Publications by authors named "T R Cowper"

12 Publications

Mortality of percutaneous endoscopic gastrostomy in the UK.

J Postgrad Med 2005 Apr-Jun;51(2):152

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May 2006

Can we assess quality of life in patients with head and neck cancer? A preliminary report from the American Academy of Maxillofacial Prosthetics.

J Prosthet Dent 2002 Sep;88(3):344-51

Clinical Dental Specialist, University of Minnesota School of Dentistry, Minneapolis, Minn, USA.

Survival statistics alone may no longer be valid when used as evidence of effective outcomes. Patient satisfaction is an end point that needs further evaluation and should be included in the outcomes assessment. A 133-item questionnaire has been designed by a special committee of the American Academy of Maxillofacial Prosthetics (AAMP) to assess the quality of life of patients with head and neck cancer impacting the orofacial region. This survey will be distributed to the entire population of 7 geographically dispersed treatment centers in the United States for a 2-year period. Patients will be stratified into several subgroups, including radiation/nonradiation, maxillary/mandibular, and surgical reconstruction/prostheses. Separate analyses will be conducted for each subgroup, and comparisons will be made within subgroups to test the sensitivity of the questionnaire to a known difference. A revised version of the AAMP questionnaire, limited to 50 items of interest to patients, will be validated against 2 established head and neck cancer questionnaires. This article provides background on previous quality-of-life studies and reviews the need for and aims of the AAMP assessment instrument.
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http://dx.doi.org/10.1067/mpr.2002.128036DOI Listing
September 2002

The use of colored elastomeric "O"s as a motivational instrument for patients with anodontia: report of case.

ASDC J Dent Child 1999 Mar-Apr;66(2):98-102, 84

Department of Dentistry, Cleveland Clinic Foundation, OH, USA.

Complete and/or removable partial dentures are the most commonly selected treatment for the prosthodontic management of young patients who present with oligodontia or anodontia such as in the case of patients with ectodermal dysplasia. Bakri, Belanger and Nowak have reported on the different ways that these prostheses can be modified to ease the child's burden of growing up with missing teeth and having to wear prostheses that make them different from their peers. Some of their suggestions include the placement of diastemas, the use of artificial "baby" teeth and their subsequent replacement with permanent teeth to simulate the primary and mixed dentition stages. They have also recommended deleting primary teeth to mimic the normal exfoliation pattern. The purpose of this article is to report the attitude change and improvement in self-esteem experienced by two young girls from the simple addition of colored elastomeric molded "O"s to the orthodontic appliances placed on their prostheses.
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August 1999

Pharmacologic management of the patient with disorders of the cardiovascular system. Infective endocarditis.

Authors:
T R Cowper

Dent Clin North Am 1996 Jul;40(3):611-47

Department of Dentistry, Cleveland Clinic Foundation, Ohio, USA.

IE, although an infrequent event, remains a serious and frequently lethal complication in patients at risk. Oral microorganisms undoubtedly play a significant role in the development of IE in such patients. For example, in a retrospective review of prosthetic cardiac valve candidates (156) at the Cleveland Clinic Foundation, 15% were found to have at least one abscessed tooth, whereas approximately 17% were found to have severe (class IV) periodontal disease. Cardiac defects in conjunction with bacteremias from such dental pathoses clearly elevate the risk, although a small but increasing number of noncardiac conditions and behavioral patterns seem also to be able to induce susceptibility. Whether dental or other medical procedures are truly direct inducers of IE, however, remains to be proven and in all probability are only minor contributors overall. Despite its ubiquitous use, antibiotic prophylaxis has not been proven in human clinical trials, and its underlying rationale is arbitrary and questionable at best; nevertheless, its efficacy in animal models has led to the current human protocols. A more profitable strategy, and certainly an adjunctive one, should be to direct one's effort at eliminating oral pathology and educating and motivating patients at risk toward meticulous oral hygiene--an exhortation published many years before the advent of antibiotics and still undoubtedly the best recommendation today.
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July 1996

Pharmacotherapy for hypertension.

Dent Clin North Am 1996 Jul;40(3):585-610

Department of Dentistry, Cleveland Clinic Foundation, Ohio, USA.

Clinicians, in general, must understand the basis of hypertension, management principles, and complications. They must recognize that these patients require multidisciplinary treatment and coordination of care. Oral health care providers must remember that hypertension may produce adverse effects on various organ systems and management of the dental needs of these patients may require modification of routine treatment.
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July 1996