completion.
    Results: The initial study population included 264 pregnant women. Overall, 213 patients (81%) attended at least one appointment, and 32 patients (12%) completed recommended treatments prior to their EDD. Fifty patients (19%) returned after delivery to resume dental care, with only 25 patients (10%) completing their recommended treatment plan. Women re-entered dental care at a median of 67 days (range 5-613 days) after their EDD and completed treatment at a median of 378 days (range 52-730 days) following delivery.
    Conclusions for practice: Despite dental clinic referral, most pregnant women do not complete recommended dental treatment before giving birth, and women who resumed dental care after birth demonstrated a lag-time between delivery and care completion. These findings highlight the need for extending post-pregnancy dental care coverage, which is limited under current dental Medicaid policies, posing a major public health issue for new mothers to continue oral health care.
    MeSH term(s) Female ; Humans ; Medicaid ; Oral Health ; Patient Acceptance of Health Care ; Policy ; Pregnancy ; Prenatal Care ; Retrospective Studies ; United States
    Language English
    Publishing date 2022-01-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1339905-6
    ISSN 1573-6628 ; 1092-7875
    ISSN (online) 1573-6628
    ISSN 1092-7875
    DOI 10.1007/s10995-021-03343-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Persistent Catechol-O-methyltransferase-dependent Pain Is Initiated by Peripheral β-Adrenergic Receptors.

    Ciszek, Brittney P / O'Buckley, Sandra C / Nackley, Andrea G

    Anesthesiology

    2016  Volume 124, Issue 5, Page(s) 1122–1135

    Abstract: Background: Patients with chronic pain disorders exhibit increased levels of catecholamines alongside diminished activity of catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines. The authors found that acute pharmacologic ... ...

    Abstract Background: Patients with chronic pain disorders exhibit increased levels of catecholamines alongside diminished activity of catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines. The authors found that acute pharmacologic inhibition of COMT in rodents produces hypersensitivity to mechanical and thermal stimuli via β-adrenergic receptor (βAR) activation. The contribution of distinct βAR populations to the development of persistent pain linked to abnormalities in catecholamine signaling requires further investigation.
    Methods: Here, the authors sought to determine the contribution of peripheral, spinal, and supraspinal βARs to persistent COMT-dependent pain. They implanted osmotic pumps to deliver the COMT inhibitor OR486 (Tocris, USA) for 2 weeks. Behavioral responses to mechanical and thermal stimuli were evaluated before and every other day after pump implantation. The site of action was evaluated in adrenalectomized rats receiving sustained OR486 or in intact rats receiving sustained βAR antagonists peripherally, spinally, or supraspinally alongside OR486.
    Results: The authors found that male (N = 6) and female (N = 6) rats receiving sustained OR486 exhibited decreased paw withdrawal thresholds (control 5.74 ± 0.24 vs. OR486 1.54 ± 0.08, mean ± SEM) and increased paw withdrawal frequency to mechanical stimuli (control 4.80 ± 0.22 vs. OR486 8.10 ± 0.13) and decreased paw withdrawal latency to thermal heat (control 9.69 ± 0.23 vs. OR486 5.91 ± 0.11). In contrast, adrenalectomized rats (N = 12) failed to develop OR486-induced hypersensitivity. Furthermore, peripheral (N = 9), but not spinal (N = 4) or supraspinal (N = 4), administration of the nonselective βAR antagonist propranolol, the β2AR antagonist ICI-118,511, or the β3AR antagonist SR59230A blocked the development of OR486-induced hypersensitivity.
    Conclusions: Peripheral adrenergic input is necessary for the development of persistent COMT-dependent pain, and peripherally-acting βAR antagonists may benefit chronic pain patients.
    MeSH term(s) Adrenalectomy ; Adrenergic beta-Antagonists/pharmacology ; Animals ; Behavior, Animal/drug effects ; Catechol O-Methyltransferase/metabolism ; Catechol O-Methyltransferase Inhibitors/pharmacology ; Catechols/pharmacology ; Female ; Hot Temperature ; Injections, Spinal ; Male ; Pain/enzymology ; Pain Measurement/drug effects ; Peripheral Nervous System/drug effects ; Physical Stimulation ; Propanolamines/pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Adrenergic, beta/drug effects
    Chemical Substances 3-(2-ethylphenoxy)-1-(1,2,3,4-tetrahydronaphth-1-ylamino)-2-propanol oxalate ; Adrenergic beta-Antagonists ; Catechol O-Methyltransferase Inhibitors ; Catechols ; Propanolamines ; Receptors, Adrenergic, beta ; ICI 118551 (46OL1UC10R) ; Catechol O-Methyltransferase (EC 2.1.1.6) ; OR486 (VK0VA22GY2)
    Language English
    Publishing date 2016-03-07
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 269-0
    ISSN 1528-1175 ; 0003-3022
    ISSN (online) 1528-1175
    ISSN 0003-3022
    DOI 10.1097/ALN.0000000000001070
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: β2- and β3-adrenergic receptors drive COMT-dependent pain by increasing production of nitric oxide and cytokines.

    Hartung, Jane E / Ciszek, Brittney P / Nackley, Andrea G

    Pain

    2014  Volume 155, Issue 7, Page(s) 1346–1355

    Abstract: Decreased activity of catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines, contributes to pain in humans and animals. Previously, we demonstrated that development of COMT-dependent pain is mediated by both β2- and β3-adrenergic ...

    Abstract Decreased activity of catechol-O-methyltransferase (COMT), an enzyme that metabolizes catecholamines, contributes to pain in humans and animals. Previously, we demonstrated that development of COMT-dependent pain is mediated by both β2- and β3-adrenergic receptors (β2ARs and β3ARs). Here we investigated molecules downstream of β2- and β3ARs driving pain in animals with decreased COMT activity. Based on evidence linking their role in pain and synthesis downstream of β2- and β3AR stimulation, we hypothesized that nitric oxide (NO) and proinflammatory cytokines drive COMT-dependent pain. To test this, we measured plasma NO derivatives and cytokines in rats receiving the COMT inhibitor OR486 in the presence or absence of the β2AR antagonist ICI118,551+β3AR antagonist SR59320A. We also assessed whether the NO synthase inhibitor L-N(G)-nitroarginine methyl ester (L-NAME) and cytokine-neutralizing antibodies block the development of COMT-dependent pain. Results showed that animals receiving OR486 exhibited higher levels of NO derivatives, tumor necrosis factor α (TNFα), interleukin-1β (IL-1β), interleukin-6 (IL-6), and chemokine (C-C motif) ligand 2 (CCL2) in a β2- and β3AR-dependent manner. Additionally, inhibition of NO synthases and neutralization of the innate immunity cytokines TNFα, IL-1β, and IL-6 blocked the development of COMT-dependent pain. Finally, we found that NO influences TNFα, IL-1β, IL-6, and CCL2 levels, whereas TNFα and IL-6 influence NO levels. Altogether, these results demonstrate that β2- and β3ARs contribute to COMT-dependent pain, at least partly, by increasing NO and cytokines. Furthermore, they identify β2- and β3ARs, NO, and proinflammatory cytokines as potential therapeutic targets for pain patients with abnormalities in COMT physiology.
    MeSH term(s) Adrenergic beta-2 Receptor Antagonists/pharmacology ; Adrenergic beta-3 Receptor Antagonists/pharmacology ; Animals ; Catechol O-Methyltransferase/metabolism ; Catechol O-Methyltransferase Inhibitors/pharmacology ; Chemokine CCL2/drug effects ; Chemokine CCL2/metabolism ; Cytokines/metabolism ; Hyperalgesia/metabolism ; Interleukin-1beta/drug effects ; Interleukin-1beta/metabolism ; Interleukin-6/metabolism ; Male ; Nitric Oxide/metabolism ; Nitric Oxide Synthase/antagonists & inhibitors ; Nitric Oxide Synthase/metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, Adrenergic, beta-2/metabolism ; Receptors, Adrenergic, beta-3/metabolism ; Tumor Necrosis Factor-alpha/drug effects ; Tumor Necrosis Factor-alpha/metabolism
    Chemical Substances Adrenergic beta-2 Receptor Antagonists ; Adrenergic beta-3 Receptor Antagonists ; Catechol O-Methyltransferase Inhibitors ; Ccl2 protein, rat ; Chemokine CCL2 ; Cytokines ; IL1B protein, rat ; Interleukin-1beta ; Interleukin-6 ; Receptors, Adrenergic, beta-2 ; Receptors, Adrenergic, beta-3 ; Tumor Necrosis Factor-alpha ; Nitric Oxide (31C4KY9ESH) ; Nitric Oxide Synthase (EC 1.14.13.39) ; Catechol O-Methyltransferase (EC 2.1.1.6)
    Language English
    Publishing date 2014-04-13
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 193153-2
    ISSN 1872-6623 ; 0304-3959
    ISSN (online) 1872-6623
    ISSN 0304-3959
    DOI 10.1016/j.pain.2014.04.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1158: Show issues Location:
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  5. Article ; Online: Novel intrathecal and subcutaneous catheter delivery systems in the mouse.

    Oladosu, Folabomi A / Ciszek, Brittney P / O'Buckley, Sandra C / Nackley, Andrea G

    Journal of neuroscience methods

    2016  Volume 264, Page(s) 119–128

    Abstract: Background: Catheter systems that permit targeted delivery of genes, molecules, ligands, and other agents represent an investigative tool critical to the development of clinically relevant animal models that facilitate the study of neurological health ... ...

    Abstract Background: Catheter systems that permit targeted delivery of genes, molecules, ligands, and other agents represent an investigative tool critical to the development of clinically relevant animal models that facilitate the study of neurological health and disease. The development of new sustained catheter delivery systems to spinal and peripheral sites will reduce the need for repeated injections, while ensuring constant levels of drug in plasma and tissues.
    New method: Here, we introduce two novel catheter delivery systems in the mouse: the O'Buckley intrathecal catheter system for sustained delivery to the spinal region and a subcutaneous bifurcated catheter system for sustained drug delivery to both hindpaws.
    Results: The O'Buckley intrathecal catheter system consistently distributed Evans Blue throughout the spinal cord, with the greatest concentration at the thoracic region, and with an 85% surgery success rate. The subcutaneous catheter system consistently distributed Evans Blue to the hindlimbs, with a 100% surgery success rate.
    Comparison to existing method: The O'Buckley intrathecal catheter system accomplishes sustained drug delivery to the spinal region, with a 2-fold increase in surgery success rate, as compared to the traditional method. Our subcutaneous bifurcated catheter system accomplishes sustained drug delivery to both hindpaws, eliminating the need for repeated intraplantar injections.
    Conclusions: We have developed catheter systems that improve upon traditional methods in order to achieve sustained localized drug delivery to spinal tissues and to hindpaw tissues surrounding peripheral sciatic nerve terminals. These methods have a broad reach, and can be used to enhance behavioral, physiologic and mechanistic studies in mice.
    MeSH term(s) Animals ; Catheters ; Drug Delivery Systems/instrumentation ; Drug Delivery Systems/methods ; Extremities ; Female ; Infusions, Subcutaneous/instrumentation ; Infusions, Subcutaneous/methods ; Injections, Spinal/instrumentation ; Injections, Spinal/methods ; Male ; Mice ; Mice, 129 Strain ; Mice, Inbred C57BL
    Language English
    Publishing date 2016-03-11
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 282721-9
    ISSN 1872-678X ; 0165-0270
    ISSN (online) 1872-678X
    ISSN 0165-0270
    DOI 10.1016/j.jneumeth.2016.03.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1486: Show issues Location:
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  6. Article ; Online: MicroRNA expression profiles differentiate chronic pain condition subtypes.

    Ciszek, Brittney P / Khan, Asma A / Dang, Hong / Slade, Gary D / Smith, Shad / Bair, Eric / Maixner, William / Zolnoun, Denniz / Nackley, Andrea G

    Translational research : the journal of laboratory and clinical medicine

    2015  Volume 166, Issue 6, Page(s) 706–720.e11

    Abstract: Chronic pain is a significant health care problem, ineffectively treated because of its unclear etiology and heterogeneous clinical presentation. Emerging evidence demonstrates that microRNAs (miRNAs) regulate the expression of pain-relevant genes, yet ... ...

    Abstract Chronic pain is a significant health care problem, ineffectively treated because of its unclear etiology and heterogeneous clinical presentation. Emerging evidence demonstrates that microRNAs (miRNAs) regulate the expression of pain-relevant genes, yet little is known about their role in chronic pain. Here, we evaluate the relationship among pain, psychological characteristics, plasma cytokines, and whole blood miRNAs in 22 healthy controls (HCs); 33 subjects with chronic pelvic pain (vestibulodynia, VBD); and 23 subjects with VBD and irritable bowel syndrome (VBD + IBS). VBD subjects were similar to HCs in self-reported pain, psychological profiles, and remote bodily pain. VBD + IBS subjects reported decreased health and function; and an increase in headaches, somatization, and remote bodily pain. Furthermore, VBD subjects exhibited a balance in proinflammatory and anti-inflammatory cytokines, whereas VBD + IBS subjects failed to exhibit a compensatory increase in anti-inflammatory cytokines. VBD subjects differed from controls in expression of 10 miRNAs of predicted importance for pain and estrogen signaling. VBD + IBS subjects differed from controls in expression of 11 miRNAs of predicted importance for pain, cell physiology, and insulin signaling. miRNA expression was correlated with pain-relevant phenotypes and cytokine levels. These results suggest that miRNAs represent a valuable tool for differentiating VBD subtypes (localized pain with apparent peripheral neurosensory disruption vs widespread pain with a central sensory contribution) that may require different treatment approaches.
    MeSH term(s) Adult ; Chronic Pain/genetics ; Female ; Gene Expression Profiling ; Humans ; Male ; MicroRNAs/genetics
    Chemical Substances MicroRNAs
    Language English
    Publishing date 2015-06-24
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2246684-8
    ISSN 1878-1810 ; 1532-6543 ; 1931-5244
    ISSN (online) 1878-1810 ; 1532-6543
    ISSN 1931-5244
    DOI 10.1016/j.trsl.2015.06.008
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