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C Gill

Publications and source records attributed to C Gill.

At least 55 records · Page 3Linked to original sources
PubMed1995

Incidence of clinically diagnosed subtypes of dementia in an elderly population. Cambridge Project for Later Life.

BACKGROUND: In developed countries, most dementia appears to be due to Alzheimer's disease and vascular dementia. We report rates for incidence of subtypes of dementia based on clinical diagnosis. METHOD: This study was a 2.4-year (s.d. 2.6 months) follow-up of a cohort aged 75 years and over, seen initially in a prevalence study of dementia. A screening interview in 1173 survivors was followed in a subsample of 461 respondents by a diagnostic interview 1.8 months after screening (s.d. 1.5 months). This comprised a standardised interview with respondent and informant, with venepuncture where possible. Clinical diagnoses of subtypes were made by specified criteria. RESULTS: The incidence of Alzheimer's disease of mild and greater severity was 2.7/1000 person-years at risk (1.6-4.4); in men 1.5 (0.8-2.7) and in women 3.3 (1.8-5.9). The incidence of vascular dementia was 1.2/100 person-years at risk (0.7-1.9); in men 1.1 (0.4-2.8) and in women 1.2 (0.7-2.0). Alzheimer's disease, but not vascular dementia, showed a marked increase with age, particularly in women. Rates for minimal dementia of different subtypes showed similar age and sex effects, but were much higher for Alzheimer's disease than vascular dementia. CONCLUSIONS: The striking rise in incidence rates of dementia in the very old appear to be due to Alzheimer's disease, while rates for vascular dementia remain relatively constant. These trends are particularly marked for minimal dementia, but emphasise the importance of Alzheimer's disease in the community as a cause of cognitive decline of all degrees.

Aged↗
PubMed1995

Microbiology and immunology in patients with leg ulcers.

Aspects of the bacteriological and immunological status of patients with leg ulcers who also need podiatric treatment have been examined. Qualitative and quantitative bacteriological analyses of 52 patients have provided values for the numbers and types of bacteria present. A simple survey of the immunological status of 11 of the patients was also undertaken. The results of the bacteriological survey are consistent with those of other workers, while the results of the immunological studies are sufficiently heterogeneous to warrant a further dedicated study of a longitudinal nature. Because of the numbers of bacteria isolated, the range of bacterial species identified and uncertainties about the immunological status of the patients and others attending multi-clinic sites, it is suggested that in order to safeguard all patients, personnel and the immediate environment, clearly defined special procedures for infection control should be in place.

Adult↗
PubMed1994

Incidence of dementia in a population older than 75 years in the United Kingdom.

BACKGROUND: Incidence studies have been relatively neglected in psychiatric epidemiology. They are particularly important for dementia, since prevalence rates are affected by length of survival, which itself falls with increasing age and presence of dementia. METHODS: Two-wave community study of 1195 elderly subjects aged older than 75 years, restudied 2.4 years after a community prevalence study. A two-stage method was used, comprising the Mini-Mental State Examination followed in a stratified sample by the Cambridge Examination for Mental Disorders of the Elderly (CAM-DEX) interview. Incidence rates were based on person-years at risk. RESULTS: Annual incidence rates for dementia were 2.3% for subjects initially aged 75 to 79 years, 4.6% for ages 80 to 84 years, and 8.5% for ages 85 to 89 years, approximately doubling every 5 years. Rates did not differ significantly by sex, educational level, or social class. Twice as many additional individuals received a diagnosis of minimal dementia not reaching case threshold. CONCLUSIONS: The findings show high rates of new onset dementia, increasing markedly with age, and suggest rapid acceleration of one or more processes that is common in advanced age.

Age Distribution↗
PubMed1994

Comparison of dietary assessment methods in nutritional epidemiology: weighed records v. 24 h recalls, food-frequency questionnaires and estimated-diet records.

Women (n 160) aged 50 to 65 years were asked to weigh their food for 4 d on four occasions over the period of 1 year, using the PETRA (Portable Electronic Tape Recorded Automatic) scales. Throughout the year, they were asked to complete seven other dietary assessment methods: a simple 24 h recall, a structured 24 h recall with portion size assessments using photographs, two food-frequency questionnaires, a 7 d estimated record or open-ended food diary, a structured food-frequency (menu) record, and a structured food-frequency (menu) record with portion sizes assessed using photographs. Comparisons between the average of the 16 d weighed records and the first presentation of each method indicated that food-frequency questionnaires were not appreciably better at placing individuals in the distribution of habitual diet than 24 h recalls, due partly to inaccuracies in the estimation of frequency of food consumption. With a 7 d estimated record or open-ended food diary, however, individual values of nutrients were most closely associated with those obtained from 16 d weighed records, and there were no significant differences in average food or nutrient intakes.

Diet Records↗
PubMed1994

Trends in incidence of various cancers in Bulgaria, 1981-1990.

BACKGROUND: Bulgaria has undergone considerable social changes in the last 40 years, including a transition from a 75% rural to a 75% urban population. These changes might be expected to be reflected in disease rates. The Bulgarian cancer registry has computerized data on cancer incidence throughout the country from 1981 onwards. METHODS: Incidence rates in Bulgaria from 1981 to 1990 of cancers of the lung, stomach, large bowel, prostate and bladder in males and of cancers of the breast, lung, stomach, large bowel, cervix and corpus uteri in females were analysed with particular attention to time trends, age-specific changes in rates and urban/rural differences. Poisson regression was used for statistical analysis. RESULTS: Male rates of cancers of the lung, large bowel, prostate and bladder increased significantly over the period, with average annual increases of 0.4%, 2.9%, 1.3% and 2.3% respectively. In females, rates of cancers of the breast, cervix and corpus uteri increased significantly, with average annual increases of 1.3%, 1.9%, and 2.9%. In both sexes, stomach cancer incidence declined significantly, by 3.0% per year for males and 3.6% per year for females. Rural rates were lower than urban rates for most cancers, particularly in the higher age groups. The decline in male stomach cancer rates was confined to rural areas. The increases in rates of lung cancer and prostate cancer in males and of colorectal cancer and breast cancer in females were most rapid in urban areas. CONCLUSIONS: Substantial changes in rates of various cancers have taken place from 1981 to 1990, in particular increases in rates of breast cancer and large bowel cancer in women resident in urban areas. It is suggested that dietary changes may be responsible for some of these changes.

Adolescent↗
PubMed1994

Assessing change over time in patients with low back pain.

BACKGROUND AND PURPOSE: This study compared the ability of the Roland-Morris (RM), Oswestry (OSW), and Jan van Breemen Institute (JVB) pain and function questionnaires to detect change over time. SUBJECTS: The sample consisted of 88 patients with mechanical low back pain who were referred by physicians to the outpatient physical therapy department of a teaching hospital. METHODS: Questionnaires were completed by the subjects at their initial visit and 4 to 6 weeks later. Clinically important change was estimated by having the subject and the clinician independently complete two rating scales. Sensitivity to change was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS: The ROC curve areas for the RM (0.79), OSW (0.78), and JVB pain (0.79) questionnaires were significantly greater than for the JVB function questionnaire (0.66). Blank and multiple responses per item were present on approximately 20% of the OSW questionnaires and 14% of the JVB questionnaires. Words rather than checks were evident on 3% of the RM questionnaires. CONCLUSION AND DISCUSSION: Based on the latter finding, we believe the RM questionnaire may be the preferred instrument for assessing change over time in patients with low back pain.

Activities of Daily Living↗
PubMed1994

Low back pain: program description and outcome in a case series.

Studies are needed to enhance our understanding of functional outcomes. The purpose of this paper is to describe a community clinic program for injured workers with low back pain and to report outcomes of the first 50 consecutive patients to enter the program who were evaluated using a standardized assessment procedure. Data for this report were collected from a retrospective chart review as part of an evaluation of the program. The patients referred to the clinic entered a 4-week treatment program. They were assessed at entry and discharge using the Toronto-Hamilton Lumbar Database. The database assessment is a standardized evaluation for documenting subjective and objective clinical data, and the protocol includes a diagnostic classification system and pain and function ratings. The results of this investigation include a statistically significant (p < 0.05) decrease in pain and increase in function as measured by the Jan van Breemen pain and disability scales and the Sickness Impact Profile. Seventy-four percent of the treatment group had returned to work by 6 weeks postdischarge from the program. This study suggests that a significant improvement in functional capabilities, a decrease in pain and disability indices, and higher return-to-work rates can be achieved through a 4-week, community-based multiprofessional rehabilitation program.

Adult↗
PubMed1993

Sensitivity of Sickness Impact Profile items to measure change over time in a low-back pain patient group.

The purpose of this study was to identify Sickness Impact Profile (SIP) items that are most sensitive to change in patients with low-back pain. Seventy-six patients with low-back pain were administered the SIP at their initial visit and after discharge from physiotherapy treatment. A formal item reduction was performed to identify the most sensitive items. An item was considered sensitive if it showed change in 20% of the patients and had an item-corrected total SIP score correlation greater than 0.30. Twenty items were identified. Seven of the 20 items identified in this study appear on the Roland-Morris disability questionnaire. Also, only 50% of the items identified are from the physical subscale of the SIP.

Activities of Daily Living↗
PubMed1992

The Cambridge Project for Later Life: design and preliminary results.

The Cambridge Project for Later Life is the follow-up at 2.4 years of the Hughes Hall Project for Later Life, a prevalence study of dementia in Cambridge city in which 40% of the population aged 75 and over were screened for dementia. In the follow-up, 1,173 people were screened a second time, and using Mini-Mental Scale Examination scores were selected for a more intensive interview with CAMDEX. This was followed by detailed neuropsychological testing and magnetic resonance imaging in a smaller proportion of individuals.

Aged↗
PubMed1992

Methodological issues in screening for dementia.

Screening for dementia in populations presents particular difficulties for researchers. In the absence of gold standards for diagnosis, the methods used must be determined by the purposes of the study. In two-stage epidemiological study the screening wave and the diagnostic instrument should be considered together in relation to a third proxy gold standard such as progression of the disorder to moderate and greater severity and neuropathological diagnosis. This provides a measure of the predictive performance of the original screening method and its diagnostic phase. To reduce the variance of estimates of prevalence and incidence it is suggested that the screening interview be a subset of the diagnostic interview.

Aged↗
PubMed1990

Dietary factors and breast-cancer risk in Denmark.

The influence of dietary factors, in particular the intake of fat and beta-carotene, on breast-cancer risk was evaluated in a case-control study including 1,486 breast cancer cases diagnosed over a 1 year period in Denmark. The control group was an age-stratified random sample of 1,336 women from the general population. Data on usual diet prior to the breast cancer diagnosis were collected by self-administered questionnaires of the semi-quantitative food frequency type. A highly significant trend (p less than 0.001) of increasing risk was observed with increasing fat intake, the RR for the highest quartile being 1.45 (95% Cl 1.17-1.80) compared with the lowest. However, information was not available to allow adjustment for the possible confounding effect of energy intake. The risk of breast cancer was not associated with consumption of vegetables rich in beta-carotene, multi-vitamin tablets or other dietary supplements, coffee, tea, sugar or artificial sweeteners.

Adult↗
PubMed1989

Preexcitation syndromes: surgical ablation therapy. The Cleveland Clinic experience.

Thirty-four patients with preexcitation syndrome had surgical ablation of the accessory atrioventricular connection. All presented with sustained symptomatic arrhythmias, which had resulted in syncope in seven patients and aborted sudden cardiac death in four. Arrhythmias induced at electrophysiologic evaluation included orthodromic reciprocating tachycardia in 32 patients, antidromic reciprocating tachycardia in five patients, and atrial fibrillation in 29 patients. A single accessory atrioventricular connection was located in 32 patients and two patients had multiple accessory connections. The accessory connection was located with intraoperative mapping in all patients and the pathway was successfully ablated in 32. Eleven patients underwent a transmural approach and 23 patients underwent an epicardial dissection. Cryotherapy was used in 22 patients. After a mean follow-up of 32 months, 28 patients were free from all arrhythmias without drug therapy. Six patients continued to have symptomatic arrhythmias but only one case was suspected to be secondary to unsuccessful ablation of the accessory connection. One patient with heart block induced at the surgical procedure is dependent upon a pacemaker.

Adolescent↗
PubMed1989

L-658,310, a new injectable cephalosporin. I. In vitro antibacterial properties.

The in vitro antibacterial spectrum of L-658,310, a new semisynthetic cephalosporin, was compared with ceftazidime, aztreonam and piperacillin against a wide variety of randomly selected human clinical isolates. The compound was found to be a broad spectrum bactericidal agent that was more potent than any of the comparison drugs against glucose nonfermenting bacteria. It has especially potent activity against Pseudomonas aeruginosa including multiply-resistant strains. The superior activity of L-658,310 against this group of organisms is attributed to the presence of the dihydroxy substituents on the 2-methylisoindoline moiety of the compound. L-658,310 is not cross-resistant with either imipenem, ceftazidime or piperacillin (representatives of three different classes of beta-lactam compounds) against P. aeruginosa. The lack of cross-resistance with ceftazidime extends to other glucose nonfermenters and several strains of Enterobacteriaceae as well. The compound is active against bacteria known to possess either R-plasmid- or chromosomally-mediated beta-lactamases.

Aerobiosis↗
PubMed1987

Comparative susceptibilities of Campylobacter pylori to norfloxacin and other agents.

Twenty-one strains of Campylobacter pylori (Campylobacter pyloridis) were tested for susceptibility to norfloxacin and other agents by the serial agar dilution method. Ampicillin (MIC for 90% of isolates [MIC90], 0.016 micrograms/ml) and famotidine (MIC90, greater than 1,024 micrograms/ml) were, respectively, the most and the least active of the agents tested. Norfloxacin (MIC90, 1 microgram/ml) and imipenem (MIC90, 0.125 micrograms/ml) were substantially active against this organism.

Anti-Bacterial Agents↗
PubMed1985

The thoracic cavity, a troublesome neighbor. Intraoperative consultation by the thoracic surgeon.

There is usually little need for intraoperative collaboration between the thoracic surgeon and his urologic colleague. However, situations occasionally arise in the urologist's operating room that require consultation with a thoracic surgeon or the use of thoracic surgical techniques. These techniques may be required during intrathoracic complications of common anesthetic procedures, or when renal pathology is extensive and demands cooperation between the specialties. The propensity of renal-cell carcinoma to extend via the renal vein into the inferior vena cava and right atrium may, on occasion, require direct surgical cooperation between the cardiac and urologic surgeon to remove safely large tumors that extend into and perhaps adhere to the right atrium.

Carcinoma, Renal Cell↗
PubMed1984

Getting married.

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Family Practice↗