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Biomedical subjects

J Buckley

Publications and source records attributed to J Buckley.

At least 91 records · Page 5Linked to original sources
PubMed1983

Voluntary regionalization and associated trends in perinatal care: the Nova Scotia Reproductive Care Program.

The Nova Scotia Reproductive Care Program is a system of voluntary regionalization that involves the 37 hospitals in the province that provide obstetric care to a population of 850,000. Between 1971 and 1980, the perinatal mortality rate in the central tertiary care unit for nonreferred patients fell progressively from 12.5 per 1,000 total births to 5.16. For all cases, including high-risk referrals, this rate has fallen from 12.7 to 7.2. During the same interval, the perinatal mortality rate for the province's seven regional hospitals fell from 18.7 to 12.2, and that for the 28 community hospitals fell from 18.4 to 7.0. Analysis of these reductions by fitted trend lines demonstrates statistical significance. Further analysis demonstrates that, with regionalization of perinatal services, it is possible to reduce the perinatal mortality rate in small community hospitals to levels that approximate those of a sophisticated tertiary care hospital.

Female↗
PubMed1983

A randomized double-blind controlled trial of the value of stilboestrol therapy in pregnancy: long-term follow-up of mothers and their offspring.

In the early 1950s, a randomized, double-blind, controlled trial of the value of prophylactic stilboestrol therapy given antenatally to reduce the incidence of late pregnancy toxaemia and to improve perinatal mortality was conducted at University College Hospital, London. Women expecting their first baby were allocated to one or other of two groups. Those in the stilboestrol group started treatment at the 12th week of pregnancy on average and received a mean dose of about 11.5 g of the drug while those in the control group received placebo tablets. In spite of the fact that the original trial documentation was lost, it was possible to be fairly certain which was the treated group and follow-up data from 650 mothers and 660 offspring were obtained from death certificates, cancer registrations and questionnaires sent to general practitioners. We found no indication of any harmful long-term effect of stilboestrol exposure during pregnancy on the mothers--in particular 10 out of 331 women in the untreated group and 9 out of 319 women in the treated group were found to have developed breast cancer. Amongst the daughters, those in the treated group suffered an excess of minor benign lesions of the cervix uteri and an excess (not statistically significant) of unfavourable pregnancy outcomes. None of the daughters had developed clear cell adenocarcinoma of the vagina or cervix uteri. Amongst the sons, we discovered no evidence of any significant excess of genital tract disorders or of impaired reproductive performance in the treated group but one son developed a (fatal) teratoma of the testis. Unexpectedly, psychiatric disease (especially depression and anxiety) was reported by general practitioners about twice as often in the treated group offspring (sons and daughters) as in the untreated group. This result cannot be due to bias, and is unlikely to be due to confounding or chance, and may thus represent an adverse effect of exposure to stilboestrol in utero.

Breast Diseases↗
PubMed1983

Motor neuron disease in England and Wales, 1959-1979.

Mortality rates from motor neuron disease in England and Wales for the years 1959-1979 were studied through death certification data supplied by the Office of Population Censuses and Surveys. The age- and sex-adjusted mortality rate increased over the period from 1.2 per 100 000 per year in 1959-61 to 1.6 in 1977-79, the increase being most apparent in women over age 45 years and men over 60 years. The ratio of the sex-specific mortality rates remained fairly constant at 1.6:1 (male to female). The distribution of motor neuron disease deaths within England and Wales showed more variation between counties and between Hospital Regions than expected, and areas of high motor neuron disease mortality along the south coast and low mortality in the Midlands could be identified. The variation was most marked in those aged over 65 years at death. Examination of occupation, as listed on the death certificates, showed an excess of motor neuron disease deaths in leather workers in all three periods for which data were available (1959-63, 1970-72 and 1975). A small study of the certified cause of death of 56 motor neuron disease patients showed that a high percentage (88%) had motor neuron disease given as the cause of death.

Adult↗
PubMed1981

An Australian choroidal melanoma survey. Factors affecting survival following enucleation.

This study is based on a computer-assisted analysis 484 enucleated malignant melanomas of the choroid from The Royal Victorian Eye & Ear Hospital, Melbourne. The following factors which might influence survival were analysed; the sex and age of the patient, the interval between presentation for medical opinion and enucleation, the size of the melanoma and its position in the eye, the cell type of the melanoma and the presence of extraocular extension. From this analysis it was found that: 1) The overall 15-year relative survival rate following enucleation was 75%. 2) the survival curve flattened out at six years after enucleation indicating relatively few melanoma-related deaths for the remainder of the 15-year period. 3) there was no increase in death rate at 2 years after enucleation. 4) considering only melanoma-related deaths, increasing age is a strongly depressing influence on survival after enucleation, the 15-year relative survival being 80% for those less than age 40 and only 30% for patients aged 70 and over. 5) submacular melanomas had a very good prognosis for patient survival due in part to their small size and benign cytology. 6) extension into a scleral emissary appeared to exert an unexpectedly depressing effect on prognosis. 7) as in other published series, small melanomas tended to have a good prognosis, and survival rates diminished with increasing size. 8) there was possibility, to be further explored, that ciliary body melanomas may over all have a worse prognosis than melanomas of the choroid.

Adult↗
PubMed1979

Hb F production of endogenous colonies of polycythemia vera.

Fetal hemoglobin was studied in endogenous colonies produced in plasma clot and methylcellulose cultures of circulating progenitors from patients with polycythemia vera (PV). Analysis of globin chain synthesis showed that gamma chains constituted from 13% to 42% of the non-alpha chains produced in cultured cells, whereas from 27% to over 50% of the endogenous colonies contained Hb F, as indicated by the fluorescent antibody probe. Since the endogenous colonies in PV cultures originate from the abnormal PV clone, the findings provide direct evidence that a single pluripotent stem cell can have committed progeny that differ in their expressions of the Hb F production program.

Cells, Cultured↗
PubMed1978

Erythroid progenitors circulating in the blood of adult individuals produce fetal hemoglobin in culture.

Erythroid colonies, raised from erythroid stem cells circulating in the peripheral blood of normal adult individuals, synthesize considerable amounts of fetal hemoglobin. In cultures from persons with sickling disorders, amounts of hemoglobin F that are known to inhibit sickling in vivo are produced. The results provide evidence that primitive erythroid progenitors are able to express the hemoglobin F production program and that cultures of mononuclear cells of the adult blood can be used to investigate the mechanisms involved in regulation of gamma-globin gene switching.

Adult↗
PubMed1978

The measurement of abdominal aortic aneurysms.

A study was made of the accuracy of different methods currently used in assessing the transverse diameter of abdominal aortic aneurysms. The maximum transverse diameter of the abdominal aorta was estimated by clinical palpation, plain radiology, ultrasonography and aortography, in a group of 47 patients who were subjected to either a surgical exploration or elective aneurysm resection. The results of these estimations were compared with the actual measurements obtained during the surgical procedure. Measurements of aortic wall calcification seen on the plain X-ray film correlated best with the operative findings. However, calcification was seen in only 30% of the patients. Ultrasonography was almost universally applicable as a technique of assessing aortic size and was found to be a reliable technique for measuring the aortic diameter.

Aorta, Abdominal↗
PubMed1977

Proper use of skin tests with food extracts in diagnosis of hypersensitivity to food in children.

This study was undertaken to determine the proper use of skin tests with food extracts in diagnosis of hypersensitivity to food in children. Cutaneous reactions evoked by graded amounts of food extracts were compared with results of double-blind food challenge and in vitro release of histamine from leucocytes. A 3 mm or greater weal reaction in skin tests by puncture technique using food extracts of 1:20 w/v concentration was found to indicate the degree of hypersensitivity likely to be associated with clinically significant hypersensitivity reactions to food. Proper use of this simple technique will facilitate accurate diagnosis of food hypersensitivity in children by identifying the group among whom all positive reactions to food challenges will be found. Nevertheless, double-blind food challenge is essential to establish a diagnosis of symptomatic hypersensitivity to food.

Adolescent↗