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Biomedical subjects

F E Alexander

Publications and source records attributed to F E Alexander.

At least 91 records · Page 5Linked to original sources
PubMed1991

Mothers' reports of childhood vaccinations and infections and their concordance with general practitioner records.

Mothers of 294 children aged 3-9 years were interviewed about their child's previous history of vaccinations and infections. The study group comprised healthy children selected at GP surgeries (n = 136) and those hospitalized for both minor and serious conditions (n = 168). The results evaluate the entire study group for the pattern of reporting vaccinations and infectious episodes under three years of age, comparing two different data sources-mothers' reports and GP records. Maternal recall accuracy is formally tested (Kappa statistic) for agreement with GP records. For vaccination history the results indicate that mothers and GPs are inadequate data sources, and suggest use of computerized health district records to improve data accuracy. Major differences on infectious history were evident for two types of questions-closed for specific infections and open-ended for 'other infections'. Specific infections (e.g. measles) were systematically over-reported by mothers compared with GP records, but mothers failed to 'time' the event. Concordance for 'other infections' was also poor, but, by contrast, GPs systematically over-recorded this range of infections, indicating substantial inaccuracy in mothers' recall. The authors suggest that GP records should be the preferred source of data for these 'other' infectious episodes, especially under one year of age. Improved questionnaire design would elicit more accurate maternal reports on specified infections for which a GP may well not be consulted and corroboration would be impossible.

Case-Control Studies↗
PubMed1991

Detection of Epstein-Barr virus genomes in Hodgkin's disease: relation to age.

An investigation as to whether any particular subgroup of patients with Hodgkin's disease was particularly likely to be Epstein-Barr virus (EBV) genome positive was made on samples from 95 patients. These were grouped according to age and Hodgkin's disease subtype, and analysed using Southern blot analysis. Most samples from children or adults aged 50 years or over contained detectable EBV genomes; samples from young adults were only rarely positive. The differences in EBV positivity by age were highly significant, but there was no significant association between EBV and histological subtype after allowing for the effect of age. The results support the hypothesis that Hodgkin's disease in different age groups may have different aetiologies, and suggest that EBV does have a pathogenetic role in Hodgkin's disease in children and older age groups.

Adolescent↗
PubMed1990

Community lifestyle characteristics and risk of acute lymphoblastic leukaemia in children.

High rates of leukaemia in children and young people have been associated with features of community isolation and population growth. Incidence data collected by two specialist registries were used to compare incidence rates at ward level with relevant ward characteristics derived from routine census and Ordnance Survey data for England and Wales. An excess risk of childhood acute lymphoblastic leukaemia (ALL) was found for wards which are farthest from large urban centres. The excess was greatest for wards of higher socioeconomic status and for children aged 1-7 years (the childhood peak), for which a two-fold excess was seen. These findings in general support the hypothesis that childhood leukaemia has an infectious aetiology.

Adolescent↗
PubMed1990

The seroepidemiology of human herpesvirus-6 (HHV-6) from a case-control study of leukaemia and lymphoma.

Sera from an epidemiological case-control study of leukaemias and lymphomas conducted between 1980 and 1986 were examined for reactivity to human herpesvirus-6 (HHV-6) by an indirect immunofluorescence assay. Statistical analyses of the data revealed higher HHV-6 seroprevalence and antibody titres in the cases, particularly evident in the disease subtypes acute myeloid leukaemia, Hodgkin's disease (HD), and low-grade non-Hodgkin's lymphoma. Within the control group alone, HHV-6 seroprevalence was placed at 55% at a serum dilution of 1:40. The controls also displayed higher seropositivity in females as compared with males. Further analyses suggest an association of increased HHV-6 seropositivity and geometric mean titre ratio with HD among young adults lacking social contact in the family group. This finding might indicate late exposure to HHV-6 in such persons and could possibly signify late exposure to a number of viruses, including those hypothesized as playing a role in the aetiology of HD. Previous reports have nominated Epstein-Barr virus as a possible candidate. Our results suggest that HHV-6 should be included in further investigations of the aetiology of HD.

Antibodies, Viral↗
PubMed1990

Edinburgh trial of screening for breast cancer: mortality at seven years.

Between 1979 and 1981, 45,130 women in Edinburgh aged 45-64 were entered into a randomised trial of breast cancer screening by mammography and clinical examination. The initial attendance rate was 61% but this varied according to age and socioeconomic status and decreased over succeeding years. The cancer detection rate was 6.2 per 1000 women attending at the first visit; the rate fell to around 3 per 1000 in the years when mammography was routinely repeated and to around 1 per 1000 at the intervening visits with clinical examination alone as the screening method. After 7 years of follow-up the mortality reduction achieved was 17% (relative risk = 0.83, 95% CI 0.58-1.18), which was not statistically significant, even when corrected for socioeconomic status. In women aged 50 years and over a mortality reduction of 20% was achieved.

Age Factors↗
PubMed1990

Leukaemia incidence, social class and estuaries: an ecological analysis.

Leukaemia incidence data for 1984-1986 for 22 counties of England and Wales have been collected by a specialist registry. The present study is an ecological analysis in which incidence in electoral wards has been tested for association with two predefined ward characteristics: socio-economic status and proximity to estuaries. Small but statistically significant associations have been observed with relative risks in the range 1.05-1.50. Adjustments have been made in the analysis for variation in the underlying regional incidence and also for statistical artefacts consequent upon the rarity of the condition. The results for socio-economic status confirm those of other recent studies, with increased incidence linked to higher status. The results for estuaries are new although derived from a prior hypothesis.

Adolescent↗
PubMed1990

Breast cancer stage, social class and the impact of screening.

Two studies were carried out to examine socio-economic factors in breast cancer: a random sample of all new cases in Edinburgh in 1979 was reviewed, and the control population of the Edinburgh randomized trial of breast screening was used to determine stage and survival in relation to social class. Small area statistics from census data were used as measures of social class, the method being now well accepted. More than one-third of women still present with obviously advanced or metastatic breast cancer, but both studies showed this has no association with socio-economic status. Late stage at presentation is a serious problem, and although mass screening is likely to cause an improvement in those who are screened, it cannot in those who do not attend for screening. As attendance is related to social class, less affluent women are less likely to benefit and will continue to be diagnosed with advanced disease.

Adult↗
PubMed1989

Estimation of sojourn time distributions and false negative rates in screening programmes which use two modalities.

Day and Walter derived methods of joint maximum likelihood estimation for the sojourn time distribution and the false negative rate for a screening programme. Their methods are not directly applicable to a programme which uses alternate screening by two modalities whose sojourn times and false negative rates will differ. A modification is proposed and the results applied to data from the Edinburgh Randomised Trial of Breast Cancer Screening. This enables the effects of mammography and clinical examination to be separated. It is estimated that in a programme using both modalities 79 per cent of tumours arising in regularly screened women would be detected by screening and if the clinical examination were omitted this figure would be reduced by 5 per cent. The confidence intervals are, however, quite wide.

Breast Neoplasms↗
PubMed1989

A specialist leukaemia/lymphoma registry in the UK. Part 1: Incidence and geographical distribution of Hodgkin's disease. Leukaemia Research Fund Data Collection Study Group.

This paper describes the epidemiology of Hodgkin's disease occurring in parts of the United Kingdom between 1984 and 1986. The cases were carefully diagnosed and the data rigorously cross-checked as part of the larger Leukaemia Research Fund Data Collection Survey of all lymphoid and haematogenous malignancies. The age-specific rates show the lack of an older adult second peak. Spatial variation is examined in some detail. At county and district levels there is little heterogeneity in the distribution of cases. However, at the electoral ward level there were real differences for the younger age group (0-34).

Adolescent↗
PubMed1989

A specialist leukaemia/lymphoma registry in the UK. Part 2: Clustering of Hodgkin's disease.

Part 1 describes the epidemiology of Hodgkin's disease occurring in those parts of the United Kingdom which are included in the Leukaemia Research Fund data collection survey. A total of 1,023 cases diagnosed between 1984 and 1986 were available for analysis. At county and district levels there was little heterogeneity in the distribution of cases. However, at the electoral ward level there were real differences for the younger age group (0-34). In this paper methods of investigation which are not dependent on census boundaries are applied and the presence of localised spatial clustering is confirmed. There is some evidence that the pattern of clustering relates to the nodular sclerosing subtype. These results are related to hypotheses of an infectious aetiology.

Adolescent↗
PubMed1989

The leukaemia research fund data collection survey: the incidence and geographical distribution of acute myeloid leukemia.

This paper reports on the 2,362 cases of acute myeloid leukemia (AML) accumulated by the Leukaemia Research Fund Data Collection Survey between January 1, 1984, and June 30, 1988 providing the recent geographical distribution and descriptive epidemiology of the AML group of conditions. Statistical approaches to this data set are described. The study shows sex differences in distribution for those aged under 55 years compared to older age groups, with variable male: female incidence in different age bands and a male excess in those over 55 years. A nonsignificant excess of females was noted in those under 5 years. The rates presented for 1984-1986 are higher than those previously described for England and Wales. Statistically significant variation in incidence was seen both between counties and districts. At electoral ward level regression analyses were suggestive of links between AML and higher social class and living close to estuaries.

Adolescent↗
PubMed1989

The Leukaemia Research Fund Data Collection Study: descriptive epidemiology of acute lymphoblastic leukemia.

This paper reports on cases of acute lymphoblastic leukemia (ALL) recorded by a specialist registry of hematopoietic malignancies. The cases have been diagnosed since January 1, 1984, and originate from certain parts of the United Kingdom. The information is analyzed by age, sex, and area of residence at diagnosis. The age distribution shows a childhood peak but fails to show an adult peak previously reported in literature from abroad. At a broad geographic level the county of Cumbria is shown to display the highest rates of ALL in all ages both in the 3 years of formal analyses (1984-1986) and in the 2 recent years. The administrative districts of Copeland, Sedgemoor, and North Devon also show excesses in all ages with Copeland having the highest SRR and level of statistical significance. This is a new observation for Copeland, the district containing the Sellafield nuclear reprocessing facility in that the high rates are for all ages of ALL. These new data were not considered in earlier official reports about that area. A regression analysis at electoral ward level shows no statistically significant association but excesses of cases, which are mirrored in a larger "all leukemias" data set, occur in wards near estuaries (a new observation) and in the upper socioeconomic groups.

Adolescent↗
PubMed1989

Statistical analysis of population screening.

Statistical techniques used for the evaluation and monitoring of screening tests and screening programmes are reviewed. Though many differences exist between screening to prevent congenital abnormalities, and screening to prevent death from chronic disease, the two are considered together. Analysis for other instances of medical screening will be conceptually similar to one or other of these.

Biometry↗
PubMed1988

Plasmid content and protein I serovar of non-penicillinase-producing gonococci isolated in Munich.

One hundred and twenty-four strains of non-penicillinase-producing gonococci isolated in Munich in 1986 were characterized in terms of their plasmid content and protein I serovar. Eighty-two per cent of the strains belonged to serogroup 1-B with over half belonging to either serovar 1B-2 or 1B-3. Half of the 22 serogroup 1A strains belonged to serovar 1A-2. Nineteen strains (15.3%) were found to lack the 2.6 Md cryptic plasmid although seven of these strains contained the 24.4 Md conjugative plasmid. Nine of the 105 strains which harboured the cryptic plasmid also contained the conjugative plasmid. The 19 strains which lacked the cryptic plasmid comprised 10 different serovars, indicating the heterogeneous nature of this group of organisms.

Bacterial Outer Membrane Proteins↗