Search PubMed⌕ Search

Biomedical subjects

D E Shaw

Publications and source records attributed to D E Shaw.

35 records · Page 2Linked to original sources
PubMed1988

Amblyopia--factors influencing age of presentation.

In the 47 months from September, 1981, 1531 new cases of amblyopia were identified in the ophthalmic clinics of Leicestershire. Amblyopia was due to strabismus in 689 (45%), combined strabismus and anisometropia in 540 (35%), anisometropia alone in 252 (17%), and form deprivation in 50 (3%). The median age at presentation for strabismic amblyopia (3.64 years) was significantly lower than for combined strabismus and anisometropia (4.68 years) and anisometropia (6.27 years). Boys presented later than girls, as did Asians compared with Caucasians. Only 38 (15%) of children with a visual defect without strabismus (anisometropia) were identified before the age of 5 years. The major reason for this late identification is the lack of a reliable single test for preschool vision assessment.

Adolescent↗
PubMed1988

The histopathology and staging of carcinoma of the ampulla of Vater.

Review of 26 resected ampullary carcinomas revealed intestinal type adenocarcinoma in all but one and overtly papillary carcinoma in only one case. Co-existing adenoma of the ampulla was present in 11 cases, over half of which were low-grade carcinomas. Flat duct epithelial dysplasia was present in a further eight cases, the adenocarcinoma in only two of these being well differentiated. The estimated 5 year survival rate, overall, was 52% and, with well differentiated adenocarcinoma, 75%. We recommend a new staging system, based on extent of local and lymph node spread: I = invasion confined to wall of common bile duct; II = infiltration of duodenal or retroperitoneal tissues, excluding pancreas; III = infiltration of pancreas; IV = metastasis to nearby lymph nodes. Long-term survival correlates inversely with stage, both by univariate analysis and independently of grade, so that a simple scoring system, based on a combination of both grade and stage, is an excellent predictor of the long-term outcome, defining two groups, with 5 year survival rates of 79% and 0% (P less than 0.001).

Adenocarcinoma↗
PubMed1988

Predicting future treatment of diabetes mellitus from characteristics available at presentation.

This study was designed to identify the clinical features of a newly diagnosed diabetic patient that are most useful in deciding treatment. A secondary aim was to formulate a statistical model for predicting subsequent treatment. The following features were considered in 289 patients: age, sex, severity and duration of symptoms, degree and duration of weight loss, glycosuria, ketonuria, blood glucose concentration, body mass index (BMI), and family history of diabetes. Three treatment groups, 6 months after diagnosis, were defined: diet alone, diet with oral hypoglycaemic agent(s), and insulin-treated. Univariate analysis showed that symptom severity, glycosuria, ketonuria, glucose concentration, weight loss, and BMI were significantly different between the three groups. Age and rate of weight loss were significantly different between the insulin-treated and non-insulin-treated groups. Multivariate analysis gave a model to calculate the probability of requiring each of the three treatments given certain characteristics. A second cohort of 174 patients was used to assess the accuracy of the model. The model predicted the actual treatment at 6 months correctly in 72%.

Adolescent↗
PubMed1988

Vision and visual acuity in an elderly population.

The data for this paper were collected during a two-year study of the elderly in the market town of Melton Mowbray. The data show that typically, persons aged 75 years and older have poor uncorrected vision (6/36 Snellen acuity), but good corrected acuity, 73.8 per cent gaining 6/12 binocular Snellen acuity or better. Over 88 per cent were able to read N8 typesize or better, under test conditions. Those with low uncorrected vision were the most likely to possess spectacles.

Aged↗
PubMed1988

Refraction and refractive errors in an elderly population.

The data for this paper were collected during a two-year study of the elderly in the market town of Melton Mowbray. The randomly selected subjects, aged 76 years of age and older, were found to be on average +1.33 D hypermetropic and the average cylinder power was 0.82 D. The mean refractive error was found to be +1.5 D with 0.5 negative cylinder at between 85 and 90 degrees. Of all the subjects, 30 per cent had significant anisometropia.

Aged↗
PubMed1988

Clinical risk factors and periventricular leucomalacia.

Two hundred infants of below 1501 g at birth were regularly examined with real time ultrasound using a 7.5 MHz transducer. Abnormalities were categorized as periventricular haemorrhage (PVH) (n = 107) or periventricular leucomalacia (PVL), with or without PVH (n = 52). Of the group with PVL, 25 had the appearances of prolonged flare without cavitation. Prospective assessments of up to 50 potential clinical risk factors were made wherever possible on each infant including stratification of all blood gas and systolic blood pressure data. Multivariate logistic regression analyses confirmed a strong correlation between immaturity and PVH but this was not found in cases of PVL. Independent variables associated with PVL included pneumothorax, maximum bilirubin concentration, surgery, and the proportion of time the infant's PaCO2 remained above 7 kPa. There was a very strong inverse correlation between anaemia and PVL. Systolic blood pressure data were carefully analysed and there was no relation between either hypotension or antepartum haemorrhage and the development of PVL.

Encephalomalacia↗
PubMed1987

Study of common bile duct exploration and endoscopic sphincterotomy in a consecutive series of 438 patients.

The outcome of 438 consecutive patients who had exploration of the common bile duct and/or endoscopic sphincterotomy (ES) in a 5-year period was reviewed. Patients were analysed according to four groups: 59 patients had planned ES followed by surgery resulting in 14 major complications (23.7 per cent) including 3 deaths (5.1 per cent) (group 1); 248 patients had surgery alone with 21 major complications (8.5 per cent) including 10 deaths (4.0 per cent) (group 2); 114 patients with gallbladder in situ underwent ES alone with 22 major complications (19.3 per cent) including 9 deaths (7.9 per cent) (group 3); 17 patients with remote cholecystectomy also had ES alone with 3 major complications (17.6 per cent) including 3 deaths (17.6 per cent) (group 4). There was no difference in mortality between the groups. Compared with group 2, major complications were significantly higher in group 1 (chi 2 = 11.0, d.f. = 1, P less than 0.001) and in group 3 (chi 2 = 8.6, d.f. = 1, P less than 0.003). Patients in group 3, however, were significantly older than those in groups 1 and 2, and the former also had higher medical and total risk factor scores than the latter (all P less than 0.001). The results indicate that routine pre-operative ES is of questionable value. ES alone is justified in elderly high risk patients; mortality in this group might be reduced by improved management of post-ES complications.

Adolescent↗
PubMed1987

Treatment and outcome in 52 consecutive cases of ampullary carcinoma.

The results of treatment and outcome in 52 consecutive patients presenting to Leicester from 1972 to 1984 are presented. The number of patients diagnosed increased from two per year before the introduction of duodenoscopy to nearly five per year afterwards. Endoscopic drainage (ED) was attempted in 21 patients with a success rate of 81 per cent. In eight cases ED was used pre-operatively and in the remainder as definitive treatment. Twenty-four patients had a Whipple's resection (12.5 per cent mortality), four patients had a local resection (no deaths), ten patients had surgical bypass (60 per cent mortality) and thirteen patients had ED alone (23 per cent mortality). The major risk factor score was significantly greater in patients undergoing surgical bypass compared with Whipple's resection. Age and risk factor scores were significantly greater in patients who had ED drainage alone than in surgical patients. The 5 year survival rate for resection was 56 per cent versus 13 per cent for drainage procedures (P less than 0.001). Survival in resection cases was directly related to the degree of tumour differentiation and a new staging system. It is proposed that all patients with ampullary tumours should have endoscopic biopsy followed by ED; Whipple's resection remains the surgical treatment of choice.

Adenocarcinoma↗
PubMed1986

Senile cataract and senile macular degeneration: an investigation into possible risk factors.

Data from the Melton Mowbray Eye Study and Community Health Study have been used to look for possible risk factors for senile cataract and senile macular degeneration. Significant associations with senile cataract were age, female sex, myopia, social class and antihypertensive treatment, whilst for senile macular degeneration age and the absence of arcus senilis were significant. These observations are presented and discussed in relation to findings from other studies.

Age Factors↗
PubMed1983

Preliminary characterization of ribosomes of Entamoeba invadens.

The ribosomes of Entamoeba invadens trophozoites have sedimentation coefficients of 77, 53 and 36 S. Most of the ribosomal proteins are basic and their one- and two-dimensional electrophoretic patterns differ from the corresponding patterns of Escherichia coli and Saccharomyces cerevisiae. Two dozen bands were observed in the 10 000 to 100 000 molecular weight range following sodium dodecylsulfate-gel electrophoresis of amoebal ribosomal proteins. Long, thin pronase-sensitive structures were seen in electron micrographs of E. invadens ribosomal preparations.

Animals↗
PubMed1977

Sago haemolysis: clinical features and microbiological studies.

Severe, acute and sometimes fatal intravascular haemolysis has occurred on several occasions in Papua New Guinea families after the ingestion of apparently 'stale' sago. Earlier cases had been recorded only from the Maprik area; however, we now report the occurrence of two similar outbreaks, involving a total of 14 persons, in the Western Province. Several bacteria and fungi were isolated and identified in a sample of suspect sago from one of the outbreaks. None of these, however, to our knowledge, has ever been incriminated as a cause of haemolysis, and the aetiological agent(s) and mechanism of haemolysis thus remain to be elucidated. No mycotoxins were detected in one sample available for analysis. It is suggested that the eating of sago stored for a long time be discouraged; and further that, if a meal of sago tastes abnormal, additional mouthfuls should not be eaten and the remaining portion should be sent for analysis or discarded.

Adolescent↗