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Biomedical subjects

K Jamrozik

Publications and source records attributed to K Jamrozik.

At least 109 records · Page 6Linked to original sources
PubMed1990

Perth Community Stroke Study: design and preliminary results.

The first aim of the study, to see every case of stroke and TIA which has occurred in a representative population, unbiased by hospital admission and with high pathological documentation, is being achieved. To date, the incidence rates for stroke in Perth are strikingly similar to those in other major population-based studies in the Western world. Further data on risk factors are likely to contribute greatly to our understanding of the aetiology of stroke. The data on stroke outcome should be of international significance.

Cerebrovascular Disorders↗
PubMed1989

Trends in risk factors for vascular disease in Australia.

Data from the National Heart Foundation Risk Factor Prevalence Surveys of 1980 and 1983 were analysed to detect national trends in risk factors for vascular disease in Australia. After statistical adjustment for differences in the demographic characteristics of the two populations of survey participants, our results show trends in smoking and blood pressure that are likely to result in a continuing fall in the incidence of vascular disease. There was a fall in the prevalence of current smoking from 32% to 29% but little change in the average daily consumption of cigarettes by current smokers. The prevalence of previously-undetected hypertension fell significantly from 10% to 7%. A small increase occurred in the proportion of all hypertensive patients who were treated and whose blood pressure was controlled, and a decline of 2.0 mmHg (P less than 0.0001) in mean diastolic blood pressures, but no significant change in mean systolic pressures. Mean total plasma cholesterol levels did not change; average levels of plasma triglycerides fell by 0.11 mmol/L (P less than 0.0001); and mean high-density lipoprotein cholesterol levels increased by 0.03 mol/L (P less than 0.0001). All indices of relative body weight increased between 1980 and 1983; mean body mass index rose by 0.23 with associated rises in the prevalence of obesity and of overweight status. The changes in other factors such as use of added salt, the consumption of alcohol, the level of physical activity and adherence to a special diet, all were in the desirable direction, although minor changes in the survey questionnaire might have served to exaggerate the apparent trends.

Adult↗
PubMed1988

Legibility of health warnings on billboards that advertise cigarettes.

At present only subjective criteria exist to determine the legibility of health warnings on billboards that display advertisements for cigarettes. We constructed a set of objective standards and used them to assess the legibility of warnings on a sample of 37 billboards in Perth, Western Australia. The three features that were analysed were the apparent size of the letters, the colour contrast between the letters and their background, and the obliqueness of the message. We also compared the size and legibility of the health warning with that of the brand name. Health warnings were not legible to passing motorists in 51% of cases and not legible to motorists who were stopped at nearby intersections in 74% of cases, whereas almost all the brand names could be read easily. These results indicate that the present system of voluntary regulation of advertisements for cigarettes has failed to ensure that health warnings on billboards are legible. For health warnings on advertisements to have any useful effect it is essential that they are legible. The only way to ensure legibility is to adopt objective requirements for it.

Advertising↗
PubMed1988

Randomised trial of prophylactic daily aspirin in British male doctors.

A six year randomised trial was conducted among 5139 apparently healthy male doctors to see whether 500 mg aspirin daily would reduce the incidence of and mortality from stroke, myocardial infarction, or other vascular conditions. Though total mortality was 10% lower in the treated than control group, this difference was not statistically significant and chiefly involved diseases other than stroke or myocardial infarction. Likewise, there was no significant difference in the incidence of non-fatal myocardial infarction or stroke--indeed, disabling strokes were somewhat commoner among those allocated aspirin. The lower confidence limit for the effect of aspirin on non-fatal stroke or myocardial infarction, however, was a substantial 25% reduction. Migraine and certain types of musculoskeletal pain were reported significantly less often in the treated than control group, but as the control group was not given a placebo the relevance of these findings was difficult to assess. There was no apparent reduction in the incidence of cataract in the treated group. The lack of any apparent reduction in disabling stroke or vascular death contrasts with the established value of antiplatelet treatment after occlusive vascular disease.

Aspirin↗
PubMed1988

Comparison of event rates among three MONICA centres.

Data from three MONICA centres in Auckland (New Zealand) and Newcastle and Perth (Australia) are used to explore some of the issues involved in comparing event rates and case fatality among MONICA centres. Auckland and Newcastle follow the "hot pursuit" method of identifying and interviewing patients while they are still in hospital. Perth follows the "cold pursuit" method, in which patients are identified by search of computerized hospital records after discharge and all data are abstracted retrospectively from case notes. Fatal cases are identified by the same method in the three centres. The distribution of events by MONICA diagnostic classification varied among centres, with Perth having the highest proportion of definite myocardial infarction events and the lowest proportion of possible myocardial infarction events. These differences appear to be due to the different methods of event ascertainment and data collection, and to variations in post mortem rates between centres. For comparisons among these three centres, the categories of non-fatal definite myocardial infarction and of all coronary heart disease deaths (that is those in the MONICA categories fatal definite myocardial infarction, fatal possible myocardial infarction, and fatal cases with insufficient data) appear to be the most useful.

Adult↗
PubMed1988

Incidence and outcome of cerebrovascular disease in Perth, Western Australia.

We estimated the event rates for stroke and transient cerebral ischemic attacks in a prospective community-based epidemiologic study in a representative segment of the city of Perth, Western Australia, during a 10-month period in 1986. Of 349 persons with an initial diagnosis of stroke or transient ischemic attack, 154 had suffered a first stroke, 75 a recurrent stroke, and 47 a transient ischemic attack; the remaining 73 persons were thought not to have had an episode of acute cerebrovascular disease. Annual event rates for first stroke (age-standardized to the "world" population) were 120 per 100,000 for males and 56 per 100,000 for females. The crude case-fatality ratio at 28 days after the index event for first stroke was 23% and varied from 0% for lacunar infarction to 57% for subarachnoid hemorrhage.

Adult↗
PubMed1987

A case-control study of cerebrovascular disease in Western Australia.

One hundred and twenty-nine patients notified to the Perth Community Stroke Study in whom the final diagnosis was cerebrovascular disease were matched with controls of the same sex and 5-year age group drawn from the records of the usual general practitioner of each index case. The control subjects were interviewed and examined briefly at home, following the same protocol as that used for assessment of cases. The significant risk factors for cerebrovascular disease to emerge in the case-control comparison were previous stroke (estimated relative risk 6.6), signs of peripheral vascular disease (3.6) and current smoking (2.6). Being married (0.6) and history of migraine (0.4) were significant protective factors. There was no association between a history of hypertension and cerebrovascular disease in this series.

Australia↗
PubMed1986

A high prevalence of diabetes in a rural village in Papua New Guinea.

The prevalence of glucose intolerance was determined in a sample of 192 adults (34% of the adult population) from Wanigela in rural Central Province, Papua New Guinea. This centre was chosen to compare the high prevalence rates previously found in residents from this village who had become urbanized in Port Moresby. The age- and sex-standardised rates for abnormal glucose tolerance in Wanigela were significantly lower than those recorded in the urban community. However, the crude rates of 8.9% for diabetes and 5.7% for impaired glucose tolerance are among the highest reported for rural populations in the Pacific. These results strongly suggest that a genetic predisposition to glucose intolerance is present in this ethnic group, and argue for the early adoption of primary prevention programmes as the process of development encroaches rapidly upon the traditional lifestyles of previously isolated communities in Papua New Guinea.

Adolescent↗
PubMed1985

Regional variation of oral cancer in Papua New Guinea.

Data from the Papua New Guinea Tumour Registry for the period 1979 to 1983 were examined for regional differences in the apparent incidence of oral cancer. The age-standardised incidence rates showed a ten-fold variation across the country, and only part of this variation could be explained by differences in availability of health services and in overall cancer-reporting rates. Incidence rates for oral cancer are significantly lower in the highlands than in the lowland regions of Papua New Guinea. The male: female ratio for oral cancer was greater than that for all cancer cases. The ways in which differences in betel- chewing and in tobacco and alcohol consumption may contribute-to these trends are discussed.

Adult↗
PubMed1984

Placebo controlled trial of nicotine chewing gum in general practice.

Of 2110 adult cigarette smokers originally recruited to a study of the effect of antismoking advice in general practice, 429 who reported at follow up after one year that they had tried unsuccessfully to stop smoking were offered "a special antismoking chewing gum," either nicotine gum or a placebo gum, in a double blind study. Of 200 who were willing to try the gum, 101 were randomly allocated to the nicotine gum and 99 to the placebo gum. They were followed up at six months by an unannounced home visit, at which they were interviewed and asked to provide a breath sample for analysis of carbon monoxide. Twenty five claimed that they had stopped smoking, but, of them, seven exhaled levels of carbon monoxide indicative of continued smoking. Of the 18 in whom giving up smoking was validated, 10 had received active gum and eight placebo gum, a difference which was not significant (odds in favour of nicotine gum = 1.25, 95% confidence limits 0.47-3.31). The value of nicotine chewing gum, if any, can be quite small when it is used in general practice.

Carbon Monoxide↗
PubMed1984

Controlled trial of three different antismoking interventions in general practice.

Of 6052 adult patients who consulted their doctors in six Oxfordshire general practices between October 1980 and February 1981, 2110 (35%) were smokers. The smokers were allocated to one of four study groups--a control (non-intervention) group; a group that received verbal and written antismoking advice from the general practitioner; a group that received this advice and also a demonstration of exhaled carbon monoxide; and a group that received the advice plus the offer of further help from a health visitor. After one year 72% of smokers replied to a postal follow up questionnaire: 11% of the control group claimed to have stopped smoking compared with 15% in the group that received advice alone, 17% in the exhaled carbon monoxide group, and 13% in the health visitor group. Validation of these findings by assays of urinary concentrations of cotinine showed that between 24% and 40% of subjects may have misreported their smoking habits, but there was no indication that the rate of misreporting was higher in the intervention groups than in the control group. Giving advice routinely against smoking has a useful effect, and showing an immediate, personal, and potentially harmful consequence of smoking using a CO-oximeter may improve this, particularly in lower socioeconomic groups.

Carbon Monoxide↗