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Biomedical subjects

J F Mayberry

Publications and source records attributed to J F Mayberry.

At least 109 records · Page 6Linked to original sources
PubMed1993

Perceived sexual dysfunction amongst patients with inflammatory bowel disease.

300 patients with inflammatory bowel disease (IBD) were randomly selected from the community-based register held in Leicester. They were invited to participate in a study investigating personal problems of patients with IBD. 188 patients agreed to participate and were subsequently sent a previously validated questionnaire. A similar questionnaire was sent to buddy controls of similar age, sex and background (n = 76) as well as matched controls drawn at random from general practitioner lists (n = 46). Details sought included demographic data, patients' perception of their disease severity, data relating to treatment, family history, fertility, frequency of sexual intercourse and the effect IBD had on personal relationships. 150 questionnaires were returned from patients (response rate 80%) and 122 from controls. The reliability of a randomly selected group of questionnaires was assessed by direct interview 4 months after the main study (n = 20). There were no demographic differences between the patient and control groups (age: t = 0.67, ns; duration of marriage: t = 0.92, and marital status/number with a regular partner: chi 2 = 14, 12 d.f., p = 0.3). Dyspareunia was commoner amongst patients (n = 15, 38%) than controls (n = 7, 18%), although this was not statistically significant (z = 2.6). There was no significant difference in the overall frequency of sexual intercourse amongst patient and control groups (chi 2 = 12.78, 12 d.f.), even when comparing those with infrequent or no sexual intercourse (chi 2 = 6.98, 4 d.f.) The reliability of these results was confirmed after 4 months when there was no difference in responses in the re-interviewed group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

British gastroenterologists' care profile for patients with inflammatory bowel disease: the need for a patients' charter.

The follow-up of patients with inflammatory bowel disease (IBD) was investigated using a postal questionnaire sent to 359 members of the British Society of Gastroenterology (BSG), of whom 235 replied. Of patients with IBD, 96% were weighed on each out-patient clinic review and over 60% had their full blood count checked. Although few centres (20%) have computerized recall of their patients for cancer surveillance, 96% did perform such surveillance on patients with ulcerative colitis. The mean duration of disease before surveillance was initiated was 9.6 years. Most clinicians (80%) only surveyed patients with disease extending beyond the transverse colon. Despite recent work on cancer risk age is relatively unimportant to 76% of clinicians in their decision to screen or not. Only 24% of clinicians undertake cancer surveillance in patients with Crohn's disease but these use similar criteria in their selection of patients. Few other tests were performed regularly. Clinic services vary considerably from centre to centre, 62% offer open access to patients with IBD, 8% have a stoma nurse in clinic and 17% a dietitian. Eighty-four per cent of respondents provide educational books and 22% videos. Forty-four per cent of clinicians refer patients for advice to fellow sufferers. We believe there should be a uniform minimum standard of care and services available in clinics throughout the United Kingdom and propose a patients' charter to ensure that this occurs. Such care profiles provide guidelines to those who need to develop standards for resource management.

Adolescent↗
PubMed1993

A survey of industries and colorectal cancer screening of employees in the East Midlands of England.

The number of industries in the East Midlands of England who were prepared to enroll their employees in a scheme to detect colorectal cancer by faecal occult blood testing was investigated. Company directors were asked if they would supply a list of their employees over the age of 40 years and allow a research team to give a 15 min talk at the workplace. Forty-nine per cent of firms responded to the questionnaire and 27% of businesses were prepared to enroll. There was no difference in mean total employees between firms willing and unwilling to participate (unpaired t-test, P > 0.05). The commonest reason given by managers rejecting the scheme was that they did not believe the workforce would be interested.

Attitude to Health↗
PubMed1993

Disease variations in Asians in Leicester.

The epidemiological study of ethnic groups provides valuable information for physicians in a number of ways. First, it assists in the diagnostic approach in individual patients, especially for doctors unfamiliar with patients of a particular ethnic background. Second, it provides population data to assist in health care planning and provision for the present and future in districts where ethnic minorities are resident in significant numbers. Third, it may provide pointers for the study of pathogenic mechanisms. Fourth, changing epidemiology in migrant ethnic minorities may help to distinguish the degree of influence of genetic and environmental pathogenic factors. These studies are particularly valuable when minority populations are of a size which allows meaningful data to be collected on uncommon conditions. Furthermore the contrasts between migrant and indigenous populations are most clearly seen if migration has occurred over a restricted period. For these and other reasons the study of the migrant population from the Indian subcontinent (defined as India, Pakistan and Bangladesh) which has settled in Leicester since the mid-1960s has proved particularly rewarding. This report summarizes the distinctive epidemiological features of these people now living in Leicester.

Adult↗
PubMed1993

An information booklet for employers on inflammatory bowel disease: an evaluation by patients.

Forty-eight patients with Crohn's disease were offered an educational booklet about inflammatory bowel disease directed at employers. They were asked to assess its value and the best method of distribution. Forty-eight per cent agreed to take part in the study and, of these, 74% completed the project. Although the book was considered valuable, and most patients believed it should be made available to their line managers, distribution was considered best left in the hands of doctors and self-help groups.

Employment↗
PubMed1993

The gastroenterology service: a survey of general practitioners' requirements.

A postal questionnaire was sent to 634 Leicestershire general practitioners about the service they wanted from their local gastrointestinal unit. Their views were specifically sought in relation to the care of chronic gastrointestinal disorders such as coeliac disease and inflammatory bowel disease. This initial survey was 'testing the water' before addressing GP needs in all areas of gastroenterology including, management issues in peptic ulcer disease and hiatus hernia. The design of the questionnaire was simple with only 12 'yes' or 'no' stems. The response rate to one mailing of the questionnaire was 41% with the rate for each question ranging from 83% (on whether a telephone hot-line would be useful) to 99% (on the value of treatment protocols). There was a poor response rate to some individual stems, with rates of less than 10%, because most GPs only answered 'yes' to the stem they were interested in without answering 'no' to other parts. Most GPs wanted a regular news bulletin on the management of both inflammatory bowel disease and coeliac disease as well as detailed protocols on their treatment. Sixty per cent of respondents wanted a telephone hot line to senior gastroenterologists, with direct dialing to provide immediate advice. Eighty per cent of GPs want shared care with hospital consultants of such patients. A similar proportion thought that this decision should be made jointly by patients and their doctors. There is a clear desire by GPs for a more specialist education in line with the current trend of extending their role. GPs in Leicestershire would value a more active role in the management of patients with chronic intestinal diseases and it is likely that such views are widespread in Great Britain.

Decision Making↗
PubMed1992

Variations in results of simultaneous ambulatory esophageal pH monitoring.

Twenty-four-hour esophageal pH monitoring is regarded as the gold standard investigation for gastroesophageal reflux (GER) (1) and the possibility of an "incorrect" answer, false positive or false negative, is only rarely considered (2). However, when a group of infants in this hospital had such pH studies performed on two consecutive days, considerable differences in the results were found (3). This also had been reported from other centers (4-6). It seems likely that most of the differences were due to true "biological" variability in the amount of GER from day to day, but it remains possible that variation in the accuracy of the equipment in detecting acid reflux was also involved.

Ambulatory Care↗
PubMed1992

Stoma anxieties: a comparison of the attitudes of Asian migrants and the indigenous population in the United Kingdom towards abdominal surgery and the role of intestinal stomas.

We have studied stoma care nurses' experience with Asian patients having a stoma. The general public's attitudes to abdominal surgery in general were assessed in a survey of employees in Leicester. Many stoma care nurses are aware of the needs of Asian patients, especially with regards to ethnic dress, but only half of the ostomists who wanted to see a stoma care nurse or fellow ostomist were able to do so (chi 2 = 4.5, p less than 0.03). All ostomists considered counselling on education, employment and marriage inadequate. There is a high level of anxiety about stomas and these anxieties are surprisingly similar for all ethnic groups.

Abdomen↗
PubMed1992

The attitude of employers to people with inflammatory bowel disease.

Many patients with inflammatory bowel disease are anxious about their future prospects of employment. Personnel managers at 61 major national and 136 principal local employers in Leicester and Cardiff were asked to provide details about their attitude to people with inflammatory bowel disease and the type of health care they offer to employees. Over one million people were employed by these companies. A poor response rate of 27% suggested at best disinterest in the subject on the part of employers. In those who did reply the attitude to people with inflammatory bowel disease was often positive, although up to a quarter (25%) would not continue to employ people if they developed these conditions and many (30%) would not provide time off work to attend hospital clinics. Only 60% of respondents would consider providing lighter duties to affected employees. In general there is a surprisingly negative attitude to promotion of people with chronic diseases such as epilepsy, multiple sclerosis or liver disease. This seems less so in inflammatory bowel disease.

Attitude to Health↗
PubMed1992

Incidence of ulcerative colitis in Cardiff over 20 years: 1968-87.

The annual incidence of ulcerative colitis in the city of Cardiff was examined over a 20 year period. In the decade 1968-77, the mean annual incidence was 6.4 per 10(5) of the population compared with 6.3 for the period 1978-87. There was no difference in the distribution or extent of the disease between decades or between sexes. This contrasts with the increased incidence of Crohn's disease during the same period. The study included a survey of family practitioners which identified a further 19 patients (11% of the total).

Adolescent↗
PubMed1992

Perceived discrimination in education and employment by people with Crohn's disease: a case control study of educational achievement and employment.

Eighty three patients in whom the diagnosis of Crohn's disease had been made before the age of 40 years and who had been resident in the city of Cardiff were asked to complete a detailed questionnaire about their educational and employment experiences. Responses were obtained from 58 patients (response rate = 70%), 23 buddy controls, and 27 community controls. The mean (SD) age of patients at the time of the survey was 31 (5) years. Twenty four of the patients were diagnosed before leaving secondary education, at a mean age of 17 years. They had lost significantly more days' schooling than controls (chi 2 = 14.3 p less than 0.001) but had achieved similar academic success as measured by examination passes and attendance at tertiary institutes of education. Similar numbers of patients and controls were employed at the time of the survey, although significantly more patients had experienced long term unemployment (z = 2.6 p less than 0.01). As a result of their experiences up to 30% actively concealed their illness from employers.

Adult↗
PubMed1992

Epidemiological study of ulcerative proctocolitis in Indian migrants and the indigenous population of Leicestershire.

A retrospective epidemiological study of ulcerative colitis (UC) and proctitis was performed in Leicestershire from 1972-89. Potential cases were identified from hospital departments of pathology, endoscopy, and medical records and from general practitioners. The county population includes more than 93,000 South Asians. There were 573 cases of UC and 286 of proctitis in Europeans and 115 cases of UC and 29 of proctitis in South Asians. The standardised incidence of UC in Europeans and South Asians was stable, except in Sikhs in whom it had increased rapidly. The relative risk of UC to South Asians was 2.45. The standardised incidences of UC in South Asians during the 1980s were: 10.8/10(5)/year in Hindus (95% confidence interval (CI) 7.4-14.1 cases/10(5)/year) 16.5/10(5)/year in Sikhs (95% CI 7.9-25.2 cases/10(5)/year), and 6.2/10(5)/year in Muslims (95% CI 1.6-10.9 cases/10(5)/year). There was no difference in incidence between Asians from East Africa and India. The standardised incidence of UC in Europeans was 5.3/10(5)/year (95% CI 4.3-6.3 cases/10(5)/year). The standardised incidences of proctitis were 3.1/10(5)/year (95% CI 1.9-2.5 cases/10(5)/year) in South Asians and 2.3/10(5)/year (95% CI 1.8-2.4 cases/10(5)/year) in Europeans. Ethnic groups had a similar disease distribution, except Sikhs in whom it was less extensive. Despite the similar disease distribution, South Asians had fewer operations and complications from UC than Europeans. There was a bimodal age specific incidence in Europeans, but not in other ethnic groups. First and second generation South Asians were at similar risk. Hindus and Sikhs have a significantly higher incidence of UC than Europeans in Leicestershire.

Adolescent↗
PubMed1992

Epidemiological study of abdominal tuberculosis among Indian migrants and the indigenous population of Leicester, 1972-1989.

A retrospective, epidemiological study of abdominal tuberculosis in the city of Leicester from 1972 to 1989 is reported. Potential cases were identified from hospital medical records and endoscopy lists, in addition to the county notification register. The city population of 280,000 included over 75,000 South Asians. There were 146 cases among South Asians and six in Europeans, four of whom were British. The standardised incidence of abdominal tuberculosis in South Asians decreased significantly from 22.3 cases/10(5)/year during the 1970s to 9.2 cases/10(5)/year in the 1980s (chi 2 = 42, p < 0.001). The incidence during the 1980s was 10.7/10(5)/year in Hindus, 8.7/10(5)/year in Sikhs, and 4.6/10(5)/year in Muslims. The relative risk to Hindus was 2.3 fold greater, and for Sikhs 1.9 fold greater, than that for Muslims, a finding similar to that in pulmonary tuberculosis. The standardised incidence in Europeans was 0.2/10(5)/year and they had significantly less abdominal tuberculosis than South Asians (Z = 8.6, p < 0.001 and relative risk = 46). The standardised mortality ratio was significantly increased in Europeans (standardised mortality ratio = 755, 95% confidence interval 90-2730, chi 2 = 11.4, p < 0.001), but not in South Asians (standardised mortality ratio = 68, 95% confidence interval 20-160). Resection rates were similar between the two ethnic groups. Abdominal tuberculosis still occurs among migrants, and clinicians should remain alert to this in South Asians.

Adolescent↗
PubMed1992

Mortality from Crohn's disease in Leicestershire, 1972-1989: an epidemiological community based study.

Mortality among 610 people with Crohn's disease identified in a population based study from 1972-89 was assessed. In Europeans the overall mortality was not increased, the standardised mortality ratio (SMR) was 71.8 (95% confidence interval (CI) 49 to 101). The SMR in South Asians was 0, (95% CI 0 to 1590). The SMR varied with the site of disease (chi 2 (4) = 10.5, p < 0.05) and was highest in those with duodenal and jejunal involvement (SMR = 210, 95% CI 44 to 621). Survival curve comparisons showed that colonic disease carried a worse prognosis than terminal ileal disease (chi-2 = 9, p < 0.01) or mixed site disease (chi-2 = 4.7, p < 0.05). Mortality was particularly high during the first six years. It was increased in patients who had undergone more than one resection (SMR = 137, 95% CI 28 to 401) or an ileoanal anastomosis (SMR = 357, 95% CI 9 to 1070), although no difference was significant. Mortality did not change significantly during the study. Such information needs to be made available, not just to patients, their families, and their doctors, but perhaps more importantly, to actuaries, insurers, and those advising employers.

Adolescent↗
PubMed1992

Crohn's disease in Bangladeshis and Europeans in Britain: an epidemiological comparison in Tower Hamlets.

The incidence of Crohn's disease in a defined Bangladeshi community was assessed in a retrospective, epidemiological study in the London Borough of Tower Hamlets from 1972 to 1989. The borough population of 164,000 includes over 28,000 Bangladeshis. Potential cases were identified from hospital pathology and medical records. There were 99 cases of Crohn's disease during the study period, of which five were Bangladeshi. The mean standardized incidence in Bangladeshis was 1.2/10(5)/year in the 1970s and 2.3/10(5)/year in the 1980s compared with 3.8/10(5)/year and 4.1/10(5)/year in Europeans, and 4.6/10(5)/year and 5.4/10(5)/year in West Indians, respectively. None of the changes with time was statistically significant. There were no cases amongst Hindus. The relative risk to Europeans, compared to Bangladeshis, was 2.5 during the 1970s and 2.0 in the 1980s. The difference between European incidence and that of other ethnic groups was not statistically significant; however, the number of Bangladeshi cases was small (five), and diminishes the power of the study. The apparent similarity of the incidences of Crohn's disease in Bangladeshis and Europeans contrasts with findings in other South Asians. Further investigations of the differences in incidence of Crohn's disease in South Asians is needed.

Adolescent↗
PubMed1992

Management of coeliac disease: a changing diagnostic approach but what value in follow up?

OBJECTIVE: To assess the management of patients with coeliac disease in relation to a change in diagnostic method from jejunal suction biopsy to endoscopic biopsy. DESIGN: 16 item questionnaire survey of consultant members of the British Society of Gastroenterology. SUBJECTS: 359 consultant physician and gastroenterologist members of the society. MAIN MEASURES: Type of routine biopsy; repeat biopsy after gluten withdrawal; gluten rechallenge; follow up measurements; screening for malignancy; and methods of follow up, including special clinics. RESULTS: 270(70%) members replied; 216(80%) diagnosed coeliac disease routinely by endoscopic duodenal biopsy, 30(11%) by jejunal capsule biopsy, and the remainder by either method. Only 156(58%) repeated the biopsy after gluten withdrawal, though more did so for duodenal than jejunal biopsies (134/216, 62% v 13/30, 43%; p < 0.02). Follow up biopsies featured more duodenal than jejunal biopsies (133/156, 82% v 23/156, 15%; p < 0.02). Regular follow up included assessments of weight (259, 96%) and full blood count (238, 88%) but limited assessment of serum B-12 and folate (120, 44%) and calcium (105, 39%) concentrations. Routine screening for malignancy is not performed, and there are few specialist clinics. 171(63%) respondents thought that patients should be followed up by a hospital specialist and 58(21%) by family doctors. CONCLUSIONS: The practice of diagnosing coeliac disease varies appreciably from that in many standard texts. Many patients could be effectively cared for by their family doctor. IMPLICATIONS: The British Society of Gastroenterology should support such management by family doctors by providing clear guidelines for them.

Biopsy↗
PubMed1992

Gastric and colorectal cancer in the rural Indian subcontinent: a survey of patients attending mission hospitals.

37 missionaries working in India, Nepal, Pakistan, Bangladesh and Bhutan completed questionnaires regarding their clinical practice during the year 1980. Information was collected on the frequency of both gastric and colorectal cancers. More than 500,000 out-patients were reviewed and over 100,000 inpatients treated. A total of 291 gastric tumours and 169 colorectal carcinomas were diagnosed. Surgery was performed in 82% of the hospitals but only 36% had a histology service. In India and Pakistan there was no significant difference between the incidence of gastric and colorectal neoplasms. The relative risk of developing gastric rather than colorectal cancer in Bangladesh was 8 (95% confidence limits 4.5-14.2) and in Nepal the relative risk was 4 (95% confidence limits 2.0-7.0). A significant variation in the occurrence of cancer was observed between countries. Nepal had the highest and Pakistan the lowest numbers of both gastric and colorectal tumours. It seems likely that local environmental factors, such as diet, play a significant role in the development of these tumours.

Bangladesh↗