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Biomedical subjects

K McPherson

Publications and source records attributed to K McPherson.

At least 235 records · Page 13Linked to original sources
PubMed1980

Neurotic illness and its response to anxiolytic and antidepressant treatment.

Two hundred and forty neurotic out-patients were allocated to no diagnostic category but were rated in terms of observer and self ratings of both depression and anxiety at weekly intervals during a 4-week trial of amitriptyline, diazepam, amitriptyline and diazepam, and placebo. The sample could not be divided into anxious and depressed groups on the basis of the clinical picture. The outcome tended to be good irrespective of medication but the significant drug effects found were due to amitriptyline and concerned measures of anxiety as well as depression. It is concluded that a distinction between anxiety and depression in neurotic out-patients is of no practical value with regard to drug treatment.

Adjustment Disorders↗
PubMed1979

An epidemiological study of oral contraceptives and breast cancer.

During 1968-77, 707 women aged 16-50 years with newly diagnosed breast cancer and 707 matched controls were interviewed at eight teaching hospitals in London and Oxford about their use of oral contraceptives. Eighty-six of the patients with breast cancer were matched with controls with gall-bladder disease; these subjects were omitted from the main analyses, which thus related to 621 case-control pairs.The results were reassuring. A few statistically significant differences in oral contraceptive use were found between the breast cancer and control groups, but the data were subdivided in many ways, so that some "significant" differences would have been expected to occur by chance. The only subgroup in which the evidence for a positive association between pill use and breast cancer was at all convincing comprised women aged 46-50 years, but trends in those aged 41-45 were by and large in the opposite direction and results of combined analysis gave no cause for concern.Information on clinical stage was available for 487 patients with breast cancer treated before the end of 1975. Those who had never used oral contraceptives had appreciably more advanced tumours at presentation than those who had been using the pill during the year before detection of the lump, while past users of the pill occupied an intermediate position. This difference in staging was reflected in the pattern of survival. Oral contraceptives may have had a beneficial effect on tumour growth and spread, though diagnostic bias could not be definitely excluded.

Adolescent↗
PubMed1979

Hospital admission rates of diabetic children.

In 1973 a children's diabetic clinic was established in Oxford. An analysis has been made of the effects this has had on the pattern of emergency admissions classified as severe hyperglycaemia (A), moderate hyperglycaemia (B) and hypoglycaemia (C). A comparison of the admission rate per "diabetic year" over the four years before and the three years after the children's clinic was established showed a significant decrease in admission rate for all hyperglycaemic admissions (p less than 0.05). This decrease was shown to be mainly due to a reduction in admissions with severe hyperglycaemia (A) (p less than 0.01), there being no significant change in admission rate for moderate hyperglycaemia (B). There was no significant change in admission rate for hypoglycaemia (C).

Age Factors↗
PubMed1978

Epidemiology and clinical significance of cervical erosion in women attending a family planning clinic.

Women attending a family planning clinic were studied to determine the relation between cervical erosion and clinical and social characteristics. The appearance of the cervix was recorded without knowledge of the women's symptoms. The prevalence of erosion increased with parity but, when the effects of other factors were controlled, decreased in women aged 35 and over. Erosion was significantly more common in women taking the "pill" and less common in women using barrier methods of contraception than in others. There was considerable variation between doctors in the reporting of erosion. No association was found between erosion and postcoital bleeding, dyspareunia, backache, or dysuria. There was a significant but modest association between erosion and vaginal discharge and a suggestion that erosion may sometimes be associated with nocturia and frequency of micturition. Vaginal flora was similar in women with and without erosion. Cervical erosion should not be regarded as pathological in asymptomatic women, nor should it be assumed necessarily to be the cause of symptoms in women with genitourinary complaints.

Adolescent↗
PubMed1978

The effect of age, sex and other factors on blood chemistry in health.

Quantitative data is presented concerning the influence that age, sex, the menopause, oral contraception, blood group and time of blood collection have on 19 commonly-determined blood chemistry values. The data were derived from 1000 healthy blood donors in whom blood sampling conditions were standardised to conform with those applying to hospital out-patients. Statistical techniques were used to allow for the effects of analytical variation and to enable the effects of the various factors and their interactions to be expressed in a practically useful manner. Age and sex effects are shown to be the rule and to interact in many instances. Creatinine, urea, glucose, cholesterol, potassium and globulin show a tendency to increase in concentration with age, while total protein, albumin, calcium, inorganic phosphate and iron levels tend to fall progressively. Evidence is given to suggest that many of the changes occurring in women at about 50 years should be attributed to hormonal changes. In all instances when the menopause has a significant influence there is a rise in the concentration of the constituent concerned. It is proposed that other laboratories should assemble age and sex stratified reference ranges from (a) figures given for the mean values for defined age and sex groups, adjusted if necessary to allow for different analytical bias, (b) figures given for nonsystematic biological variation, and (c) their own measurements of analytical precision. Details of the necessary procedure are given, allowance being made for logarithmic transformation of the results where necessary.

Adolescent↗
PubMed1978

Fertility after stopping different methods of contraception.

Data on the return of fertility after discontinuing various methods of contraception were collected from among the women taking part in the Oxford-Family Planning Association contraceptive study. Return of fertility was measured as the time taken to give birth to a child. The fertility of both nulligravid and parous women who stopped taking oral contraceptives was initially impaired in comparison with that of women who stopped using other methods of contraception. But the effect of oral contraceptives on fertility had become negligible by 42 months after cessation of contraception in nulligravidae and by 30 months in multiparae. Impairment seemed to be independent of the length of use of oral contraceptives. Data relating to IUD users were sparse, but the figures that were available were reassuring. These results suggest that, although women may have temporary impairment of fertility after discontinuing oral contraception, they are unlikely to become permanently sterile through taking the pill.

Adult↗
PubMed1978

Neoplasia and dysplasia of the cervix uteri and contraception: a possible protective effect of the diaphragm.

Among the 17,032 women included in the Oxford-Family Planning Association contraceptive study, 65 developed biopsy proven cervical neoplasia (including dysplasia) prior to 1 September 1977. The incidence rate in diaphragm users (0.17 per 1000 woman-years of observation) was much lower than the rates in oral contraceptive users or intrauterine device users (0.95 and 0.87 respectively). This difference could not be explained in terms of confounding variables, nor was it attributable to a lower frequency of cervical smearing among diaphragm users within the clinics. Detailed information about age at first intercourse, numbers of sexual partners and the frequency of cervical smearing outside the clinics was obtained from 52 of the women with cervical neoplasia and 139 matched controls. Diaphragm users were less likely to have had coitus at an early age and had had materially fewer sexual partners than users of the other two methods of contraception. After adjusting for the effects of these variables, however, the risk of cervical neoplasia in diaphragm users was still only about one quarter that in the users of the other methods. Patterns of smearing varied little between users of the various contraceptive methods. Smoking emerged as a major "risk factor" for cervical neoplasia in this study. This probably implies that the smoking habit reflects some important aspect of sexual behaviour relevant to the production of the disease that we have been unable to measure.

Adult↗
PubMed1977

Mortality among women participating in the Oxford/Family Planning Association contraceptive study.

43 deaths are known to have occurred among the 17 032 participants in the Oxford/Family Planning Association contraceptive study up to the end of April, 1977. 9 deaths from cardiovascular causes have been observed among the women in the oral-contraceptive entry group (49 681 woman-years of observation) while no such deaths have been observed among the women who entered the study while using a diaphragm or an intrauterine device (39 146 woman-years of observation). These findings are consistent with the results presented in the accompanying report from the Royal College of General Practitioners Oral Contraception Study.

Adult↗
PubMed1977

Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples.

Part I of this report appeared in the previous issue (Br. J. Cancer (1976) 34,585), and discussed the design of randomized clinical trials. Part II now describes efficient methods of analysis of randomized clinical trials in which we wish to compare the duration of survival (or the time until some other untoward event first occurs) among different groups of patients. It is intended to enable physicians without statistical training either to analyse such data themselves using life tables, the logrank test and retrospective stratification, or, when such analyses are presented, to appreciate them more critically, but the discussion may also be of interest to statisticians who have not yet specialized in clinical trial analyses.

Drug Evaluation↗
PubMed1976

Biological and analytical variation of commonly determined blood constituents in healthy blood donors.

The relative contributions of analytical error and non-systematic biological variation to the reference range for 19 commonly-determined blood chemistry values have been estimated during the course of studying 1000 healthy blood donors. Estimates of non-systematic biological variations are arrived at by determining the variation found in donors matched for factors known to affect blood chemistry such as age and sex, and deducting the within-batch analytical error which applied. Comparison of the within-batch and between-batch analytical precision with the biological variation showed that the percentage increases in the normal range attributable to between-batch analytical error varies between 1 and 29%. This contribution is particularly large in the case of the electrolytes and amounts to no less than 29% in the case of calcium. Apart from well-known relationships a remarkable lack of correlation between the concentration of the different constituents in health is demonstrated.

Adolescent↗