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Biomedical subjects

A Esterman

Publications and source records attributed to A Esterman.

At least 37 records · Page 2Linked to original sources
PubMed1992

Factors predictive of corneal graft survival. Report from the Australian Corneal Graft Registry.

Risk factors for graft failure after penetrating keratoplasty were investigated in 961 patients from records collected prospectively by the Australian Corneal Graft Registry. The most common cause of graft failure was irreversible rejection. A multivariate proportional hazards regression analysis indicated that the key predictors of graft failure were: an indication for graft other than keratoconus or corneal dystrophy; a failed previous graft (ipsilateral eye); aphakia; inflammation at the time of graft; presence of an anterior chamber or iris-clip intraocular lens; graft size outside the range of 7.0 to 7.9 mm diameter; and corneal vascularization occurring in the postoperative period.

Adolescent↗
PubMed1992

Stages of readiness to quit smoking: population prevalence and correlates.

We examined the population prevalence and correlates of stages in smokers' readiness to quit, using data from 1,048 smokers recruited in a self-weighting, multistage, systematic clustered area sample from 0.44% of South Australian dwellings, with an 89% response rate. Smokers in the precontemplation stage comprised 24.1% of the sample, smokers in the contemplation stage comprised 47.2%, and smokers in the preparation stage comprised 28.7%. No sociodemographic variables (i.e., age, sex, marital status, educational level) were found to be significant independent predictors of membership in the different stages. The five significant independent predictors of being in the precontemplation stage (vs. the contemplation stage) were (a) having a higher confidence of quitting, (b) seeing fewer health risks associated with smoking, (c) not having made an attempt to quit, (d) seeing quitting as more difficult, and (e) smoking 25 or more cigarettes a day. The two significant independent predictors of being in the contemplation stage (vs. the preparation stage) were (a) having lower confidence of quitting and (b) not having tried to quit. We discuss implications for the understanding of smoking behavior in populations and also consider how cessation campaigns might address the factors associated with different stages of readiness to quit.

Adaptation, Psychological↗
PubMed1992

Hearing loss--an underestimated public health problem.

Estimates of hearing loss in Australia, collected over the last decade and a half, have reported a prevalence rate ranging from 0.1 to 7 per cent. This survey of a random sample of South Australians provides, depending upon definition, two estimates of 15 and 19 per cent. These data suggest that hearing loss has been underestimated as a public health problem. The need for an epidemiological study which measures actual hearing impairment, which can be used to develop an appropriate public health response, is discussed.

Adolescent↗
PubMed1992

Workplace smoking restrictions, occupational status, and reduced cigarette consumption.

Reductions in workday cigarette consumption among indoor workers subject to different levels of smoking restriction were examined using representative population data for both blue-collar and white-collar workers. Regardless of whether workplace smoking bans were total or applied only to the usual work station, reported workday cigarette consumption was reduced by approximately five cigarettes per day compared with leisure-day consumption. This was in contrast to there being no difference between workday and leisure-day consumption among those who had no ban on smoking at their usual work station. This pattern of findings applied to all occupational-status groups, after controlling for sex and number of cigarettes smoked on a leisure day. These results are discussed with reference to potential public-health benefits and to implications for reduced retail sales of cigarettes.

Adult↗
PubMed1991

Case-survival rates for infiltrating ductal carcinomas by category of hospital at diagnosis in South Australia.

OBJECTIVE: To determine whether case-survival rates for infiltrating ductal carcinomas diagnosed in South Australia during 1980-1986 have varied by hospital of attendance at diagnosis. A null hypothesis was tested. DESIGN: All 2589 cases notified to the State Cancer Registry were included. The date of censoring for survival analyses was June 30, 1989. Multivariate analyses were undertaken adjusting for age at diagnosis, diameter of tumour, and extent of nodal involvement. RESULTS: After adjusting for differences in age, diameter and nodal status, there was not a significant difference in case outcome between large public hospitals, large private hospitals and smaller hospitals (P greater than 0.05). CONCLUSIONS: Although protocols for treatment of breast cancer are in a transitional phase and differences exist, case-survival rates have not shown a substantial variation by hospital of attendance at diagnosis.

Adult↗
PubMed1990

Malignant astrocytoma in South Australia: treatment and case survival.

Kernohan grade III and IV astrocytomas are usually fetal and in the past have had a case survival rate of only about 10% two years from diagnosis. Data on 285 cases registered at the Royal Adelaide Hospital in 1977-1986 showed a median survival of approximately six months. The survival rate was 25% at one year and 15% at two years. Survival reduced markedly with increase in age at diagnosis from a two-year rate of 53% for patients under 40 years of age to 5% for patients aged 70 years or more. This may have been due in part to the more frequent treatment of younger patients by decompression and radiotherapy. Apart from age and treatment mode, factors related to extended survival included a longer duration of symptoms before diagnosis and location of the tumour in the frontal lobes. Notwithstanding prospects for an increase in short-term survival from the use of radiotherapy as an adjunct to surgery, long-term outcomes for these neoplasms are still very poor.

Adult↗
PubMed1990

Infiltrating ductal carcinoma of the breast in South Australia. Implications of trends in tumour diameter, nodal status and case-survival rates for cancer control.

The SA Central Cancer Registry gained sufficient information from routine pathology reports to record both the diameter and the nodal status for approximately half the infiltrating ductal carcinomas of the breast that were diagnosed in that State between 1980 and 1986. Of these, 27% of cancers had diameters of less than 2.0 cm at diagnosis and a similar proportion measured 4.0 cm or more. Almost half (48% of cancers) showed evidence of axillary nodal metastasis. Although the over-all variation in diameters by socioeconomic status did not approach statistical significance, lesions tended to be smaller in cases from the upper than the middle or lower socioeconomic areas of Adelaide. There also was evidence of earlier diagnosis during a breast self-examination campaign, but only a marginal increase in case-survival rates that readily was attributable to chance. A relatively poor case-survival rate applied in non-metropolitan areas, especially among older women, after adjusting for the available information on the stage of disease at diagnosis. A more limited access to treatment services may have been responsible. It will be important in a State-wide mammographic screening programme to provide for ready access by women in non-metropolitan areas to both screening and follow-up treatment services.

Age Factors↗
PubMed1990

Vaccine prophylaxis of abattoir-associated Q fever: eight years' experience in Australian abattoirs.

During the period 1981-8 a clinical trial of a Q fever vaccine (Q-vax; Commonwealth Serum Laboratories, Melbourne) has been conducted in abattoir workers and other at-risk groups in South Australia. Volunteers in four abattoirs and visitors to the abattoirs were given one subcutaneous dose of 30 micrograms of a formalin-inactivated, highly-purified Coxiella burnetii cells, Henzerling strain, Phase 1 antigenic state, in a volume of 0.5 ml. During the period, over 4000 subjects have been vaccinated and the programme continues in the abattoirs and related groups. 'Common' reactions to the vaccine comprised tenderness and erythema, rarely oedema at the inoculation site and sometimes transient headache. Two more serious 'uncommon' reactions, immune abscess at the inoculation site, were observed in two subjects, and two others developed small subcutaneous lumps which gradually dispersed without intervention. Protective efficacy of the vaccine appeared to be absolute and to last for 5 years at least. Eight Q fever cases were observed in vaccinees, but all were in persons vaccinated during the incubation period of a natural attack of Q fever before vaccine-induced immunity had had time (greater than or equal to 13 days after vaccination) to develop. On the other hand, 97 Q fever cases were detected in persons working in, or visiting the same abattoir environments. Assays for antibody and cellular immunity showed an 80-82% seroconversion after vaccination, mostly IgM antibody to Phase 2 antigen, in the 3 months after vaccination. This fell to about 60%, mostly IgG antibody to Phase 1 antigen, after 20 months. On the other hand, 85-95% of vaccinees developed markers of cell mediated immunity as judged by lymphoproliferative responses with C. burnetii antigens; these rates remained elevated for at least 5 years. The Q fever vaccine, unlike other killed rickettsial vaccines, has the property of stimulating long-lasting T lymphocyte memory and this may account for its unusual protective efficacy as a killed vaccine.

Abattoirs↗
PubMed1989

Epidemiological features of melanoma in South Australia: implications for cancer control.

South Australian Cancer Registry data for 1977-1987 show an increase in the recorded incidence of invasive malignant melanomas of the skin of approximately 54% in men and 33% in women. However, the abrupt nature of this increase after a relatively stable incidence level in 1977-1981, the absence of any evidence yet of an increase in mortality after this increase in incidence, and the trend towards thinner lesions are consistent with the conclusion that earlier diagnosis has had an influence. Case-survival rates were higher in 1982-1987 compared with 1977-1981. The thickness of lesions at diagnosis was less for women, younger patients and patients from more affluent areas; parallel trends were found in case-survival rates. After adjusting for tumour thickness and the level of invasion at diagnosis, trends in survival by sociodemographic features were not apparent. The implications of these and related findings for cancer control programmes are discussed.

Adult↗
PubMed1989

The use of State and hospital-based cancer-registry data to describe the epidemiological and clinical characteristics of laryngeal cancer in South Australia.

State and hospital-based cancer registries can be complementary sources for data that describe the general epidemiological and clinical features of cancers in specific populations. This has been illustrated with data on laryngeal cancer from registries in South Australia. The data were sufficiently detailed to indicate: trends in incidence by calendar year, age, sex, place of residence and country of birth; the distribution of cases by the subsite of the tumour, the histological type and grade, and the pretreatment clinical stage of the cancer at diagnosis; the complaints of patients at presentation; the modes of treatment by the stage of the cancer; and case-survival rates, both over all and as related to the subsite of the tumour, the sex and the stage of disease. Data also were available to indicate the increased risks of disease that were associated with tobacco smoking and alcohol consumption. The findings broadly are consistent with the results of previous epidemiological studies and show the utility of the combined use of state and hospital registry data to describe the general features of cancers in local populations.

Aged↗
PubMed1989

Pregnancy and birth risk factors for intellectual disability in South Australia.

It is generally accepted that developmental handicaps can often be minimized through early detection and intervention. For this reason, it is normal practice in many hospitals to follow-up and screen infants who present at birth with established risk factors. Clinical judgement will always be important when selecting children for follow-up. However, as hospital data systems improve, automated systems could be developed for listing children potentially "at risk". Where initial clinical decisions not to follow-up individual children prove to be at odds with this automated output, the individual child could be re-assessed clinically. This process could increase the level of quality control. An initial risk-factor model for intellectual disability has been developed, based on the South Australian Perinatal Statistics Collection, for use in this context.

Australia↗
PubMed1988

Cancer case-survival rates for South Australia: a comparison with US rates and a preliminary investigation of time trends.

Five-year relative case-survival rates for all cancers collectively are similar in South Australia (49%) and the United States (50%). This suggests that outcomes of cancer treatment do not vary appreciably between the two populations. There is an indication of higher survival rates in South Australia for melanoma, Hodgkin's disease, multiple myeloma and gastric cancer, but lower survival rates for cancers of the thyroid, corpus uteri, prostate, colon, kidney and lung. The differences in point estimates of the rates were most conspicuous for Hodgkin's disease, multiple myeloma and prostatic cancer. The reasons for a cautious interpretation of these findings are discussed and some possible explanations are suggested. South Australian data point to an upward trend in survival rates between the diagnostic periods 1977-1980 and 1981-1985 for patients with Hodgkin's disease, diffuse large-cell lymphomas, melanomas and cancers of the prostate and rectum.

Epidemiologic Methods↗
PubMed1988

Laboratory diagnosis of Mycoplasma pneumoniae infection. 1. Direct detection of antigen in respiratory exudates by enzyme immunoassay.

Direct and indirect antigen capture enzyme immunoassays (Ag-EIA) have been developed for the detection of Mycoplasma pneumoniae in nasopharyngeal aspirates or sputum from respiratory infection. The sensitivity of the two Ag-EIA were similar, but the indirect method using polyclonal rabbit and guinea-pig antisera was more convenient. The Ag-EIA had a detection limit of 10(4-4.5) colony-forming units/ml of sample. It was specific for M. pneumoniae and gave a low level response with M. genitalium. There were no cross-reactions with 10 other species of mycoplasmas. Tests with a wide range of bacteria and chlamydia group antigen, representing agents sometimes found in the respiratory tract, were also negative. At the current level of development, the Ag-EIA detected about 90% of specimens that were also positive for culture; 43% of specimens from culture-negative--seropositive patients gave a positive result. The overall pattern of results indicated that while antigen detection is a quick and effective substitute for the slow culture method, serological examination for specific IgM antibody is also necessary to give a complete diagnostic coverage.

Antibody Specificity↗
PubMed1988

Zellweger syndrome amniocytes: morphological appearance and a simple sedimentation method for prenatal diagnosis.

Zellweger syndrome is the prototype of a growing group of genetic diseases caused by an absence or deficiency of peroxisomes. The defect causes the enzyme catalase to remain in the cytosol instead of being packaged into peroxisomes. This mislocalization can be easily detected by sedimentation analysis. Amniocytes were homogenized and then centrifuged to pellet organelles. Catalase was found to sediment with the peroxisomes in the homogenates of normal cells, but to remain in the supernatant with Zellweger syndrome amniocyte homogenates. This striking difference is unambiguous and reproducible, and provides a simple method for prenatal diagnosis. Moreover, it allows one to differentiate diseases in which peroxisomes are deficient from other peroxisomal diseases in which the organelle is intact, but one enzyme is defective. Electron microscopic observations support the biochemical determinations. Normal amniocytes contain small peroxisomes in which a weak cytochemical reaction for catalase may be demonstrated. Zellweger amniocytes appear to lack these organelles, although some cells have rare structures that might be residual or abnormal peroxisomes.

3,3'-Diaminobenzidine↗
PubMed1986

Melanoma case survival rates in South Australia by histological type, thickness and level of tumour at diagnosis.

Data from the South Australian Cancer Registry on malignant melanoma of the skin showed that case survival rates were higher for lentigo maligna melanomas and superficial spreading lesions than for nodular and other histological classifications. Lower case survival rates applied to the thicker melanomas and those at a more invasive level at diagnosis. After adjusting for differences in thickness and level in this study, no statistically significant differences were apparent between case survival rates for the nodular lesions and the lentigo maligna and superficial spreading melanomas.

Adult↗
PubMed1985

Promotion of breast self-examination in South Australia. A short-term evaluation.

In early October 1982, a campaign was launched in South Australia to encourage women to practice breast self-examination. A study of data from the State Cancer Registry was conducted to determine the impact of the campaign on the detection rate, the patient-survival rate and the extent of the tumour at the time of diagnosis. In the three months after the launch, 30% more cancer cases were detected than expected from the numbers presenting during similar periods in previous years. The increase was 53% for women under 50 years of age and 21% for older subjects. There is an indication that tumours diagnosed in the three months after the launch of the campaign were diagnosed earlier than those presenting in corresponding periods in earlier years. The proportion of cases with four or more affected nodes at diagnosis was substantially reduced. The slight differences in tumour diameter and one-year patient survival were also consistent with earlier diagnosis.

Australia↗