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Biomedical subjects

J Townsend

Publications and source records attributed to J Townsend.

At least 73 records · Page 4Linked to original sources
PubMed1996

Neurologic abnormalities in infantile autism.

Neuroanatomic, pathologic, and neurobehavioral studies point to a cerebellar and parietal abnormality in autism. We used a standardized protocol to examine neurologic function in 28 pediatric autistic subjects and 24 pediatric normal healthy volunteer controls. As a group, the autistic subjects had quantitative measures from magnetic resonance imaging suggesting hypoplasia or hyperplasia of the cerebellar vermis, as well as measurements of posterior corpus callosum suggesting abnormalities of posterior cortex. In groups of tests that reflect cerebellar and parietal function, the neurologic abnormalities detectable by clinical examination were significantly greater for autistic subjects than for normal controls. These studies confirm that the structural and behavioral deficit in autism does lead to abnormalities that can be detected on the clinical neurologic examination.

Adolescent↗
PubMed1995

UKCCCR multicentre randomised controlled trial of one and two view mammography in breast cancer screening.

OBJECTIVE: To compare one view (oblique) and two view (oblique and craniocaudal) mammography in breast cancer screening. DESIGN: Randomised controlled trial. SETTING: Nine breast screening centres in England. SUBJECTS: 40,163 women aged 50-64 attending their first breast screening examination. INTERVENTIONS: Women were randomised to have one view mammography, two view mammography, or two view mammography in which one view was read by one reader and both views were read by another. MAIN OUTCOME MEASURES: Prevalence of cancer detected, recall rates, cost per cancer detected, and marginal cost per extra cancer detected. RESULTS: Two view mammography detected 24% more women with breast cancer (95% confidence interval 16% to 31%) than one view mammography. Prevalence of detected cancer was 6.84 with two view mammography and 5.52 per 1000 women with one view. The proportion of women recalled for assessment was 15% lower (95% confidence interval 6% to 23%) with two view (6.97%) than with one view (8.16%) mammography. The cost of two view screening was higher (26.46 pounds compared with 22.00 pounds per examination) but the average cost per cancer detected was similar (5330 pounds compared with 5310 pounds) and the marginal cost per extra cancer detected with two views was similar to the average cost (5400 pounds). CONCLUSION: Two view mammography is medically more effective than one view; it detects more cancers and reduces recall rates; it is also similarly cost effective financially.

Breast Neoplasms↗
PubMed1995

NMR intensity of corpus callosum differs with age but not with diagnosis of autism.

NMR signal intensities in five regions of the midsagittal corpus callosum were measured in autism patients and normal controls. An age-related increase in signal was observed in the anterior regions in both groups. No significant differences in intensity were detected between the groups. The finding of normal myelination supports the attribution of callosal narrowing to absence of axons rather than absence of myelin.

Age Distribution↗
PubMed1994

Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity.

OBJECTIVE: To assess effects of price, income, and health publicity on cigarette smoking by age, sex, and socioeconomic group. DESIGN: Econometric multiple regression analysis of data on cigarette smoking from the British general household survey. SUBJECTS: Random sample of adult population in Britain interviewed for biennial general household surveys 1972-90. MAIN OUTCOME MEASURES: Changes in cigarette consumption and prevalence of smoking. RESULTS: Price elasticities of demand for cigarettes (percentage change in cigarette consumption for a 1% change in price) were significant at -0.5 (95% confidence interval -0.8 to -0.1) for men and -0.6 (-0.9 to -0.3) for women, were highest in socioeconomic group V (-1.0 for men and -0.9 for women), and lowest (not significantly different from zero) in socioeconomic groups I and II. The gradient in price elasticities by socioeconomic group was significant for men (F = 5.6, P = 0.02) and for women (F = 6.1, P = 0.02). Price was a significant factor in cigarette consumption by age for women in every age group and for men aged 25-34. Cigarette consumption by young men aged 16-34 increased with income. There was a significant decrease in smoking over time by women in socioeconomic groups I and II and by men in all age and social groups except socioeconomic group V attributable to health publicity. Price significantly affected smoking prevalence in socioeconomic group V (-0.6 for men and -0.5 for women) and for all women (-0.2). CONCLUSIONS: Men and women in lower socioeconomic groups are more responsive than are those in higher socioeconomic groups to changes in the price of cigarettes and less to health publicity. Women of all ages, including teenagers, appear to have been less responsive to health publicity than have men but more responsive to price. Response to health publicity decreased linearly with age. Real price increases in cigarettes could narrow differences between socioeconomic groups in smoking and the related inequalities in health, but specific measures would be necessary to ameliorate effects on the most deprived families that may include members who continue to smoke. The use of a policy to steadily increase cigarette tax is likely to help achieve the government's targets for smoking and smoking related diseases.

Adolescent↗
PubMed1994

Impairment in shifting attention in autistic and cerebellar patients.

MRI and autopsy evidence of early maldevelopment of cerebellar vermis and hemispheres in autism raise the question of how cerebellar maldevelopment contributes to the cognitive and social deficits characteristic of autism. Compared with normal controls, autistic patients and patients with acquired cerebellar lesions were similarly impaired in a task requiring rapid and accurate shifts of attention between auditory and visual stimuli. Neurophysiologic and behavioral evidence rules out motor dysfunction as the cause of this deficit. These findings are consistent with the proposal that in autism cerebellar maldevelopment may contribute to an inability to execute rapid attention shifts, which in turn undermines social and cognitive development, and also with the proposal that the human cerebellum is involved in the coordination of rapid attention shifts in a fashion analogous to its role in the coordination of movement.

Adolescent↗
PubMed1994

Relation between neurodevelopmental status of very preterm infants at one and eight years.

The relation between neurodevelopmental status at one and eight years of age was investigated in a cohort of 207 infants born between 1979 and 1982 at < 33 weeks of gestation. The probability of a major disabling impairment at eight years was only 1 per cent among 164 children with normal neurodevelopment at one year, but 56 per cent for the 43 impaired children and 92 per cent for the 23 of these who had major disabling impairments. Close correspondence was found between the type of major impairment diagnosed at one and eight years. Neurodevelopmental status at one year also predicted the need for extra educational provision by eight years, with probabilities of 9 per cent for children without impairment at one year, 56 per cent for impaired children and 87 per cent for those with major impairments. Similarly, neurodevelopmental status predicted an IQ of more than 2 SD below the mean (< 70), with probabilities of 0, 30 per cent and 48 per cent, respectively.

Child↗
PubMed1994

The brain in infantile autism: posterior fossa structures are abnormal.

Infantile autism is a neurologic disorder of social, cognitive, and language development. Earlier MRI studies found hypoplasia of posterior vermal lobules VI and VII and cerebellar hemispheres in the majority of autistic patients, and recent autopsy analyses find severe Purkinje neuron loss in the posterior vermis (lobules VI and VII and VIII to X) and hemispheres. A second type of cerebellar pathology in infantile autism was recently found: hyperplasia (excessive enlargement) of posterior vermal lobules VI and VII. If the autistic samples in some MRI studies that did not detect cerebellar hypoplasia were actually composed of both the hypoplasia and hyperplasia subtypes, then the autistic mean size reported in such studies would have appeared to be near the normal mean size only because it would be the sum of the two opposite subtypes. To test this possibility, we statistically reanalyzed previously published vermal area measures of 78 autistic patients from four separate studies. The results revealed that the autistic patient samples from these four studies were indeed composed of both the hypoplasia subtype (87%, 92%, 89%, and 84% of patients) and the hyperplasia subtype (13%, 8%, 11%, and 16% of patients). Cerebellar abnormalities have been found in 15 autopsy and quantitative MRI reports from nine laboratories involving a total of 226 autistic cases. Autism may be one of the first developmental neuropsychiatric disorders for which substantial concordance exists among several independent microscopic and macroscopic studies as to the location and type of neuroanatomic maldevelopment. Onset might be as early as the second trimester. Discovery of the etiologies underlying cerebellar maldevelopment may be the key to uncovering some of the causes of infantile autism.

Adolescent↗
PubMed1994

Capital costs of supporting young disabled people at home.

The quality of life of disabled people depends partly on resources accessible to them. In this study, the capital costs of disability are defined and quantified for disabled people aged 16-64 years, inrelation to: their families, the state, the level of disability, medical diagnosis, and income, for 173 people in the Harrow area on Social Services registers of very severe and appreciable handicap. The mean cost of capital equipment and adaptations was 5,700 pounds (inter-quartile range 200 pounds to 6,600 pounds) to individuals and their families, and 4,500 pounds (inter-quartile range 100 pounds to 6,900 pounds) to statutory bodies (1993 prices, based on a 1988 survey). Two-thirds of this was spent on structural alterations, and one-third on aids and equipment, and costs to the individual were not apparently related to income from employment or state allowances. Capital costs of disability acquired in later life were partly ameliorated for some by accrued pensions, and for those disabled earlier in life, costs were often borne by carers and family. High capital outlay, often borne by the family, was reported for those with congenital disorders. The study indicates the need for financial support, and the need to increase suitable available accommodation for disabled people; regular review may help to identify individual requirements and changing needs.

Activities of Daily Living↗
PubMed1993

Phase II evaluation of echinomycin (NSC-526417) in patients with central nervous system malignancies. A Southwest Oncology Group study.

The objective of this trial was to determine the efficacy of echinomycin (1.2 mg/m2) administered on a weekly times four schedule in the treatment of patients with recurrent or progressive central nervous malignancies despite adequate radiotherapy. Thirty-five patients were registered on study. The majority of patients (20) had glioblastoma multiforme. Ten had anaplastic astrocytoma. Eight patients had received prior nitrosoureas. SWOG performance status was 1 in 11 patients and 2 in 22. The median age was 51 years (25-75 years). One patient had a partial remission (3%:95% confidence interval: 1%-16%). Twenty two patients had progressive disease. The median survival was 5.9 months. Toxicity was primarily gastrointestinal with nausea and vomiting in 13 patients and nausea only in 11 patients. Hepatotoxicity occurred in 10 patients. Echinomycin given at this dose and schedule is not effective in treating patients with recurrent or progressive glioblastoma multiforme or anaplastic astrocytomas.

Adult↗
PubMed1993

Policies to halve smoking deaths.

Britain still has amongst the highest mortality rates in the world for all the major smoking diseases. A third of all adults smoke cigarettes regularly and smoking causes one third of UK deaths in middle age. This paper discusses factors related to changes in smoking levels and concludes that without the intervention of government policies, smoking prevalence and the amount smoked per smoker is likely to rise, particularly for young people. Measures to reduce smoking are surveyed and estimates made of the maximum likely effects from health education, advertising control, general practitioner smoking cessation advice and public and work place policies. A pricing policy is suggested which, with the other policies could reduce cigarette consumption by a half so that only one in five adults smoke by the year 2000. Predictions are made of the effect of this policy package on lives and life years saved. Within twenty five years there would be 50,000 fewer deaths from smoking and half a million life years saved annually. This would rise to two thirds of a million within forty years. Deaths from lung cancer would fall by 38%. The quality of these life years saved would tend to the average for their age.

Adolescent↗