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Biomedical subjects

D Ashby

Publications and source records attributed to D Ashby.

At least 73 records · Page 4Linked to original sources
PubMed1988

Increased incidence of anti-glomerular basement membrane antibody (anti-GBM) nephritis in the Mersey Region, September 1984-October 1985.

We report an increase in the incidence of anti-glomerular basement membrane antibody nephritis in the Mersey Region over the 13 months from September 1984 to October 1985. During this period anti-glomerular basement membrane antibody nephritis was diagnosed in 10 patients: seven cases occurred between 1 June and 31 October 1985. We could identify no common infective agent or history of toxic exposure. Although outbreaks of parvovirus infection were reported in the region during this period, no patient had serological evidence of recent infection with parvo- or other virus. The only atypical feature was the high incidence of allergic rash which was seen in four of six patients treated with antibiotics before admission. Only two patients recovered sufficient renal function to make dialysis unnecessary. Both had a longer duration of prodromal symptoms, lower levels of circulating anti-glomerular basement membrane antibody antibodies and histological evidence of less aggressive disease.

Adult↗
PubMed1988

Blood pressure and hypertension in middle-aged British men.

Blood pressure measurements in 7735 middle-aged men from general practices in 24 towns in England, Wales and Scotland provide information on the prevalence of hypertension and its management in Great Britain. Despite a substantial correlation (r = 0.70) between systolic and diastolic blood pressures, individuals can show considerable discrepancies between these two measurements; they are not interchangeable. This observation has important implications for the choice of criteria used to define hypertension. However defined, the prevalence of hypertension increases markedly with age, increasing body mass index and with heavy alcohol consumption. It is not related to smoking and only to a small extent to social class. Diastolic hypertension (greater than or equal to 90 mmHg) was present in 26% and systolic hypertension (greater than or equal to 160 mmHg) in 22% of these men. In both systolic and diastolic hypertension, only one quarter of affected men could recall having been diagnosed as hypertensive by a doctor, and only one third of these were on regular antihypertensive treatment. There is a threefold variation in the prevalence of measured hypertension in the 24 towns with a trend towards higher rates in Northern England and Scotland. No relationship was seen between the prevalence rates of measured hypertension in the towns and the rates of doctor diagnosis of hypertension. Cardiovascular mortality rates in the towns were correlated with the measured prevalence rates for systolic and diastolic hypertension (r = 0.70 and r = 0.57, respectively). The geographic variations in blood pressure and hypertension in Great Britain provide a major opportunity for research into the causes of 'essential' hypertension.

Adult↗
PubMed1987

Lead exposure and children's intellectual performance.

The Institute of Child Health/Southampton study is the largest cross-sectional survey of lead exposure and children's intelligence. 402 six year olds in London with tooth lead concentration in three pre-defined ranges were selected for neuropsychological testing. This paper presents new findings on the relationship between child IQ and tooth lead levels which build on previous findings in four respects: Rather than simply classifying children into high, medium and low lead groups the actual concentrations of lead in each child's tooth have been used to provide a more powerful assessment of the association between IQ and body lead burden. The influence of parental and social factors on child IQ is explored in detail in order to see if any residual lead-IQ association exists after allowance for such confounders. The methods of multiple regression, including an 'optimal' statistical policy, are more fully described. The possibility of interactions between lead and confounders is explored. Findings are that parental IQ is the most important influence on child IQ, though several other factors (eg: family size, social class and quality of marital relationships) were also significantly related. There was no overall evidence that tooth lead concentrations were related to child IQ once these other factors were taken into account. However, a significant interaction between tooth lead and sex of child indicates that the lead-IQ association appears much more pronounced in boys. This unexpected finding needs cautious interpretation and further exploration in other studies.

Child↗
PubMed1986

Harmonizing multiple choice question marks with essay marks.

Many examinations contain both a multiple choice question (MCQ) section, which has wide-marking and is often norm-based, and an essay or other section which is criterion-based and often close-marked. The necessary addition or averaging of the marks is unsatisfactory without adjustment. We propose a procedure that adjusts the MCQ marks to the essay marking scale by equating the interquartile ranges of the two sets of marks.

Education, Medical↗
PubMed1986

Long-term trends in biochemical data obtained from two population surveys.

A study has been made of the variations in monthly mean values of 10 serum constituents in subjects participating in two partly-concurrent long-term epidemiological surveys. Closely similar patterns of variation were found in men in both surveys and in men and women in one survey. During the 6 years of the study, four types of variation of the monthly mean concentrations were identified in varying combinations: abrupt changes of less than 2% not detected by quality control procedures; a gradual drift in mean value; haphazard variations in mean values; and seasonal variations in bilirubin and urea, identical in men and women. The implications of these findings for the design of long-term epidemiological surveys, and the criteria for designating variations as seasonal, are discussed.

Adult↗
PubMed1986

Designing chemotherapy and radiation therapy facilities.

Few disorders, regardless of their associated mortality rate, evoke the same degree of anxiety as that produced by cancer. Cancer treatment facilities should be designed to alleviate stress and provide comfort. This article addresses design considerations for selected areas of chemotherapy and radiation therapy facilities.

Hospital Departments↗
PubMed1985

The demographic characteristics of pregnant women infected with cytomegalovirus.

An analysis was made of the demographic characteristics of 1000 women who were screened for serological evidence of cytomegalovirus (CMV) infection while receiving antenatal care in central London. The prevalence of antibodies against CMV was shown, by multiple discriminant analysis, to be significantly associated with non-Caucasian race (p less than 0.001), increasing maternal age (p less than 0.001) and poor social class (p less than 0.05). These results are interpreted as reflecting increased childhood exposure to CMV as a result of poor social environments. When data from 48 women who acquired primary CMV during pregnancy were analysed, infection was also related to non-Caucasian race (p less than 0.01), but in contrast, there was no demonstrable effect of social class, maternal age or marital status. We conclude that pregnant women acquiring the form of CMV infection with the greatest pathological potential for the fetus (primary infection) belong primarily to the middle-class sections of communities. Since middle-class women traditionally avail themselves of prophylactic measures, this result provides some optimism for the ultimate control of this common disease by immunization.

Adolescent↗
PubMed1985

Biochemical and haematological response to alcohol intake.

In a clinical survey of 7735 middle-aged men, alcohol consumption has been related to 25 biochemical and haematological measurements obtained from a single blood sample. Most measurements showed some association with alcohol consumption, gamma-glutamyl transferase (GGT) being the most strongly associated. Lead, mean corpuscular haemoglobin (MCH), mean corpuscular volume, high-density lipoprotein-cholesterol (HDL-C), urate and aspartate transaminase also showed substantial associations with alcohol intake. Using a discriminant analysis technique, a simple score based on five variables (GGT, HDL-C, urate, MCH and lead) provided the best discrimination between heavy drinkers (e.g. more than three pints of beer daily) and occasional drinkers, but still failed to identify more than half of the heavy drinkers. This combined score may prove a useful measure of an individual's biochemical/haematological response to alcohol consumption for use in epidemiological and clinical studies of alcohol related disorders. The use of such indices should complement but not replace measures of alcohol intake derived from questionnaires.

Adult↗
PubMed1984

Blood lead concentration, blood pressure, and renal function.

Blood lead concentrations were related to blood pressure and indicators of renal function in a clinical survey of 7735 middle aged men from 24 British towns. There was no overall evidence that blood lead concentrations were associated with systolic or diastolic blood pressure (r = +0.03 and +0.01, respectively). In the 74 men with a blood lead concentration of 1.8 mumol/l (37.3 micrograms/100 ml) or more there was some suggestion of increased hypertension, but this did not reach significance. Blood lead concentration did not have any relation with serum creatinine concentration. Moderate increases in blood lead concentration were associated with small increases in mean serum urate concentration and small decreases in mean serum urea concentration; these associations were both reduced when alcohol consumption was taken into account. There is no indication that exposure to lead at concentrations commonly encountered in British men is responsible for impaired renal function or increased blood pressure.

Adult↗
PubMed1984

Psychiatric illness in residential homes for the elderly: a survey in one London borough.

The mental state, demographic details, dependency level and presence of problem behaviours have been recorded for 438 (82%) of the residents of the 12 Part III homes, managed by the London Borough of Camden, using standard interview. One third of the residents were suffering from severe dementia, another third from mild to moderate dementia and one third were free of dementia. Of the latter two groups, 38% were depressed. The prevalence rate of dementia increased with the age of the resident and was higher among females. Depression was associated with the presence of visual handicap and incontinence, and was commoner when the resident had been admitted from his own home or belonged to a minority religion. A third of residents needed daily help with dressing and use of the lavatory, one quarter were incontinent each day. Depression and dementia both were associated with increased rates of dependency and of problem behaviours (incontinence, wandering, aggression). This survey has revealed evidence of sufficient psychiatric morbidity in these homes to support a re-appraisal of their current aims, staffing and health-care provision.

Aged↗
PubMed1984

Reduction in exposure to lead from drinking water and its effect on blood lead concentrations.

The water supply in Ayr (Scotland, UK) was plumbosolvent and many dwellings in Ayr contained lead pipes. In 1981 treatment of the water supply to reduce its plumbosolvency was initiated. Measurements of water and blood lead concentrations were made before and subsequent to the treatment. Most of the measurements made before and after water treatment began were made on water samples from the same dwellings and blood samples from the same women. Water treatment produced a sharp fall in water lead concentrations and a decrease in the median blood lead concentration from 21 to 13 micrograms/100 ml. Two women had higher than expected blood lead concentrations, both these women had been removing old paint. Women who had lead pipes removed from their dwellings all showed substantial decreases in their blood lead concentrations. The curvilinearity of the relation between blood lead and water lead concentrations is confirmed. Even relatively low (less than 40 micrograms/l) water lead concentrations may make a substantial contribution to blood lead concentrations.

Adult↗
PubMed1983

Blood lipids in middle-aged British men.

The concentrations of serum total cholesterol, high density lipoprotein-cholesterol, and triglycerides have been measured in 7735 men aged 40 to 59 years who were drawn from general practices in 24 towns in England, Wales, and Scotland. The distribution of these blood lipids, their interrelations and their association with age, social class, body mass index, cigarette smoking, alcohol intake, and physical activity at work have been examined. Body mass index emerges as the factor most strongly associated with these three blood lipids. Serum total cholesterol increased with increasing body mass index until about 28 kg/m2 but thereafter showed no further rise. The relation between body mass index and high density lipoprotein-cholesterol was negative and linear; that between body mass index and triglycerides was positive and linear. The inverse relation between high density lipoprotein-cholesterol and triglycerides was independent of the fact that both were related to body mass index. Alcohol intake was associated with increased high density lipoprotein-cholesterol concentrations and cigarette smoking with lowered high density lipoprotein concentrations; the association with alcohol appeared to be dominant. No significant trends with age were observed for the three blood lipids. In this population, body mass index is closely associated with the concentration of blood lipids but its effects are probably indirect and mediated by a complex of dietary and other factors.

Adult↗