Biomedical subjects

K Byth

Publications and source records attributed to K Byth.

At least 55 records · Page 3Linked to original sources

PubMed1995

Differential alterations of cytochrome P450 proteins in livers from patients with severe chronic liver disease.

To determine whether cytochrome P450 proteins were differentially altered in severe chronic liver diseases, we examined 50 livers removed at liver transplantation from patients with end-stage cirrhosis, including 18 with and 32 without cholestasis, and compared the results with 21 histologically normal livers. NADPH-cytochrome c reductase activities were unaltered in microsomes from cirrhotic livers. Total cytochrome P450 content was significantly reduced. The catalytic activities of four xenobiotic-metabolizing P450s and the level of the corresponding proteins were differentially altered. Thus, P450 3A-supported testosterone 6 beta-hydroxylase activity and 3A protein appeared to be reduced, but only in the subgroup without cholestasis was this change significant. In contrast, 2E1 and the related N,N-dimethylnitrosamine N-demethylase activity were clearly reduced in livers from patients with cholestatic forms of cirrhosis but appeared not to be changed in other cirrhotic livers. Similarly, P450 2C protein was reduced only in patients with severe chronic cholestasis. Finally, P450 1A2 and 1A2-supported ethoxyresorufin O-deethylase activity were significantly reduced in hepatic microsomes from patients with both types of advanced liver disease. In summary, these data demonstrate that cytochrome P450 proteins are selectively altered in severe chronic liver disease, some being profoundly decreased, others less so or not at all. Our results also suggest that there may be different patterns of altered hepatic P450 expression according to the presence or absence of cholestasis in patients with cirrhosis severe enough to require transplantation.

Adolescent↗

PubMed1994

Renal graft thrombosis. A survey of 134 consecutive cases.

Despite overall improved graft survival, renal graft thrombosis (RGT) remains an important cause of graft loss. Of 6153 consecutive renal transplants (RTx), 134 index cases of graft loss from RGT were reported to the Australian and New Zealand Dialysis and Transplant Registry between 1980 and 1992. Two groups were selected for comparison: (1) institutional controls (n = 127), the previous RTx at the same institution as each index case; and (2) graft controls (n = 107), the contralateral cadaveric donor kidney of each index case. RGT cases that coincidentally occurred in control groups were deleted from those groups (6 of institutional controls, 2 of graft controls). RGT within the first 30 days after RTx occurred in 1.9% of all RTx and was constant from 1980 to 1992. In contrast, RGT caused an increasing proportion of early (within 30 days of RTx) graft losses (P = 0.01). The cumulative occurrence of RGT in those who thrombose was 62.6%, 83.7%, 90.2%, and 93.5% at 2, 7, 14, and 30 days after RTx, respectively. By comparison, with the control groups, no association with RGT was demonstrated for recipient age or sex, primary renal disease, type of dialysis, treatment with CsA, degree of HLA mismatch, panel reactive antibody levels, perfusion solution and perfusion technique, or immunosuppressive therapy. There was a significantly increased incidence of RGT with both extremes of donor age, female donors, and prolonged total ischemic time.

Adolescent↗

PubMed1994

Can the electrophysiologic study predict treatment outcome in patients with sustained ventricular tachyarrhythmias unrelated to coronary artery disease?

UNLABELLED: Sustained ventricular tachyarrhythmias unrelated to coronary artery disease are uncommon. Currently there are no clear guidelines to aid selection of the most appropriate treatment strategy. Therefore, factors potentially predictive of arrhythmia recurrence and death and the ability of the electrophysiologic study to predict treatment outcome in patients with spontaneous sustained ventricular tachyarrhythmias unrelated to coronary artery disease were examined in 41 medically treated patients followed for a median of 25 (range 1-76) months. Examined factors were: syncope associated with the spontaneous arrhythmia, the morphology and cycle length of the presenting arrhythmia, underlying ventricular function, cardiac pathology, and the results of drug assessment at electrophysiologic study. Random variability in the ease of arrhythmia induction at electrophysiologic study was measured for the group as a whole and was allowed for in prediction of an effective drug response. The 95% confidence intervals for variability in the ease of repeat arrhythmia induction at the same study were < or = 1 extrastimulus and for variability in the ease of repeat arrhythmia inductions at different studies were < or = 2 extrastimuli. Poisson regression models were used for data analysis. Arrhythmia recurrence was most likely in: (1) patients on treatment not predicted to be anti-arrhythmic at electrophysiologic study; (2) patients whose treatment was not assessable at electrophysiologic study because the arrhythmia was not reliably inducible; (3) patients with impaired ventricular function; and (4) re-entered patients whose arrhythmia had recurred on previously allocated therapy. The risk of arrhythmia recurrence decreased with time from hospital assessment. All five deaths occurred in patients with impaired ventricular function. CONCLUSIONS: drug efficacy should be tested at electrophysiologic study in patients with reproducibly inducible clinical arrhythmias. Treatment not proven to be anti-arrhythmic at electrophysiologic study is usually ineffective. Patients with ventricular dysfunction are at highest risk of death from arrhythmia recurrence and should be considered for an implantable defibrillator, arrhythmia surgery, or heart transplantation if drug treatment is not predicted to be effective or is not assessable at electrophysiologic study.

Adolescent↗

PubMed1994

Postural tremor of Parkinson's disease.

Previous studies have reported the resting tremor (RT) of Parkinson's disease to occur at frequencies between 3-7 Hz and to be characterised by an alternating pattern of electromyographic (EMG) bursting activity between opposing muscles. A postural tremor (PT), of higher frequency (> 6 Hz) and with a synchronous pattern of EMG activity, has also been previously described in Parkinson's disease. We investigated the electrophysiological and pharmacological properties of both the RT and PT of 11 patients with Parkinson's disease and 10 patients with essential tremor in a double-blind, placebo-controlled study of L-Dopa/benserazide and propranolol. Tremor amplitude and frequency were assessed via bidirectional accelerometry, and the pattern of activation of the antagonist muscles of the forearm was determined with use of surface EMG. In the Parkinson's disease group studied, the frequency, EMG pattern of bursts, and response to L-Dopa were similar for the two tremors (median improvement of RT by 70% and PT by 61%). Despite some overlap between the Parkinson's disease and essential tremor groups in the electrophysiology of the tremor, there was no such dramatic pharmacological response in the latter group. These results suggest that the RT and PT of Parkinson's disease share a common pathophysiology and are distinct from essential tremor.

Adult↗

PubMed1993

Analysis of the mechanism of adhesion of precursor-B acute lymphoblastic leukemia cells to bone marrow fibroblasts.

Normal B lymphopoiesis is dependent on a close relationship between B-cell precursors and the bone marrow (BM) microenvironment. To further understand the mechanisms regulating the proliferation of the malignant counterpart of B-cell precursors, namely precursor-B acute lymphoblastic leukemia (ALL), we examined the adhesion to BM fibroblasts (BMF) of 19 cases of precursor-B ALL using a chromium labeling assay. Eleven of 19 cases showed greater than 10% binding to BMF (range 2.3% to 54.8%, mean 19.1%). Binding was increased approximately twofold by preincubation of BMF with tumor necrosis factor and interleukin-4, which also resulted in upregulation of expression of vascular cell adhesion molecule-1 (VCAM-1) on BMF. The mechanism of attachment was investigated using murine monoclonal antibodies to leukocyte integrins, principally the beta, integrins VLA-4 and VLA-5, which were demonstrated to be present on most cases by flow cytometry. Statistically significant inhibition of adhesion was observed with antibodies to the beta 1 common subunit, VLA-4, and VLA-5, whereas little effect was seen with antibodies to VLA-6 or the beta 2 integrin subunit. Preincubation of fibroblasts with an antibody to VCAM-1 (a ligand of VLA-4) inhibited leukemic cell binding in the majority of cases, which was an effect also observed on cytokine-stimulated BMF. However, a minority of cases, as well as the pre-B lines NALM-6 and KM-3, showed no evidence of inhibition of adhesion with anti-VCAM-1 antibodies. Treatment of BMF with antifibronectin antibody alone had little effect on ALL adhesion and did not enhance the inhibitory effect of anti-VCAM-1. These data indicate that precursor-B ALL cells bind to BM stroma through the beta 1 integrins VLA-4 and VLA-5 and that this effect is partly mediated by VCAM-1 on stromal cells, although other undefined VLA ligands are also likely to be involved. Attachment of ALL cells to stroma is likely to play a key role in regulating the survival and growth of these cells through exposure to stromal cytokines.

Adolescent↗

PubMed1993

Pseudomonas aeruginosa bacteraemia. Is pancreatobiliary disease a risk factor?

OBJECTIVE: To review changes in the epidemiology, course, and outcome of bacteraemia caused by Pseudomonas aeruginosa. DESIGN AND SETTING: A retrospective, descriptive study of consecutive cases of P. aeruginosa bacteraemia occurring at a university teaching hospital. PATIENTS AND METHODS: Between January 1980 and December 1989, 164 patients were admitted to Westmead Hospital with P. aeruginosa bacteraemia. Patients in whom there was no clinical evidence of sepsis were excluded from analysis leaving a cohort of 152 patients. Hospital records were reviewed and details of demography, clinical features, therapy, and outcome were recorded. RESULTS: One hundred and fifty-five episodes of P. aeruginosa bacteraemia were recorded at an average rate of 0.39 per 1000 admissions per year. The respiratory and pancreatobiliary tracts were the most common sources of the bacteraemia. Pancreatobiliary disease, independent of an underlying malignancy or immunosuppression, emerged as a previously undescribed risk factor for pseudomonal bacteraemia (incidence of 3.0 episodes per 1000 hospital admissions for patients with this disease). The crude mortality rate was 52%; 35% was attributable to pseudomonal bacteraemia. Factors identified as being independently associated with an increased mortality included hypotension, age of 60 years or older, and the presence of an underlying malignancy. Combination therapy with an antipseudomonal penicillin and an aminoglycoside confers a significant survival advantage independent of underlying neutropenia. CONCLUSIONS: Bacteraemia caused by P. aeruginosa remains an important cause of morbidity and mortality. Pancreatobiliary disease represents a new risk factor for P. aeruginosa bacteraemia, independent of an underlying malignancy or immunosuppression. It may be prudent to consider P. aeruginosa as a cause of sepsis in these circumstances, especially if there has been instrumentation of the biliary tree. Hypotension, age of 60 years or older, and the presence of an underlying malignancy were independently associated with significantly increased mortality. Appropriate antibiotic therapy consisting of an antipseudomonal beta-lactam in addition to an aminoglycoside resulted in a significant decrease in mortality compared with the use of an aminoglycoside alone, not only in the study population as a whole, but also in patients without neutropenia.

Adolescent↗

PubMed1993

Trends in peptic ulcer mortality in Sydney from 1971 to 1987.

Gastric and duodenal ulcer (GU,DU) mortality in Western countries has varied over time by age and sex. Temporal variation raises the question of whether these ulcers have an environmental etiology. Using death certificate data, we investigated peptic ulcer mortality time trends from 1971 to 1987 in Sydney, Australia, and whether ulcer mortality and overall mortality in Sydney were similar with regard to time trends and associations with demographic and environmental factors. In men in all age groups and in women age < 65, GU and DU mortality decreased. In women age > or = 70, GU mortality remained constant and DU mortality increased. Average age at ulcer death increased: from 1971 to 1987, ulcer deaths at age > or = 70 rose from 52 to 80% of all ulcer deaths. In men who died at age 30-54, GU and DU mortality decreased relative to overall mortality. In women who died at age > or = 55, DU mortality increased relative to overall mortality. Compared with overall mortality, the ulcer mortality rate was affected more adversely by lower social class and lack of the marriage tie, and smoking rates tended to correlate more strongly with GU mortality. The greater-than-expected decrease in GU and DU mortality in younger men and the increase in DU mortality in elderly women suggest important changes in as yet unidentified environmental risk factors for ulcer mortality within the young adult male and elderly female general populations.

Adult↗

PubMed1993

Sequential changes in the bone marrow trephine biopsy in B-cell chronic lymphocytic leukaemia.

BACKGROUND: Trephine biopsy of the bone marrow is integral to both diagnosis and prognosis in B-cell lymphocytic leukaemia (B-CLL), but its usefulness would be enhanced by more information on the type, degree and rate of change that occur over time in histologic pattern and lymphocytic infiltration. AIMS: To investigate these changes by serial trephine biopsy in totally untreated patients, in treatment-free intervals in treated patients and during intervals of treatment. METHODS: In 82 patients with predominantly early B-CLL observed for a median of 65 months (13-331), 309 trephine biopsies were carried out, a median of three (two to eight) per patient. The biopsies were classified into nodular, interstitial, mixed and diffuse patterns. Lymphocytic infiltration was subjectively graded into minimal (< 20%), intermediate (20-50%) and majority (> 50%) categories and all changes were compared. RESULTS: Intensity of infiltration increased through this histologic range, as did the relative risk of death. Survival of patients with > 50% involvement was significantly poorer than those with < 50%. Changes in both lymphocyte numbers and pattern occurred slowly in early disease but quickened as the leukaemia advanced. Under treatment, lymphocytes decreased but the histology did not alter significantly. Examining the marrow for disease progression should be part of regular follow-up. It may help identify the minority of patients with early disease which will run a more active course and in whom early therapy may yet be indicated. We recommend biopsy at two-yearly intervals in early disease, more frequently as the leukaemia advances. The minimal, intermediate and majority classification in addition to the histologic pattern is a useful grading.

Adult↗

PubMed1992

Hepatotoxicity from paracetamol self-poisoning in western Sydney: a continuing challenge.

OBJECTIVE: To determine the annual incidence of admissions for paracetamol overdosage in the years 1985 to 1990, morbidity and mortality rates, predictors of poor prognosis and the most appropriate use of N-acetylcysteine (NAC). DESIGN: A retrospective review of case records of all patients with a discharge diagnosis of paracetamol overdosage. SETTING: A 900-bed tertiary referral teaching hospital in western Sydney with a busy accident and emergency department. PATIENTS: 306 patient records were reviewed and details of the overdose and admission were recorded. INTERVENTIONS: NAC infusion in patients with possible paracetamol hepatotoxicity. MAIN OUTCOME MEASURES: Blood paracetamol levels; elevated alanine aminotransferase levels; prolonged prothrombin time; severe liver injury; and NAC side effects. RESULTS: Annual admission rate was constant at circa 55 per annum. Female to male ratio was 2:1. Predictors of liver injury included paracetamol dose over 10 g, presentation more than 10 hours after the overdose and chronic ingestion of more than 80 g alcohol per day. There were no deaths. Fifty-five patients (18%) had toxic paracetamol levels, 51% received treatment with NAC, including 40% of those with non-toxic levels, and 11% of those treated with NAC experienced side effects. CONCLUSION: Paracetamol overdosage continues to be a significant cause of hospital admissions in western Sydney. Severe hepatic damage occurs infrequently and the prognosis for liver injury, when it occurs, is good. Treatment with NAC should be reserved for patients with definite indications for the drug.

Acetaminophen↗

PubMed1992

Accuracy of various methods of localization of the orifice of the coronary sinus at electrophysiologic study.

The coronary sinus (CS) orifice is an important reference point for determining electrode and, thereby, accessory pathway location at electrophysiologic study. The reliability of fluoroscopic landmarks used to identify the CS orifice is not known. This study compared the accuracy of several fluoroscopic landmarks for identifying the CS orifice with the location defined by radiopaque contrast injection of the CS. Forty patients were studied. Radiographic markers of the CS orifice that were examined included: (1) the point at which the CS catheter prolapsed during advancement, (2) the point of maximum convexity of the CS catheter when a superior vena caval approach was used, (3) the right side of the ventricular septum, and (4) the relation to the underlying vertebrae. The least-significant difference method of multiple comparisons was used for statistical analysis. The point at which the CS catheter prolapsed was the most accurate noncontrast method for determining the location of the CS orifice (p less than 0.05), but was possible without the use of excessive force in only 48% of patients. The point of catheter prolapse was a median of 1 mm (range 0 to 11) from the true location of the os. Errors with other examined landmarks ranged up to 3 cm. Identification of the CS orifice is best performed by radiopaque contrast injection. The point of prolapse during catheter advancement in the CS is an accurate alternative when contrast injection is not feasible. Other noncontrast fluoroscopic landmarks are less reliable and are best avoided.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Alcohol consumption and the risk of cirrhosis.

OBJECTIVE: To determine risk levels for the development of cirrhosis in Australian men who consume alcohol and to compare this risk with that of Australian women. DESIGN AND SETTING: A case-control study using an interview technique, based in two major tertiary referral hospitals in Sydney. PATIENTS: Forty-three men with newly diagnosed cirrhosis of the liver and a total of 115 male control subjects, age matched with the case subjects. The data for women (36 cases and 99 controls) have been reported previously. RESULTS: The risk of men developing cirrhosis increases significantly above the baseline when the alcohol intake exceeds 40 g per day. The risk to women is significant at a similar intake level. Dietary intake and past major illnesses appear to have no role in determining risk. CONCLUSION: The recommended safe drinking level for men and women should be 40 g per day, as suggested by the National Health and Medical Research Council.

Adult↗

PubMed1992

Changes in criminal activity after entering methadone maintenance.

The impact of different approaches to methadone maintenance on the level of crime committed by heroin addicts was examined in a cohort of addicts entering methadone treatment. The cohort comprises three groups: 72 subjects (group 1) who were approved for treatment and referred to a long-term programme which tolerated continued illicit drug use in treatment; 159 subjects (group 2) who were referred to an abstinence orientated programme from which clients who continued to use heroin were expelled; and 84 subjects who were rejected as unsuitable or failed to complete the assessment process. Official records of convictions were used to calculate conviction rates in the pre- and post-assessment periods. Differences between groups in conviction rates for drug and property crimes were analysed using Poisson regression. Three variables--age, sex and age of first criminal conviction--were significant predictors of conviction rates and all analyses controlled for these variables. Most of the rejected subjects entered treatment during the study period and it was, therefore, not possible to interpret differences between treated and untreated subjects. Among those who entered treatment, property offence rates actually rose, due to a significant increase in conviction rates in group 2. Subjects in group 1 were retained significantly longer in treatment than those in group 2. Among those who remained in treatment less than 12 months, most offences occurred after leaving treatment. When conviction rates were adjusted for time spent in treatment, the differences between the clinics disappeared.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Who should receive methadone maintenance?

The aim of this study was to evaluate the assessment policies of a regional unit established to process requests for entry to several long-term methadone maintenance programmes. The factors which led staff to reject an applicants request for methadone maintenance were retrospectively analysed from assessment records. Analysis indicated that the decision to reject applicants had been based on the judgement that they were not physically dependent on opioids; other factors favouring rejection included less involvement in crime, youth, and short duration of drug use. Eighty-four applicants who had either been rejected (n = 58) or failed to complete the assessment (n = 26) were followed. At follow-up, more than half of the subjects had entered methadone programmes, usually after a long delay. Four subjects had achieved a degree of stable abstinence. The remainder were continuing to use illicit drugs, or were in treatment or prison. Four subjects had died. We conclude that: (1) our criteria for excluding people from treatment were based on the perceived need to keep non-addicted people from maintenance treatment; and (2) such a policy in practice served to prolong the applicants' illicit drug use and delay their entry to treatment.

Adult↗

PubMed1992

A note on sex-specific mortality and social class in Sydney, 1979 to 1983.

Simple indicators such as education, income, occupation, and employment status are often used to adjust for social class in studies of morbidity or mortality. The effect of social class on such outcomes can be different for men and women. In population-based studies, residential area may be the only means of assessing social class. This study investigated sex differences in the association between mortality between 1979 and 1983 and several area indices of social class--percentage with a degree, percentage professional, percentage blue collar, percentage unemployed, percentage with annual income greater than $40,000, and the composite indicator constructed by the Australian Bureau of Statistics. Thirty-seven Sydney statistical local areas were ranked for men and women separately according to the indicators and standardised mortality ratios. Correlations between the indicators and mortality were all negative and stronger for men than for women. The composite indicator and percentage unemployed correlated most strongly with mortality. There was a moderate correlation between the remaining indicators and mortality for men, but only a weak correlation for women. The results suggest that the use of simple area indicators may be inadequate to classify the social class of women, and that the unemployment rate in those over 35 years of age may be a reasonable alternative to the composite indicator for the purpose of social class adjustment in mortality studies.

Female↗

PubMed1991

Dimensions of the human posterior septal space and coronary sinus.

Accurate anatomic localization of accessory pathways during preoperative electrophysiologic study and during operative mapping depends on a knowledge of the dimensions of the posterior septal space and the left free wall. These dimensions were therefore studied in 48 human cadaver hearts. Mean distance from the coronary sinus orifice to the left margin of the posterior septal space was 2.3 +/- 0.4 cm and mean length of the left free wall was 5.0 +/- 1.0 cm. The posterior septal space at the level of the valve anuli extended a mean of 3.4 +/- 0.5 cm around the epicardium. The width of the posterior septum measured in the coronary sinus was related to heart weight and a combination of body weight and patient age (p less than 0.05). The probability of an accessory pathway being located in the left free wall or the posterior septum during catheter mapping was calculated for various distances from the coronary sinus orifice for adults of different ages and body weights. In adults, accessory pathways located in the proximal 1.5 cm of the coronary sinus are almost always in the posterior septum. Those located between 1.5 and 3 cm from the coronary sinus orifice may be in either the left free wall or the posterior septum, and those located greater than 3 cm from the coronary sinus orifice are almost invariably in the left free wall.

Adolescent↗

PubMed1991

Patterns of dyspepsia during the course of duodenal ulcer.

Dyspepsia patterns during the course of duodenal ulcer (DU) were examined in terms of the number of consecutive months that patients experienced dyspepsia either intermittently or continuously, or were dyspepsia-free. The patients (n = 224) were community-based. After ulcer healing, they were evaluated every 3 months for less than or equal to 7 years. Antiulcer agents were prescribed at the physicians' discretion. We analyzed the data on a patient-month basis using a 2-state Markov chain model. The fitted mean number of consecutive months with dyspepsia and the number of months dyspepsia-free were, respectively, 1.7 and 14 in patients on antiulcer agents, and 1.5 and 9 in patients not taking them. On average, patients experienced dyspepsia during 15% of months studied if they were on antiulcer agents, and during 20% of months if not. Regardless of antiulcer therapy, dyspepsia periods were lengthened by age, especially greater than 60 years; male sex; widowhood/divorce/separation; increasing acetaminophen use; and increasing length of time since initial onset of ulcerlike dyspepsia. Dyspepsia-free periods were lengthened by age greater than 70 years, and shortened by widowhood/divorce/separation and increasing cigarette consumption. These results suggest that dyspepsia occurs for less than or equal to 20% of the time in DU patients on about a yearly basis. The least dyspepsia may be expected in patients neither widowed, divorced, nor separated, in whom length of time since the initial onset of ulcerlike dyspepsia does not exceed 7 years, and who neither smoke nor use analgesics regularly.

Aged↗

PubMed1991

What is the best predictor of spontaneous ventricular tachycardia and sudden death after myocardial infarction?

BACKGROUND: Death during the first year after myocardial infarction is most commonly due to spontaneous ventricular tachycardia (VT) or fibrillation (VF). The purpose of this study was to compare, in a single cohort of patients, the values of inducible VT, delayed ventricular activation, low left ventricular ejection fraction, high-grade ventricular ectopy, and ST segment displacement on exercise in predicting electrical events (witnessed instantaneous death and spontaneous VT or VF) during the first year after myocardial infarction. METHODS AND RESULTS: Three hundred sixty one patients aged less than 71 years underwent electrophysiological study, signal-averaged electrocardiogram, gated blood-pool scan, 24 hour ambulatory electrocardiographic monitoring, and exercise testing 1-2 weeks after myocardial infarction and were then followed up for at least 1 year. There were 34 deaths (eight witnessed instantaneous, 26 other), and nine patients survived one or more episodes of spontaneous VF or VT. Patients with inducible VT were 15.2 times more likely to suffer electrical events than patients without inducible VT. No proportional-hazards model excluding inducible VT was as good a predictor of electrical events as was inducible VT alone. CONCLUSIONS: Inducible VT at electrophysiological study was the single best predictor of spontaneous VT and sudden death after myocardial infarction.

Aged↗

PubMed1991

Causes of death amongst a population of gastric ulcer patients in New South Wales, Australia.

The purpose of this study was to investigate whether any specific causes of death were more frequent than expected in an Australian group of 305 gastric ulcer patients (131 men, 174 women) who had died in New South Wales between 1 January 1974 and 31 December 1983. The distribution of causes of death among the ulcer population deaths was compared with that among the New South Wales population deaths, after adjusting for sex, 5-year age group, and time period of death (1974-1978, 1979-1983). Causes of death were ascertained from death certificates. Deaths due to peptic ulcer, liver cirrhosis, and diffuse pulmonary disease were more frequent than expected (p less than 0.05). The associations found with these other diseases accord with those found in previous surveys on causes of death in gastric ulcer patients and in studies of living gastric ulcer populations. Overall, the combined evidence suggests that liver cirrhosis and diffuse pulmonary disease are associated with gastric ulcer.

Adult↗