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Biomedical subjects

J F Mayberry

Publications and source records attributed to J F Mayberry.

At least 163 records · Page 9Linked to original sources
PubMed1988

Value of endoscopic surveillance in the detection of neoplastic change in Barrett's oesophagus.

Fifty-six patients with Barrett's oesophagus diagnosed between 1977 and 1986 were prospectively studied by 6-monthly endoscopic surveillance and biopsy. During follow-up to-date, four patients have developed high-grade dysplasia and three have adenocarcinoma of the oesophagus. Two of the adenocarcinomas were preceded by progressively severe dysplastic changes but in the third no dysplasia had been previously detected. The incidence of adenocarcinoma was 1 per 56 patient-years of follow-up. Changes in symptomatology or gross endoscopic appearances were usually absent, even after adenocarcinoma had developed, indicating that biopsy is essential for early diagnosis. The high risk of malignant change makes endoscopic surveillance advisable in all patients with Barrett's oesophagus.

Adenocarcinoma↗
PubMed1988

Epidemiological study of achalasia in children.

One hundred and twenty nine children under the age of 15 years were diagnosed as having achalasia in Britain and Ireland between 1976 and 1985 by 175 surgeons with an interest in paediatrics or oesophageal disease. The incidence in Eire was 0.31 cases/10(5) population/year and this was significantly higher than in England and Wales (0.1/10(5)/year), Scotland (0.06/10(5)/year/or Northern Ireland (0.02/10(5)/year). Details of age at diagnosis were only obtained for 36 of the 129 patients. The disease appeared to become commoner with increasing age but there is no evidence of a delay in diagnosis until early adulthood. Such a delay would not account for the apparent regional variations in incidence, as they have also been reported in adults. Southern Irish children are at greater risk of the disease than other children in the British Isles.

Adolescent↗
PubMed1988

Cardiff Crohn's disease jubilee: the incidence over 50 years.

The incidence of Crohn's disease in Cardiff between 1931 and 1985 has been examined using hospital diagnostic indices supplemented in recent years by records from clinicians, and the departments of pathology and radiology. Four hundred and seven new patients were confirmed after all notes had been reviewed. There has been a large increase from 0.18 cases/10(5) of the population per year in the 1930s to current values of 8.3/10(5)/year. The incidence continues to rise and shows an increasing proportion of patients with colorectal disease. Peak age specific incidences occur in the third and eighth decades of life.

Age Factors↗
PubMed1988

Choice of therapy for achalasia in relation to age.

Over an 11-year period 132 patients with achalasia underwent a total of 253 pneumatic bag dilatations of the cardia as the initial treatment. Adequate symptomatic relief was obtained in the majority, but 16 needed cardiomyotomy after pneumatic dilatation had failed to give lasting symptomatic relief. Older patients, aged 60 years or more, showed longer-lasting improvement with pneumatic dilatation than did younger ones and only 1 patient over 50 required cardiomyotomy. Benefit from pneumatic dilatation showed a closer relationship to age than to oesophageal diameter. Of 50 patients followed for more than 5 years, 48% required no further treatment, 40% needed at least one further dilatation to achieve symptomatic relief and 12% came to cardiomyotomy. This study suggests that pneumatic dilatation is safe, effective and particularly useful in the management of the elderly achalasic patient.

Adolescent↗
PubMed1988

A preliminary report on the role of lay counselling amongst patients with inflammatory bowel disease.

A team of lay counsellors was trained by the Nottingham Counselling Centre to provide advice to members of the East Midlands branch of the National Association for Colitis and Crohn's Disease. Initial contact was by telephone and the results of the first 25 client/counsellor discussions are presented. Twenty enquiries were made directly by the patient and 5 by a relative of the patient. All but two of the patients were women. The median age of the patients was 52 years with a median duration of symptoms of 3 years. A failure of communication between the patient and other people underlay most of the problems discussed. Eighteen people welcomed the opportunity simply to talk; in 10 cases there was little rapport with their own doctor and in 8 cases people felt too embarrassed to discuss their problems with friends or relatives. This sense of isolation had been anticipated by counsellors from their own experience and may be a substantial, but as yet unrecognized problem amongst many patients with inflammatory bowel disease.

Adult↗
PubMed1988

Information booklets for patients with inflammatory bowel disease.

Patients with inflammatory bowel disease wish to know more about their disease. Booklets must deal with such problems as prognosis and cancer risk. Although this information may depress up to 13% of patients who accept such booklets, between 30% and 39% become less anxious. Patients are highly motivated and can deal with quite difficult text, although illustrations can be helpful. Up to 34% of patients offered such booklets refused them. Nevertheless such booklets reach many people who are not members of self-help groups, and can be used by the doctor in counselling sessions with his or her patient, and in many cases produce reassurance and even lead to fewer consultations.

Humans↗
PubMed1988

An international study of mortality from achalasia.

Mortality associated with achalasia was studied in 28 populations from 26 countries. 829 deaths were reported in a total population of 754 million over periods ranging from 1 to 8 years. Standardised mortality rates (SMR) were calculated in comparison with the USA white population (SMR = 100; 95% confidence limits = 89-112). The highest mortalities were recorded in New Zealand (SMR = 259; 95% confidence limits 131-420) and the lowest in Spanish speaking countries such as Panama (SMR = 0; confidence interval 0-210) and Spain (SMR = 22; confidence interval 3-79).

Cause of Death↗
PubMed1988

Crohn's disease in West Indians.

An epidemiological survey in the City of Derby from 1976 to 1985 indicated that there was no significant difference in the incidence of Crohn's disease in West Indians (4.5-5.6/10(5)/yr) and the caucasian population (7.0/10(5)/yr). These results indicate that West Indians are not genetically protected against the development of Crohn's disease.

Adolescent↗
PubMed1987

Epidemiology of Crohn's disease in Regio Leiden, The Netherlands. A population study from 1979 to 1983.

An epidemiologic study of inflammatory bowel disease was conducted in Regio Leiden, the Netherlands, between 1979 and 1983. Archives of endoscopy, radiology, pathology, and specialist letters were reviewed for suspected patients with inflammatory bowel disease, together with a survey of all general practitioners to verify completeness of data. One thousand forty patients were identified and each diagnosis was reviewed. Two hundred ten patients had Crohn's disease and 257 had ulcerative colitis. Of the other 573 patients, the largest proportion (21%) had incomplete data for disease classification. Others had irritable bowel syndrome, diverticulitis, or ischemic or irradiation colitis; some were nonresident patients with inflammatory bowel disease treated within the region and others were out of the period for inclusion in this investigation. The incidence of Crohn's disease was 3.9 per 10(5) per year and the period prevalence was 48 per 10(5). The sex-specific incidence was similar, although the disease was significantly more common in women aged 20-29 yr. The prevalence in the city municipalities of Leiden and Alphen on the Rijn (63 per 10(5)) was similar but significantly greater than in suburban (39 per 10(5)) or agarian areas (40 per 10(5)). This may be partially due to urban density but not to differences in water supply. The lack of cases in the migrant population almost reaches significant levels, but studies in locations with a higher migrant population may clarify the issue.

Colitis, Ulcerative↗
PubMed1987

Achalasia and pregnancy.

Forty-one women with achalasia diagnosed between the ages of 18 and 45 years were interviewed and 37 of them who had been married at some time were asked to provide details of their fertility and reproductive histories. Thirty-six agreed to do so and were compared with 36 healthy age-matched women. The mean age at the time of study was 44 and the women had been married, on average, for 21 years. The disease developed at a mean age of 27 years and was diagnosed and treated at a mean age of 32 years. For a mean period of 5 years the disease was untreated. There were no significant differences in the number of conceptions or live births before or after the onset of symptoms or during the period when the disease was untreated. In only three of the 20 women who became pregnant after the onset of disease did symptoms become worse. Achalasia during pregnancy is probably best managed by endoscopic dilatation and there is no reason to consider termination.

Adolescent↗
PubMed1987

Time relationships between cessation of smoking and onset of ulcerative colitis.

From 5 centres 154 patients with ulcerative colitis and a history of smoking completed a questionnaire about the temporal relationship between diagnosis of colitis and cessation of smoking. One hundred and thirty-eight of these were ex-smokers and 107 (69.5%) had stopped smoking before the diagnosis of colitis was made. Fifty-six patients (52%) developed colitis within 3 years of stopping smoking. The findings suggest that smoking exerts protective effect against the development of ulcerative colitis.

Adolescent↗
PubMed1987

Inflammatory bowel disease: one condition or two?

Demographic data obtained from epidemiological studies of Crohn's disease and ulcerative proctocolitis in Regio Leiden (Leiden health care region) were compared. Ulcerative colitis (6.8 cases/10(5) population/year) had an incidence almost twice that of Crohn's disease (3.9/10(5)/year; p less than 0.001). Each disease occurred with equal frequency in both sexes and diagnosis of the diseases occurred at similar ages (Spearman's correlation coefficient = 0.84; p less than 0.01). Where ulcerative colitis was common in the various municipalities so was Crohn's disease (Spearman's correlation coefficient = 0.88; p less than 0.001). No cases of Crohn's disease were identified amongst migrants, but 6 cases of ulcerative colitis (prevalence = 85/10(5); 95% confidence interval = 35-195) were found. This difference was significance (p less than 0.05). It seems likely that the two diseases may simply represent the opposite ends of a continuous spectrum of inflammatory bowel disease.

Colitis, Ulcerative↗