Background: In some patients chronic asthma results in irreversible airflow obstruction. High resolution computed tomography (HRCT) has been advocated for assessing the structural changes in the asthmatic lung and permits investigation of the relationships between airway wall thickening and clinical parameters in this condition. Methods: High resolution CT scanning was performed in 49 optimally controlled asthmatic patients and measurements of total airway and lumen diameter were made by two independent radiologists using electronic callipers. Wall area as % total airway cross sectional area (WA%) and wall thickness to airway diameter ratio (T/D) were calculated for all airways clearly visualised with a transverse diameter of more than 1.5 mm, with a mean value derived for each patient. Intra-and inter-observer variability was assessed for scope of agreement in a subgroup of patients. Measurements were related to optimum forced expiratory volume in 1 second (FEV 1 ), forced mid expiratory flow, carbon monoxide gas transfer, two scores of asthma severity, airway inflammation as assessed with induced sputum, and exhaled nitric oxide. Results: Neither observer produced a statistically significant difference between measurements performed on two occasions but there was a significant difference between observers (limits of agreement -2.6 to 6.8 for WA%, p<0.0001). However, mean WA% measured on two occasions differed by no more than 5.4% (limits of agreement -4.0 to 5.4; mean (SD) 0.7 (2.4)). Statistically significant positive associations were observed between both WA% and T/D ratio and asthma severity (r S =0.29 and 0.30, respectively, for ATS score), and an inverse association with gas transfer coefficient was observed (r S =-0.43 for WA% and r S =-0.41 for T/D). No association was identified with FEV 1 or airway inflammation. Conclusions: The airway wall is thickened in more severe asthma and is associated with gas transfer coefficient. This thickening does not relate directly to irreversible airflow obstruction as measured with FEV 1 .
As the impact of the intervention was not sustained even for the modest duration of 6 weeks postnatally, it would be premature to justify widespread use of peer support programmes to increase the prevalence of breastfeeding in socially disadvantaged communities.
Background: Breastfeeding rates in Scotland are very low, particularly in the more disadvantaged areas. Despite a number of interventions to promote breastfeeding very few women actually intend to breastfeed their baby. The aim of this study was to identify personal and social factors independently associated with intention to breastfeed.
The aims of this study were to compare the mean shear-peel bond strength and predominant site of bond failure of micro-etched orthodontic bands cemented with resin-modified glass ionomer cement (RMGIC; Fuji Ortho LC or 3M Multi-Cure), a modified composite or a conventional GIC. The survival time of bands was also assessed following simulated mechanical stress in a ball mill. One hundred and twenty molar bands were cemented to extracted human third molars. Eighty bands (20 cemented with each cement) were used to assess the debonding force and 40 bands (10 cemented with each cement) were used to determine survival time. The specimens were prepared in accordance with the manufacturers' instructions for each cement. After storage in a humidor at 37 degrees C for 24 hours, the shear debonding force was assessed for each specimen using a Nene M3000 testing machine with a crosshead speed of 1 mm/minute. The predominant site of band failure was recorded visually for all specimens as either at the band/cement or cement/enamel interface. Survival time was assessed following application of mechanical stress in a ball mill. There was no significant difference in mean shear-peel bond strength between the cement groups (P = 0.816). The proportion of specimens failing at each interface differed significantly between cement groups (P < 0.001). The predominant site of bond failure for bands cemented with the RMGIC (Fuji Ortho LC) or the modified composite was at the enamel/cement interface, whereas bands cemented with 3M Multi-Cure failed predominantly at the cement/band interface. Conventional GIC specimens failed mostly at the enamel/cement interface. The mean survival time of bands cemented with either of the RMGICs or with the modified composite was significantly longer than for those cemented with the conventional GIC. The findings indicate that although there appears to be equivalence in the mean shear-peel bond strength of the band cements assessed, the fatigue properties of the conventional GIC when subjected to simulated mechanical stress seem inferior to those of the other cements for band cementation.
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