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Biomedical subjects

A Green

Publications and source records attributed to A Green.

At least 487 records · Page 27Linked to original sources
PubMed1988

Mortality in women in relation to their childbearing history.

With data from the Office of Population Censuses and Surveys' longitudinal study the mortality of currently married women aged under 60 in 1971 was investigated in relation to the number of liveborn children reported at the 1971 census, adjusting for their husbands' social class. Women who had never had children experienced a higher mortality from many causes of death than the parous women, and this was probably due, at least in part, to selective factors. When the analysis was confined to parous women mortality from diabetes mellitus and cervical cancer increased significantly and oesophageal cancer decreased significantly with increasing number of liveborn children. Mortality from all circulatory diseases and from hypertensive disease, ischaemic heart disease, and subarachnoid haemorrhage tended to rise with parity, though the trends were not statistically significant. Mortality from breast cancer decreased significantly with the number of liveborn children, but only when nullipara were included in the analyses. These data suggest that there may be residual and cumulative effects of childbearing which influence patterns of disease in the long term.

Adolescent↗
PubMed1988

Evaluation of eight and a half years of neonatal screening for haemoglobinopathies in Birmingham.

A pilot neonatal screening programme for haemoglobinopathies linked with screening for phenylketonuria and congenital hypothyroidism was reviewed. During 1978 to December 1986 137,000 neonates were tested. There were improvements in the detection rate and accuracy of diagnosis for homozygotes and mixed heterozygotes, mainly associated with the introduction of citrate agarose gel electrophoresis as a follow up procedure on all specimens showing any abnormality on the initial cellulose acetate electrophoresis. We recommend that the programme is continued on a service basis.

Anemia, Sickle Cell↗
PubMed1988

Diagnosis of skin cancer in the general population: clinical accuracy in the Nambour survey.

The accuracy and validity of diagnoses of skin cancer that were made by experienced dermatologists in a Queensland community survey have been investigated. Histological examination confirmed 54% of 100 clinical diagnoses of basal-cell carcinoma, squamous-cell carcinoma or intraepidermal carcinoma. Clinical accuracy was higher for basal-cell carcinoma (59%) than for squamous-cell carcinoma (39%) or intraepidermal carcinoma (38%). Such levels of diagnostic accuracy are to be expected when an unselected population is surveyed because of the relatively low prevalence of skin cancer compared with that in the patient population of a specialist practice. This reduction in diagnostic accuracy is unrelated to clinical skills, and should be borne in mind when conducting any skin-cancer screening programme in the general community.

Adult↗
PubMed1988

Nutritional anaemia in 11-year-old schoolchildren in the western Cape.

A nutritional anaemia survey was carried out on 610 11-year-old coloured, black and white schoolchildren in urban and rural communities in the western Cape. The mean (+/- 1 SD) haemoglobin concentration was 13.0 +/- 1.2 g/dl. The coloured and black subgroups considered together had a significantly lower mean haemoglobin concentration than the white subgroup (12.8 +/- 1.2 g/dl v. 13.4 +/- 1.0 g/dl) (F = 37.47; P less than 0.0001). The urban population as a whole had a significantly lower geometric mean (1 SD range) serum ferritin concentration than the rural population (25.6 (13.5-48.6) micrograms/l v. 34.1 (21.3-54.6) micrograms/l) (F = 42.94; P less than 0.0001). The lowest geometric mean serum ferritin values were found in the urban coloured (23.1 (11.5-46.4) micrograms/l) and urban black schoolchildren (23.7 (13.2-42.6) micrograms/l), with figures of less than 12 micrograms/l in 11.7% and 12.5% respectively. Although 28% of the children had red cell folate values below the recommended lower limit of normal (175 ng/ml), probability plot analysis of the data suggested that folate deficiency was not a major problem in the study population. The calculated daily iron and folate intakes were below the age-related recommended dietary allowance (RDA) in all the subgroups, yet anaemia was relatively uncommon. These findings suggest that the RDA values are too high. Overall the prevalence of nutritional anaemia was low and only the urban coloured subgroup showed significant second populations with low haemoglobin and serum ferritin measurements.

Black or African American↗
PubMed1988

Phenotypic expression of the HLA-linked iron-loading gene in the Afrikaner population of the western Cape.

A previous study conducted on a group of Afrikaans-speaking subjects in the south-western Cape indicated a high frequency (0.115) of the HLA-linked iron-loading gene which causes idiopathic haemochromatosis. The results of phenotypic and genotypic studies on the first degree relatives of identified homozygotes and heterozygotes are now reported. There was considerable heterogeneity of phenotypic expression in the group of heterozygotes, with overlap between the homozygous and heterozygous subjects. The heterozygous relatives of heterozygous index cases, who had been identified on the basis of a serum ferritin concentration greater than 400 micrograms/l, appeared to have more frequent and more marked abnormalities of iron measurements than the heterozygote relatives of homozygous index cases (serum ferritin value greater than 400 micrograms/l, percentage transferrin saturation greater than 60). This suggests that the screening test was identifying a group of more significantly affected heterozygotes, with biochemical abnormalities that overlapped with the identified homozygotes. The index cases were followed up over a period of 5 years and during this time the 7 subjects diagnosed as heterozygotes showed a progressive increase in serum ferritin concentrations, which suggests some iron accumulation. Individual pedigrees included instances of gene recombination within the major histocompatibility complex, and of probable false-positive genotype assignment. The overall results confirm a high frequency of the gene in this particular community.

Adult↗
PubMed1988

Priority setting and economic appraisal: whose priorities--the community or the economist?

Scarce resources for health require a process for setting priorities. The exact mechanism chosen has important implications for the type of priorities and plans set, and in particular their relationship to the principles of primary health care. One technique increasingly advocated as an aid to priority setting is economic appraisal. It is argued however that economic appraisal is likely to reinforce a selective primary health care approach through its espousal of a technocratic medical model and through its hidden but implicit value judgements. It is suggested that urgent attention is needed to develop approaches to priority setting that incorporate the strengths of economic appraisal, but that are consistent with comprehensive primary health care.

Cost-Benefit Analysis↗
PubMed1988

Skin cancer in a Queensland population.

In the present study we have estimated the current prevalence of actinic skin disease in young and middle-aged adults in Queensland, Australia by surveying a representative community. It was found that 4.6% of persons aged 20 to 69 years had skin cancer, mostly basal cell carcinoma, and 40% had solar keratoses. The age distribution and site distribution of actinic lesions in this population were not as classically described; persons below age 40 years exhibited substantial sun-related skin damage, and a large proportion of actinic lesions occurred on sites other than the head, backs, of hands, or forearms. Allowing for age and sex, the strongest risk factors for skin cancer and solar keratoses were fair skin, as assessed by a dermatologist, and clinical signs of solar damage such as solar lentigines, facial telangiectasia, and actinic elastosis of the neck. Associations with self-reported tendencies toward sunburn, frequent painful sunburns, occupational sun exposure, and a previous history of skin cancer were confirmed.

Adult↗
PubMed1988

Variable region (V delta) gene segment most frequently utilized in adult thymocytes is 3' of the constant (C delta) region.

A variable region (V delta 5) of the T-cell receptor (TcR) delta chain that is preferentially expressed in adult murine thymocytes is located 2.5 kilobases 3' of the constant region (C delta) element. The V delta 5 coding sequence is in a transcriptional orientation opposite the J delta (joining region) and C delta coding elements and rearranges by inversion. The C delta is divided into four exons, three of which encode amino acids of TcR delta polypeptide, and the fourth comprises the entire 3' untranslated region. In this respect, C delta resembles C alpha rather than C beta or C gamma.

Amino Acid Sequence↗
PubMed1988

Self-reports of mole counts and cutaneous malignant melanoma in women: methodological issues and risk of disease.

The relation of the presence of moles (nevi) on all four limbs to risk of cutaneous malignant melanoma was explored among 98 incident cases aged 32-59 years at diagnosis and 190 age-matched controls drawn from the Nurses' Health Study, a prospective cohort of female nurses in the United States. Cases diagnosed during follow-up from 1976 to 1982 were included in this study. Participants reported counts of all moles and raised moles alone on postal questionnaires. Distributions of moles were similar for right and left sides on upper and lower limbs for cases and controls. Counts declined with increasing age for all women, from a median of 15 for the youngest tertile of controls (aged 36-46 years) to three for the oldest (aged 54-62 years). Cases had more moles than did controls (medians of 23 and 9, respectively, for total moles on all four limbs): The presence of any mole on a limb gave relative risks for melanoma ranging from 2.2 (95% confidence interval (CI) = 1.2-4.0) for one or more moles on an arm to 2.9 (95% CI = 1.6-5.3) for one or more moles on the lower limb. For raised moles, relative risks were 1.7 (95% CI = 1.0-2.7) for arm, 2.1 (95% CI = 1.3-3.5) for lower limb, and 3.5 (95% CI = 2.0-6.3) for leg (below knee). The highest site-specific risk (i.e., for any moles on the same limb as the melanoma vs. no moles on that limb) was for moles on the lower limb (relative risk = 5.0 (95% CI = 1.8-13.5)). There were positive and significant trends in overall and site-specific risk with increasing numbers of moles on all limbs when absolute mole counts were considered, e.g., for total moles on all four limbs combined, chi for trend = 4.0, one-sided p less than 0.001, with relative risk for more than 100 moles versus none of 6.0. Inclusion of sun exposure and other constitutional factors in logistic regression analyses did not alter these observed relations between the presence of moles and risk of melanoma.

Adult↗
PubMed1988

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Journal Article↗
PubMed1988

Cystic fibrosis in Denmark 1945 to 1985. An analysis of incidence, mortality and influence of centralized treatment on survival.

The entire population of cystic fibrosis (CF) patients in Denmark diagnosed in the period January 1, 1945, to June 30, 1985, comprised 514 persons of whom 62 were diagnosed at autopsy. Of the remaining 452 patients, 372 were probands and 80 were secondary cases. The effect of a centralized treatment on the prognosis was evaluated using a Cox's regression model. Furthermore an incidence analysis was performed using probands including autopsies. Centralized treatment had a significantly beneficial effect on the prognosis (p = 0.02), the death intensity (hazard rate) being decreased by a factor of 0.60. It was calculated that at present 1 out of 4,760 newborn Danes may be diagnosed as suffering from CF before the age of 15 years, and 3% of the Danish population are heterozygotes for CF.

Adolescent↗