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Biomedical subjects

J Philip

Publications and source records attributed to J Philip.

At least 127 records · Page 7Linked to original sources
PubMed1988

The effect of dydrogesterone on premenstrual symptoms. A double-blind, randomized, placebo-controlled study in general practice.

The effect of dydrogesterone on premenstrual symptoms was investigated in a double-blind, randomized, placebo-controlled study comprising 161 patients from unselected practice material. Dydrogesterone 10 mg twice daily from the 12th day until onset of the following menstrual period was compared with placebo throughout 3 cycles. No clinically relevant effect of dydrogesterone was found. There was an overall therapeutic effect in 52% of the patients on dydrogesterone, and in 44% of the placebo-treated patients. Therapeutic gain ranged between -7 and +23% (95% confidence limits). Type II error risk of failure to detect a therapeutic gain of 20% was 6%. A significant effect of dydrogesterone was found on decreased libido, and statistical significance was nearly achieved for the symptoms irritability and headache. The significant effect on libido can be attributed to mass significance.

Administration, Oral↗
PubMed1987

Incidence of fetal chromosome abnormalities in 2264 low-risk women.

Among a population of 6305 pregnant women, aged 25 to 34 years and estimated to be at no increased risk of genetic disease in the fetus, 4606 women participated in a randomized controlled trial of genetic amniocentesis between 1980 and 1984. In the study group having amniocentesis (2264 women), 23 fetal chromosome abnormalities (1.0 per cent) were found: eight autosomal aneuploidies, seven sex chromosome aneuploidies, seven balanced structural rearrangements and one case of a marker chromosome. The structural rearrangements and the marker chromosome were all shown to be inherited. The study group seemed representative for the whole population of younger women at low genetic risk. Therefore, a 1.0 per cent total rate of fetal chromosome abnormalities, consisting of one-third autosomal aneuploidies, one-third sex chromosome aneuploidies and one-third structural rearrangements, may be expected in the second trimester in younger low-risk women. In the same period of time, 562 women in the same age group were offered amniocentesis because of an estimated increased risk of fetal genetic disease. The total rate of fetal chromosome abnormality in this 'high-risk' group was 0.9 per cent and thus no different from the rate in the low-risk group.

Adult↗
PubMed1987

Screening for Down's syndrome using an iso-risk curve based on maternal age and serum alpha-fetoprotein level.

On the basis of the significantly different distributions of maternal serum alpha-fetoprotein (AFP) levels in 86 pregnancies associated with fetal Down's syndrome and in 2018 unaffected pregnancies, an iso-risk curve for Down's syndrome was constructed. An iso-risk curve shows, for women of all ages, which combinations of maternal age and level of maternal serum AFP result in the same risk of carrying a fetus with Down's syndrome. A 1:400 risk of Down's syndrome, corresponding to the risk of a 35-year-old woman, was chosen as the lowest risk indicating referral for amniocentesis. If all women, irrespective of their age, are offered amniocentesis, when their risk of carrying a Down's syndrome fetus is 1:400 or higher, 53% of the affected fetuses can be detected as compared with 28% of the affected fetuses diagnosed at present in women above 35 years of age.

Adult↗
PubMed1987

Clinical performance of a system for semiautomated chromosome analysis.

Until recently equipment for automated chromosome analysis has not been used for routine purposes in clinical cytogenetic laboratories. During a 3 1/2-year period the chromosome laboratory of Rigshospitalet has tested the Magiscan chromosome system under routine conditions and performed the first evaluation of its clinical performance. The system consists of an image processor with a light pen for manual interaction connected to a hard-copy printer and a microscope with a TV camera and a motorized scanning stage for eight slides. Automated metaphase finding takes place without operator assistance. An operator is involved in the analysis after the metaphases are located. Using two of these complete systems, we have performed a total of 4,691 chromosome analyses comprising a count of 10 metaphases, of which three were "eyeball" karyotyped and one was "machine" karyotyped. Presently, two-thirds of our prenatal analyses (amniotic-cell cultures) are carried out with these two machines. A third Magiscan system without scanning stage is used as a "karyotyping-only" system to produce hard-copy karyograms in those cases in which metaphases are manually located and counted in the microscope. Since the end of 1984, 4,773 additional machine karyograms have been produced with this system. With a complete system, a prenatal analysis can be carried out in an average of 35 min. The average time for a machine karyotype is 7 min. Since 1984 the productivity of the laboratory has increased 17%-20% without enlarging the staff.

Female↗
PubMed1986

Clinical measures to assess the practice and efficiency of breast self-examination.

If women examine their breasts thoroughly and regularly they may promptly recognize abnormal tissue changes. The level of skill and motivation required for effective breast self-examination (BSE), however, is very high. In a prospective study of 304 patients with newly diagnosed breast cancer, 165 (54%) claimed to practice BSE. On comparison with the remaining 139, the BSE practitioners reported their symptoms sooner than the nonpractitioners, and presented more often with clinically early tumors. There was, however, no difference in tumor size, and pathologic status of axillary nodes between the two groups. There were 60 patients who discovered the abnormalities during self-examination. On comparison with the remaining 244, significantly more BSE discoverers had shorter patient delay in presentation, but there was no significant difference in tumor size, clinical stage, and nodal status. It is concluded that these or similar clinical measures must be used in assessing the effectiveness of population-based BSE campaigns.

Age Factors↗
PubMed1986

Randomised controlled trial of genetic amniocentesis in 4606 low-risk women.

Outcome of pregnancy after amniocentesis was studied in a randomised controlled trial of 4606 women, age-range 25-34 years, without known risk of genetic disease. Spontaneous abortion rate was 1.7% in the study group after amniocentesis and 0.7% in the control group after ultrasound (relative risk 2.3). In the study group, increased levels of maternal serum alpha-fetoprotein before amniocentesis, perforation of the placenta during amniocentesis, and withdrawal of discoloured amniotic fluid were associated with an increased risk of spontaneous abortion. In the first six weeks after amniocentesis/ultrasound scan, amniotic fluid leakage occurred more often in the study group but there was no difference in the rate of vaginal bleeding. Frequency of postural malformations in the infants in the two groups was the same. In the study group, respiratory distress syndrome was diagnosed more often (relative risk 2.1) and more babies were treated for pneumonia (relative risk 2.5).

Abortion, Spontaneous↗
PubMed1986

Breast screening clinic versus health education session as outlets for education in breast self-examination.

A population based programme to educate women in breast self-examination (BSE) was organised as part of the UK Trial of Early Detection of Breast Cancer. Women who responded to an invitation to a meeting were educated in groups and were not routinely screened. Open access clinics offered x ray and clinical examination to all women in the study age group of 45 to 64. Women who presented for screening without prior BSE education were taught individually by clinic staff. Women taught by the two methods were surveyed by post and their BSE practice since education was compared. It was hypothesised that the women taught in clinics, who had been reassured of their breast normality, would practice BSE more regularly and correctly. Results did not confirm this hypothesis. Lower standards of practise and a higher level of anxiety at the time of survey were found in the group who presented at a free access clinic and had received individual teaching at the time of screening.

Breast↗
PubMed1985

Semiautomated chromosome analysis. A clinical test.

An interactive system for semiautomated chromosome analysis, consisting of a high-speed image processor with light-pen, TV monitor and key-board interfaced to a microscope with motorized scanning stage and video-camera and to a hard-copy printer, has been clinically tested for twenty consecutive working days. Metaphase search takes place over night. Identified metaphases are ranked automatically according to their suitability for analysis. Less than every second metaphase found cannot be either counted or analysed. 164 samples were analysed. Only one was not completed. Two numerical and two structural abnormalities were identified and clinical consequences taken. Average time per completed analysis (10 counts, four karyotypes) were 37.5 min (28-84). Average time varied between technicians. In another test including 120 metaphases and 40 karyotypes average time for counting the chromosomes of a metaphase was 37 sec. (28-48), and average time for producing one karyotype, including a hard-copy was 4 min 30 sec (3 min 43 sec-5 min 54 sec). Number of manual interactions was 8 (2-17) and 36 (25-61), respectively. Although improvements are possible, the system is able to at least double the output of four cytogenetic technicians.

Automation↗