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Biomedical subjects

G Berry

Publications and source records attributed to G Berry.

At least 109 records · Page 6Linked to original sources
PubMed1990

Trauma triage in western Sydney: results of a pilot study.

A pilot study of the effectiveness of prehospital triage of trauma patients was carried out in a western Sydney between February and July 1988. Triage guidelines were developed to identify seriously injured persons at the incident site who might warrant admission to a Level 3 Trauma Service Hospital (Trauma Centre), as part of the NSW Department of Health trauma services plan. The study results were based on 64% of ambulance trauma transports for which a triage decision was provided. Of trauma transports studied, 3.7% had injuries serious enough to warrant admission to Level 3 Trauma Service Hospital. Ambulance officers correctly triaged 77% of these cases in the field. However, 62% of trauma transports triaged 'severe' or 'critical' did not have injuries serious enough to warrant admission to a Level 3 Trauma Service Hospital. Nevertheless, the triage guidelines compared favourably with similar instruments used elsewhere. Based on the performance of the triage guidelines it was concluded that the introduction of a regionalized trauma service in metropolitan NSW with local bypass is possible.

Adolescent↗
PubMed1990

A randomised controlled trial of counseling in a workplace setting for coronary heart disease risk factor modification: effects on blood pressure.

This paper reviews a prospective study of occupational factors in coronary heart disease risk incorporated in a randomised controlled trial of a worksite based occupational health nurse counseling program for reducing coronary heart disease risk factors. The aim of the trial was to evaluate the longterm effectiveness of the counseling program in persons with mildly elevated risk factor levels. Of the 2,489 Australian government employees with mildly elevated risk factor levels who entered the intervention trial, 1,937 (78%) attended a followup examination three years later. This paper reports on changes in systolic and diastolic blood pressure. Multiple linear regression models were used with three-year blood pressure reduction as the dependent variable, intervention status as the main determinant, and sex, age, initial risk level and initial blood pressure as covariates. Although systolic and diastolic blood pressure fell in both the intervention and control groups, intervention was significantly associated with systolic blood pressure change only.

Adult↗
PubMed1990

Letter identification declines with increasing retinal eccentricity at the same rate for normal and dyslexic readers.

It has recently been claimed (Geiger & Lettvin, 1987; Perry, Dember, Warm, & Sacks, 1989) that the acuity/eccentricity function is flatter in dyslexics than in normal subjects, with dyslexics showing better performance in the periphery and worse performance at fixation. In these studies, all target letters were presented to the right of fixation, a procedural flaw inviting subjects to optimize performance by directing attention and/or gaze to the right of the designated fixation point. It is suggested that dyslexic and normal readers may differ in the degree to which they might adopt the optimal strategy in this situation. To overcome this problem, target letters were briefly presented at 16 randomly intermixed locations derived from the orthogonal combination of four eccentricities and four directions from fixation (above, below, right, left). The accuracy of letter identification declined with increasing eccentricity at the same rate for good and poor adult readers and dyslexic teenagers. This finding provides no support for the view that the acuity/eccentricity function might vary with and possibly cause differences in reading level.

Adult↗
PubMed1989

Smoking and infectious agents and risk of in situ cervical cancer in Sydney, Australia.

In a study of 116 in situ cervical cancer patients and 193 matched community controls in Sydney, Australia, smoking was found to be a major risk factor. Current smokers had a adjusted relative risk [RR] of 4.5 compared to nonsmokers [95% confidence interval (CI) 2.2-9.1] and exsmokers a RR of 1.3 [95% CI 0.6-3.0]. There was a stepwise dose-response relationship between risk and number of cigarettes smoked (30+ cigarettes/day, RR = 5.1, 95% CI 1.5-17.3); this dose-response relationship was more marked among current smokers. Years of cigarette smoking was not consistently related to risk. Exposures to herpes simplex virus type 2 and cytomegalovirus as measured by antibody prevalence were unrelated to risk (RR = 1.1 for both measures). However, cases appeared to have more exposure than controls to herpes simplex virus type 1 (RR = 2.3, 95% CI 1.1-4.4).

Adolescent↗
PubMed1989

Incidence and risk factors for human immunodeficiency virus seroconversion in a cohort of Sydney homosexual men.

By means of prospective cohort data from the Sydney AIDS Project, we report on 55 homosexual or bisexual men who have become infected with human immunodeficiency virus (HIV), as measured by the development of serum HIV antibodies (seroconversion). We have compared the sexual practices, recreational drug abuse, history of sexually-transmissible diseases, and antecedent immunological findings of the men who seroconverted with those of 588 subjects who persistently remained seronegative in the same time-period. The cumulative incidence rate of HIV infection over the three years of observation was 8.5%. The cumulative incidence rate ranged from less than 1% for the six months before August 1, 1984, to a peak of 5% in the six months before August 1, 1985. Of those subjects for whom we had data for the period of seroconversion, all but two of the subjects who seroconverted admitted to a recognized high-risk sexual practice in the six months before the first visit at which they were found to be seropositive. Univariate analysis found that men who seroconverted were significantly more likely to have had a greater number of recent sexual partners (relative risk per partner, 1.02; P less than 0.001), to have engaged in receptive anal intercourse (incidence rate ratio, 3.1; 95% confidence interval [CI], 1.3-7.6; P = 0.01) and to have used nitrite inhalant (incidence rate ratio, 2.6; 95% CI, 1.2-5.9; P = 0.02) and amphetamine (incidence rate ratio, 4.8; 95% CI, 2.2-10.5; P less than 0.001) drugs. The men who seroconverted were significantly (incidence rate ratio, 2.7; 95% CI, 1.2-6.1; P = 0.014) more likely to have antecedent T-suppressor-cell counts of greater than 800 cells/microL. Factors that retained significance in multivariate analysis were the number of recent sexual partners, recent amphetamine abuse and a T-suppressor-cell count of greater than 800 cells/microL.

Adolescent↗
PubMed1989

Sexual, reproductive and contraceptive risk factors for carcinoma-in-situ of the uterine cervix in Sydney.

Sexual, reproductive and contraceptive risk factors were investigated in a matched community-based case-control study of carcinoma-in-situ of the uterine cervix in Sydney. The risk was related strongly to the number of sexual partners: women who had had seven or more sexual partners in a lifetime had a six-fold increased risk compared with those with one or no partner. Early age at first sexual intercourse was also a risk factor, but this effect was reduced substantially after adjustment for the number of partners, with only a two-fold excess risk persisting for those with first intercourse before the age of 16 years as compared with those whose first sexual intercourse was at the age of 25 years or later. The long-term use of oral contraceptive agents was associated with an elevated risk (relative risk, 2.3 for more than six years of use); this effect was maintained for both oestrogen and progestogen doses. The risk increased with the number of induced abortions that had been undergone (relative risk, 2.2 for two or more abortions), but this effect was not statistically significant. A protective effect was found for women who had had a tubal ligation, for those who practised the rhythm method of birth control, and for women who breastfed. It is possible that these reduced risks may relate to unmeasured variables of life-style.

Adolescent↗
PubMed1989

Mesotheliomas--asbestos exposure and lung burden.

The assessment of asbestos fibres in the lungs at post mortem in groups of mesotheliomas, groups occupationally exposed to asbestos, and controls has shown that all these groups contain significant levels of asbestos as a lung burden. The amounts in each group are dependent on the degree of past exposure, being highest in those cases with a known or extrapolated occupational exposure, less in those cases with recorded neighbourhood or environmental exposure, and less again in those cases with no evidence of exposure to asbestos and in controls. Relative risk estimates and the use of models developed for occupational situations do not provide good estimates of the relevance of environmental fibres in producing mesotheliomas in the general population. This may be the result of differences between the groups in their time periods of exposure and long-term elimination of asbestos from the lungs. The number of mesotheliomas that might be due to low-level environmental exposure to asbestos cannot be determined from lung contents alone, but an assessment based on detailed occupational histories from the Australian Mesothelioma Surveillance Program show that the problem is not one of great importance when compared with other public health issues.

Air Pollutants↗
PubMed1989

Evaluation of heart-lung transplant recipients with prospective, serial transbronchial biopsies and pulmonary function studies.

The insidious development of obliterative bronchiolitis after heart-lung transplantation is thought to be due to rejection and possibly infection (cytomegalovirus). To evaluate further, we prospectively managed the last 16 consecutive heart-lung transplant recipients with serial transbronchial biopsies with lavage and pulmonary function studies as part of a surveillance protocol or as dictated by clinical presentation. A total of 123 transbronchial biopsies with lavage were performed, 77 for clinical indications (group I) and 46 for routine surveillance (group II). Results of 64 (83.1%) group I biopsies were positive for rejection or infection. Thirty-one of these biopsy specimens showed signs of rejection (29 in group I and two in group II), characterized by a perivascular mononuclear infiltrate, lymphocytic bronchiolitis, and occasionally alveolar septal mononuclear infiltrate. Forty-six serial pulmonary function tests were performed. The forced expiratory volume in 1 second (percent predicted), forced expiratory flow rate between 25% and 75% of the forced vital capacity (percent predicted), and arterial oxygen tension (millimeters of mercury) were significantly reduced from baseline values during rejection episodes: forced expiratory volume in 1 second, 75.7% +/- 20.1% versus 52.7% +/- 18.3% (p less than or equal to 0.05); forced expiratory flow rate between 25% and 75% of the forced vital capacity, 97.6% +/- 30.5% versus 49.8% +/- 22.3% (p less than or equal to 0.05); and arterial oxygen tension, 92.1 +/- 8.8 mm Hg versus 71.4 +/- 18.8 mm Hg (p less than or equal to 0.05). The fall in pulmonary function was reversible with pulse methylprednisolone. Asynchronous heart and lung rejection was documented. Of the 29 episodes of pulmonary rejection, 18 (62%) occurred asynchronously. Ten of the 16 (62%) heart-lung recipients had at least one episode of cardiac rejection. Thirteen of 16 (81%) had at least one episode of lung rejection. Serial transbronchial biopsies with lavage, as dictated by pulmonary function tests and clinical status, have guided early and more specific therapy directed against rejection and infection. With early detection, small airway dysfunction has been reversible.

Adult↗
PubMed1989

BCG vaccination in leprosy: final results of the trial in Karimui, Papua New Guinea, 1963-79.

The efficacy of BCG vaccine in preventing the clinical manifestations of leprosy in a tuberculosis-free area of Papua New Guinea is reported. Between 1963 and 1966 a total of 5356 subjects, randomized to receive BCG or saline inoculations, were examined for leprosy before the vaccination and surveillance was continued until 1979. BCG afforded 48% protection against clinical leprosy, being most effective against borderline tuberculoid leprosy and in children vaccinated when under 15 years old. Protection was evident within 12 months in those vaccinated between the ages of 10 and 15 years but was delayed in other age groups. There was evidence for accelerated manifestations of tuberculoid leprosy in children vaccinated when under 5 years of age. Tuberculin sensitivity was more likely to be sustained following multiple BCG inoculations; vaccinees with sustained tuberculin sensitivity had the lowest incidence of leprosy, but protection was also evident in tuberculin-negative vaccinees. These results may have implications for ongoing trials of leprosy vaccine incorporating BCG.

Adolescent↗
PubMed1989

Conceptual and design features of a practical, clinically effective intravenous mechanical blood oxygen/carbon dioxide exchange device (IVOX).

Conceptual and design features of a new intravascular blood gas exchange device include: placing multiple, thin-walled microporous hollow fibers in an elongated arrangement with a small overall outside diameter; covering the outer surface of each microporous hollow fiber with an ultra-thin continuous silicone coating; forming the hollow fibers into a configuration that produces disturbed flow of blood over the external surface of each fiber; placing the device in the subject's vena cava through a femoral or jugular venotomy; producing a flow of oxygen through the lumens of the hollow fibers, permitting exchange of oxygen and carbon dioxide between the venous blood outside and the gas inside the hollow fibers. Based on these principles, a practical, easily insertible, disposable, intravenacaval blood gas exchange device (IVOX) has been fabricated. Currently, devices with from 2,000 to 6,000 square centimeters of gas transfer surface area are being placed in the vena cavae of dogs and sheep for up to 7 days without altering the animal's hemodynamics, without producing serious hematologic sequelae, and with the capability of transferring in excess of 100 ml of oxygen and carbon dioxide to and from the venous blood of an intact, awake, standing animal. Clinical trials on human subjects with severe, acute, potentially reversible respiratory failure are in the planning stage.

Animals↗
PubMed1988

Nutrients in diet and plasma and risk of in situ cervical cancer.

Both plasma and dietary measures of vitamin A status were investigated along with previously established risk factors (number of sexual partners, age at first intercourse, smoking, and oral contraceptive use) in a study of 117 in situ cervical cancer patients and 196 matched community controls in Sydney, Australia. Neither total calories nor retinol from foods was related to cancer risk, nor was plasma retinol. When plasma and dietary indexes were considered together, vitamin C, fruit juices, and plasma beta-carotene showed protective effects. Plasma beta-carotene reduced risk from top to bottom quartile by 80%, vitamin C by 60%, and fruit juices by 50%. Thus the evidence suggests that cancer risk is associated with some aspect of diet that is reflected in the effect of plasma beta-carotene. There is no clear effect of any one nutrient but fruit juices appear protective. Thus vitamin C and beta-carotene are likely candidates.

Adult↗
PubMed1988

Caffeine consumption and blood pressure: an epidemiological study.

A cross-sectional survey of 5147 Australians attending a health screening clinic was conducted to determine if there was an association between habitual consumption of caffeine, or particular caffeine-containing beverages, and blood pressure. The average caffeine consumption of the study population was 240 mg/day. Caffeine consumption within the last three hours was found to be associated with significantly higher mean systolic and diastolic blood pressure in both sexes after controlling for age, adiposity, first degree relatives with hypertension, serum cholesterol level, alcohol consumption and tobacco smoking. Mean systolic and diastolic blood pressures differed significantly by 4 mmHg and 2 mmHg respectively for both males and females between those who had consumed caffeine within the last three hours and those who had not consumed it within the last nine hours (p less than 0.01). Average caffeine consumption per day was not associated with blood pressure in either sex after controlling for time since caffeine consumption. Logistic regression analysis was used to estimate the relative risk of high blood pressure (treated and untreated) for the groups consuming and not consuming caffeine in the last three hours. This relative risk was significantly greater than unity in females only (p less than 0.05). After controlling for time since caffeine consumption, caffeine consumption per day was not associated with significantly increased risk of high blood pressure.

Adult↗
PubMed1988

Smoking, nonsteroidal anti-inflammatory drugs, and acetaminophen in gastric ulcer. A study of associations and of the effects of previous diagnosis on exposure patterns.

A study was conducted in Sydney, Australia to investigate whether the use of some nonaspirin nonsteroidal anti-inflammatory (anti-arthritic) drugs was associated with gastric ulcer in patients who had had neither a gastric nor a duodenal ulcer diagnosed previously (i.e., in new cases of peptic ulcer), and whether the use of anti-arthritic drugs, aspirin, acetaminophen, and cigarettes was influenced by the diagnosis of a peptic ulcer--either gastric or duodenal. Bleeding of gastric ulcer in new cases was studied in relation to smoking, use of aspirin or anti-arthritic drugs, and age. The 417 patients in the study lived in Sydney and were interviewed between 1982 and 1985 after diagnosis of a gastric ulcer; 192 patients had had a gastric or duodenal ulcer diagnosed previously (i.e., were recurrent cases of peptic ulcer), and the remaining 225 patients were new cases to whom 411 community controls were matched on sex, age, and prestige of area of residence. In new cases, odds ratios of gastric ulcer were 5.0 for daily aspirin use and 2.3 to 5.4 for daily anti-arthritic drug use. Fewer recurrent cases than new cases had used aspirin daily (odds ratio (OR) = 0.5) or anti-arthritic drugs daily (OR = 0.5), and more recurrent than new cases had used acetaminophen daily (OR = 2.5). Among new cases, bleeding of gastric ulcer was less common in smokers (OR = 0.6), and more common in daily users of aspirin (OR = 2.1) and, to a lesser extent, in daily users of anti-arthritic drugs (OR = 1.5), and in patients aged 60 or more years (OR = 2.3) independent of usage of the above drugs. It is concluded that 1) the use of anti-arthritic drugs increases gastric ulcer risk; 2) diagnosis of a gastric or duodenal ulcer causes a decrease in the use of aspirin and anti-arthritic drugs and an increase in acetaminophen use, but does not change smoking habits; 3) aspirin use or advancing age may add to the risk of bleeding ulcer although the role of anti-arthritic drugs is less clear.

Acetaminophen↗