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Biomedical subjects

K McPherson

Publications and source records attributed to K McPherson.

At least 217 records · Page 12Linked to original sources
PubMed1982

Small-area variations in the use of common surgical procedures: an international comparison of New England, England, and Norway.

We examined the incidence of seven common surgical procedures in seven hospital service areas in southern Norway, in 21 districts in the West Midlands of the United Kingdom, and in the 18 most heavily populated hospital service areas in Vermont, Maine, and Rhode Island. Although surgical rates were higher in the New England states than in the United Kingdom or Norway, there was no greater degree of variability in the rates of surgery among the service areas within the three New England states. Hernia repair was more variable in England (P less than 0.05) and hysterectomy in Norway (P less than 0.05) than in the other countries. There was consistency among countries in the rank order of variability for most procedures: tonsillectomy, hemorrhoidectomy, hysterectomy, and prostatectomy varied more from area to area than did appendectomy, hernia repair, or cholecystectomy. The degree of variation generally appeared to be more characteristic of the procedure than of the country in which it was performed. Thus, differences among countries in the methods of organizing and financing care appear to have little relation to the intrinsic variability in the incidence of common surgical procedures among hospital service areas in these countries. Despite the differences in average rates of use, the degrees of controversy and uncertainty concerning the indications for these procedures seem to be similar among clinicians in all three countries.

Appendectomy↗
PubMed1982

Vaginal spermicides and outcome of pregnancy: findings in a large cohort study.

By the end of 1980, 5729 singleton planned pregnancies, 1552 singleton unplanned pregnancies, and 81 multiple pregnancies had been observed among the 17032 participants in the Oxford-Family Planning Association contraceptive study. The outcome of these pregnancies was investigated in relation to the use of vaginal spermicides. There was some suggestion that spermicide use might have a small adverse effect on the risk of congenital malformations, especially among infants conceived as a result of contraceptive failure. There was not, however, any evidence of any other adverse effect of spermicide use. In particular, the results provide strong evidence against the hypothesis that spermicide use has any appreciable effect on the risk of spontaneous abortion.

Abnormalities, Drug-Induced↗
PubMed1982

Natural science and medicine: social science and medicine: some methodological controversies.

The paper is in five parts. A discussion of the flaws in social science as seen from the viewpoint of medical science is followed by a consideration of what they hold in common--the shared institutions and ideal programme of Science. The major differences that still remain are then characterized in two further sections; the first concentrates on the issues raised by the human species' distinctive place in evolution, while the second discusses the problems and advantages created for social science by its necessary closeness to lay thought. We conclude with a summary of the difficulties involved in scientific progress in social science and some speculation concerning disciplinary re-alignment.

England↗
PubMed1982

Oral contraceptive use and abortion before first term pregnancy in relation to breast cancer risk.

A recent publication from California in this journal has suggested that both prolonged oral contraceptive use and abortion before first term pregnancy increases the risk of breast cancer in young women. Data are presented on 1176 women aged 16-50 years with breast cancer, interviewed in London or in Oxford, together with a like number of matches control subjects. The results are entirely reassuring, being, in fact, more compatible with protective effects than the reverse. Possible reasons for the differences between the 2 sets of data are discussed.

Abortion, Spontaneous↗
PubMed1982

Effect of beta-adrenoceptor antagonists on prevalence of peripheral vascular symptoms in hypertensive patients.

1 Eight hundred patients were approached by questionnaire to give details of side effects of their antihypertensive medications. The response rate was 72.8%. The percentage of those questioned who were taking beta-adrenoceptor antagonists at the time was 54.6%. 2 Raynaud's phenomenon (P less than 0.05) and complaints of cold extremities (P less than 0.001) were significantly more frequent in women than in men, 74.8% of women complained of cold extremities. 3 Exposure to beta-adrenoceptor antagonists did not increase the prevalence of Raynaud's phenomenon in either men or women in the study, but did increase the prevalence of cold extremities in men (P less than 0.001). Propranolol, labetalol, oxprenolol and possibly atenolol were likely to produce such side effects. Smoking and the addition of vasodilators did not alter the effect of beta-adrenoceptor blockers on peripheral vascular symptoms. Complaints of cold extremities were not associated with an excess of complaints of other side effects.

Adrenergic beta-Antagonists↗
PubMed1981

Breast cancer and oral contraceptives: findings in Oxford-Family Planning Association contraceptive study.

Among the 17 032 women taking part in the Oxford-Family Planning Association contraceptive study, 72 were first diagnosed as having breast cancer between the date they were admitted to the study and 1 September 1980. The relative risk of developing the disease in women who had used oral contraceptives in comparison with those who had never used them was estimated to be 0.96 (95% confidence limits 0.59 to 1.63). Among women aged under 35 years, the corresponding relative risk (based on only 14 women with breast cancer) was estimated to be 0.61. No relation was apparent between the risk of developing breast cancer and duration of oral-contraceptive use or interval since first oral-contraceptive use in any age group. The data in this study are thus reassuring; but observations based on women with long-term use of oral contraceptives, especially those starting to use the preparations at an early age, are few.

Adult↗
PubMed1981

Pelvic inflammatory disease and the intrauterine device: findings in a large cohort study.

The incidence of pelvic inflammatory disease was investigated among parous women taking part in the Oxford-Family Planning Association contraceptive study. Hospital admission rates for "acute definite" disease were 1.51 per 1000 woman-years among those currently using an intrauterine device (IUD) and 0.14 per 1000 woman-years among those using other methods of birth control (age-standardised relative risk 10.5 to 1 with 95% confidence limits of 5.4 to 1 and 32 to 1). There was little evidence of an increased risk of such disease in ex-users of an IUD. Hospital admission for "chronic definite" disease, on the other hand, was commoner in ex-users of an IUD than in current users. Acute definite disease occurred somewhat more frequently during the early months of use of an IUD than during the later months. While the rate of such disease was increased in users of each type of device, the highest rate (8.1 per 1000 woman-years) was observed in users of the Dalkon shield. This rate, however, was based on only three affected women.

Acute Disease↗
PubMed1981

Longitudinal study of intraocular lens implants after intracapsular cataract extraction. Complete follow-up of the first 7 years.

Lens implant surgery has a significant complication rate, although most complications are treatable and occur within the first 2 months after operation. The short-term visual results are comparable with the published results of intracapsular extraction alone. Six cases of bullous keratopathy developed in 138 cases in 7 1/2 years. When endothelial cell density fell below 500/mm2, corneal oedema developed within the year. However, a more recent study showed that endothelial cell loss was much reduced by the closed chamber technique of insertion and by serum coating of the implant.

Aged↗