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Biomedical subjects

J Stephenson

Publications and source records attributed to J Stephenson.

At least 127 records · Page 7Linked to original sources
PubMed1999

Selective versus universal antenatal HIV testing: epidemiological and implementational factors in policy choice.

OBJECTIVE: To develop an epidemiological basis for economic analyses of selective and universal antenatal screening strategies, and to apply it to the UK. METHODS: The prevalence of higher-risk women and the prevalence of undiagnosed infection within groups of high-risk and low-risk women was estimated from surveillance and survey data. The numbers of women tested and the numbers of infected women who would be identified by universal and selective strategies were then calculated under a range of assumptions about the identification of higher-risk women and acceptance of testing. RESULTS: In higher-risk women estimated prevalence of undiagnosed infection was between 0.06% and 2.8%, comparing well with independent estimates. In low-risk women, estimates ranged from 0.014% in London to 0.002% in the rest of the UK. If uptake among the high-risk women was the same in selective and universal strategies, universal testing would entail testing between 7100 (London) and 50000 (rest of England) additional women to detect an additional case. However, if selective screening identified only 60% of those at high risk and achieved only 60% acceptance compared with a universal programme, then universal screening would require only 1150 additional women to identify one additional case in London, compared to 6470 in Scotland and 13140 in the rest of the UK. CONCLUSIONS: Overall prevalence does not form an adequate basis for determining screening strategy. Instead, universal screening can be justified either because the prevalence of HIV in the low-risk group is sufficiently high, or because it achieves sufficiently higher uptake relative to selective screening among those at higher risk.

Female↗
PubMed1999

Initial paclitaxel improves outcome compared with CMFP combination chemotherapy as front-line therapy in untreated metastatic breast cancer.

PURPOSE: To determine the place of single-agent paclitaxel compared with nonanthracycline combination chemotherapy as front-line therapy in metastatic breast cancer. PATIENTS AND METHODS: Patients with previously untreated metastatic breast cancer were randomized to receive either paclitaxel 200 mg/m(2) intravenously (IV) over 3 hours for eight cycles (24 weeks) or standard cyclophosphamide 100 mg/m(2)/d orally on days 1 to 14, methotrexate 40 mg/m(2) IV on days 1 and 8, fluorouracil 600 mg/m(2) IV on days 1 and 8, and prednisone 40 mg/m(2)/d orally on days 1 to 14 (CMFP) for six cycles (24 weeks) with epirubicin recommended as second-line therapy. RESULTS: A total of 209 eligible patients were randomized with a median survival duration of 17.3 months for paclitaxel and 13.9 months for CMFP. Multivariate analysis showed that patients who received paclitaxel survived significantly longer than those who received CMFP (P =.025). Paclitaxel produced significantly less severe leukopenia, thrombocytopenia, mucositis, documented infections (all P <.001), nausea or vomiting (P =.003), and fever without documented infection (P =.007), and less hospitalization for febrile neutropenia than did CMFP (P =.001). Alopecia, peripheral neuropathy, and myalgia or arthralgia were more severe with paclitaxel (all P <.0001). Overall, quality of life was similar for both treatments (P > = .07). CONCLUSION: Initial paclitaxel was associated with significantly less myelosuppression and fewer infections, with longer survival and similar quality of life and control of metastatic breast cancer compared with CMFP.

Adult↗
PubMed1999

Influence of body condition score on carcass characteristics and subprimal yield from cull beef cows.

Mature beef cows (n = 83) were slaughtered to measure the influence of body condition score (BCS) on carcass characteristics and subprimal yields. All cows were weighed and assigned BCS, based on a 9-point scale, 24 h before slaughter. Cows were slaughtered, and, after a 48-h chilling period, quality and yield grade data were collected on the left side of each carcass. The right side was quartered, fabricated into primal cuts, and weighed. Each primal cut was further processed into boneless subprimal cuts, minor cuts, lean trim, fat, and bone. Cuts were progressively trimmed to 6.4 and 0 mm of external and visible seam fat. Weights were recorded at all stages of fabrication, and subprimal yields were calculated as a percentage of the chilled carcass weight. Live weight, carcass weight, dressing percentage, fat thickness, longissimus muscle area, muscle:bone ratio, and numerical yield grade increased linearly (P = .0001) and predicted cutability and actual muscle-to-fat ratio decreased linearly (P = .0001) as BCS increased from 2 to 8. Carcasses from BCS-8 cows had the most (P<.05) marbling. The percentage of carcasses grading U.S. Utility, or higher, was 16.7, 20.0, 63.6, 43.3, 73.3, 100.0, and 100.0% for cows assigned a BCS of 2, 3, 4, 5, 6, 7, and 8, respectively. At 6.4 mm of fat trim, carcasses from BCS-5 cows had higher (P<.05) shoulder clod yields than carcasses from cows having a BCS of 6, 7, and 8. Carcasses of BCS-2 cows had lower (P<.05) strip loin yields than carcasses from BCS-3, 4, 5, 6, and 7 cows. Top sirloin butt yields were higher (P<.05) for carcasses of BCS-2, 3, 4, and 5 cows than those of BCS-6, 7, or 8 cows. Carcasses from BCS-7 and 8 cows had lower (P<.05) tenderloin and inside round yields than carcasses of BCS-5, or less, cows. At both fat-trim levels, carcasses from BCS-5 cows had higher (P<.05) eye of round yields than cows assigned BCS of 2, 7, or 8. When subprimal cuts were trimmed to 6.4 mm of visible fat, carcasses from BCS-5 cows had higher (P<.05) total lean product yields than cows assigned a BCS of 2, 4, 7, and 8. Regardless of fat trim, total fat yields increased (P = .0001) and total bone yields decreased (P = .0001) linearly as BCS increased from 2 to 8. Although carcasses from BCS-5 and 6 cows had the highest yields of lean product, cattle producers and packers may benefit most by marketing and(or) purchasing BCS-6 cows because a higher percentage of their carcasses had quality characteristics deemed desirable for fabrication into boneless subprimal cuts.

Animal Husbandry↗