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Biomedical subjects

K W Cross

Publications and source records attributed to K W Cross.

At least 37 records · Page 2Linked to original sources
PubMed1991

Assessment of a screening process to detect patients aged 60 years and over at high risk of hypothyroidism.

General practitioners are increasingly expected to screen elderly patients for common disorders, such as hypothyroidism, and the identification of at-risk patients by simple means would reduce the financial and other costs of such screening. A general practice based study of 1193 patients aged 60 years and over has been carried out to investigate the usefulness of the following factors in identifying those in whom biochemical testing for hypothyroidism would be indicated: personal history or family history of thyroid disease, symptoms of thyroid disease and body mass index. Of the 190 patients with either a personal or family history of thyroid disease, 28 (14.7%) had an elevated concentration of thyroid-stimulating hormone. Thus, 66 of the 94 patients (70.2%) with elevated concentrations of thyroid-stimulating hormone had no such thyroid history. Similarly, only nine (4.7%) of the patients with a personal or family history of thyroid disease required thyroxine replacement therapy. Thus, 22 of the 31 patients (71.0%) requiring such treatment had no such history. Discriminant analysis of the responses of women patients to questions concerning personal or family history of thyroid disease, the presence of symptoms of hypothyroidism, their age and body mass index identified only 51.3% of those with an elevated thyroid-stimulating hormone concentration and 77.2% of those with normal thyroid-stimulating hormone. Analysis of the responses of the men patients was even less discriminating.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Changes in practice morbidity between the 1970 and 1981 national morbidity surveys.

The primary aim of the study was to evaluate practice differences in reported morbidity in the second and third national morbidity surveys (1970/71, 1981/82) and to discuss their cause. A secondary aim concerned the validation of trends identified from analysis of the data from the total populations in the practices. Altogether 19 practices participated in both surveys. Annual prevalences (that is, the number of patients attending the general practitioner with a condition per 1000 persons at risk) were examined for: all conditions; each of three categories of seriousness of disease; diseases aggregated by chapter of the International classification of diseases; and each of 130 rubrics of the disease classification. Annual prevalence for 'all conditions' was approximately the same for males in both surveys, whereas for females there was an increase. In both sexes, annual prevalence for 'serious conditions' increased slightly and for 'trivial conditions' increased substantially. For 'intermediate conditions', there was a modest decrease in males. In the analysis at ICD chapter level, substantial increases in prevalence occurred in infectious diseases, nervous system diseases, circulatory diseases, genitourinary diseases, musculoskeletal diseases, symptoms, signs and ill-defined conditions, injuries and poisonings. Decreases were found in blood diseases, mental disorders and digestive diseases. Among 130 individual conditions examined, increased annual prevalence was found for mumps, fungal infections, hypothyroidism, diabetes, gout, senile dementia, angina, left heart failure, catarrh, hay fever and asthma, orchitis, acne, osteoarthritis and for some symptoms. Decreases were found for iron deficiency anaemia, anxiety state, refractive errors, haemorrhoids, chronic bronchitis, functional disorders of the stomach, carbuncle and skin infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Observations on the influenza epidemic of November/December 1989.

This paper reports on the surveillance of influenza by the weekly returns service of the Royal College of General Practitioners during the epidemic of November/December 1989. An epidemic of influenza became evident in mid-November and incidence peaked in the week beginning 6 December. The increase in incidence of influenza-like illness and of aggregated data for all respiratory disease to above the levels for non-epidemic years occurred one week before that attributed to influenza. The pattern of incidence was similar in the three geographic regions of England and Wales. The peak was first achieved in the age group 5-14 years and last in age 65+ years. The pattern of deaths from all causes closely followed the pattern of respiratory disease with an interval of between one and two weeks. During the period 15 November to the end of the year there were approximately twice as many people reporting respiratory disease than was usual for this time of year. The peak weekly incidence was the highest recorded for 12 years but it was substantially less than the peaks for the winters of 1969/70, 1972/73 and 1975/76. Further research is in progress to establish the most effective means of monitoring influenza epidemics.

Adolescent↗
PubMed1988

A preliminary study of excess mortality using a psychiatric case register.

Systematic screening of death certificates referable to residents of two health districts covered by a psychiatric case register allows the study of excess mortality in unselected psychiatric patients from a defined area of known population. Deaths among the case register patients exceeded those expected by 80%; the relative risk was maximal during the first year after registration and was significantly raised in both sexes and in patients of all age-groups. Patients may be selected by service use and by diagnostic group: the excess mortality of "inpatients" both in relative and absolute terms exceeded that of "outpatients". For dementia patients both the relative risk and more notably the absolute risk was high, and the excess mortality was significantly raised in both sexes and all age-groups. It was again greatest during the first year after registration. Deaths of patients with schizophrenia and paranoid psychosis exceeded those expected by 40 per cent and the excess was limited to the first year after registration and occurred predominantly among men.

Adolescent↗
PubMed1985

List size, screening methods, and other characteristics of practices in relation to preventive care.

Twenty eight practices carried out a review of patient records for information about preventive procedures on two occasions in 1980 and 1982. We have now undertaken a survey of certain characteristics of the practices in an attempt to demonstrate features associated with effective preventive care. Significant favourable factors are a small list size, the setting up of a formal screening programme for cervical cytology and measuring blood pressure, and few registered patients in social classes IV and V. More successful practices also tend to be training practices, have principals with higher qualifications, and have developed good records organization. Opportunistic screening for cervical cytology and measuring blood pressure was not shown to be more effective than no policy of screening at all.

Adolescent↗
PubMed1984

Respiratory symptoms and pulmonary function of welders in the engineering industry.

We have studied respiratory symptoms, smoking habits, chest radiographs, sickness absence, and pulmonary function among 258 welders and an equal number of matched control subjects in three engineering factories. Welders who smoked had a higher frequency of chronic phlegm production than control subjects but there was no difference in cough or dyspnoea. The frequency of abnormality on chest radiographs was low and similar in welders and controls. Upper respiratory infections were a more frequent cause of sickness absence in welders than in controls but no difference was found in other respiratory diseases. FEV1 and peak expiratory flow rate were similar in welders and controls. In a subset of 186 subjects the maximum expiratory flow rate at low lung volumes was significantly less in welders who smoked than in control subjects who smoked, but there was no difference in non-smokers. Welders working under these conditions in the engineering industry appear to have no increased risk of chronic obstructive lung disease.

Absenteeism↗
PubMed1984

Psychotropic drug prescribing.

This study was based on the recording of psychotropic drug prescribing over two weeks by 269 doctors using practice activity analysis (PAA) data sheets. The overall mean rates for patients receiving one or more psychotropic drugs were 17.5 per 1,000 list size and 130 per 1,000 consultations; and for prescriptions issued the rates were 20.6 per 1,000 list size and 153 per 1,000 consultations. Recorders were classified into five categories ;low' to ;high', by the volume of prescribing and this paper is concerned with the comparison between them. Between the high and low categories there was a twofold difference in the prescribing of new prescriptions, a fourfold difference for continuing prescriptions and a tenfold difference for repeat prescriptions; 51 per cent of all prescriptions were issued as ;repeats'.Other features of prescribing have been studied in each of the categories. Prescribing rates vary little with workload. Increasing trends are evident from the low to high categories for the use of polytherapy and for the proportion of elderly persons who received prescriptions; the proportion of male patients (28 per cent) was consistent in all categories. The relative proportion of prescriptions by drug group (tranquillizers, antidepressants and hypnotics) was reasonably uniform in all categories.

Adult↗
PubMed1983

Life events, social interaction and psychiatric symptoms in general practice: a pilot study.

Thirty-two adult females who consulted a general practitioner with psychiatric training were assessed by questionnaires on first attendance and at follow-up 6 months later. Major life events and the degree of social support were of importance. Failure to improve was associated with major negative life events; in the absence of such events, improvement seemed likely to occur given a high degree of social support; major positive events appeared to be associated with improvement, regardless of the degree of social interaction. These factors, and the initial and final GHQ scores, are inter-related in a complex manner and it is suggested that these findings merit further investigation on a larger sample of patients.

Adult↗
PubMed1979

Hats for the newborn infant.

The efficacy of a Gamgee-lined hat in reducing the rate of fall in rectal temperature of infants during the first 30 minutes of life was studied. The trial, which included 211 infants, was randomised, prospective, and controlled. One hundred and seven infants were exposed to overhead radiantheaters. Of these, only 30 had normal deliveries, so the analysis was confined to the infants who were not subjected to radiant heat, and in this group no conclusions were drawn about the efficacy of a hat or a radiant heater. In the 104 infants not subjected to radiant heat, body weight, initial rectal temperature, the application of hat, the environmental temperature, and the duration of exposure while naked were all found to influence measureably the rate of fall in rectal temperature during the first 30 minutes. Gamgee-lined hats should be routinely used to minimise heat loss, especially in small infants exposed at birth, during surgical operations, and during investigations necessitating prolonged exposure.

Body Temperature↗
PubMed1979

An estimation of intracranial blood flow in the new-born infant.

1. A non-invasive method for the estimation of the intracranial blood flow of the new-born infant is described, and results obtained with it are presented. 2. The technique is a novel application of the principle of blood flow measurement by venous occlusion plethysmography. It is possible to apply a plethysmographic technique to the neonatal cranium because the presence of open sutures between the component bones permits small, but readily measurable, changes in intracranial volume to occur. 3. Skull volume changes are calculated from changes in the occipito-frontal circumference of the cranium as recorded and measured with a mercury-in-Silastic strain gauge. 4. The jugular veins in the baby's neck are occluded by finger pressure and there follows an increase in skull volume, which is rapid at first, but which decreases exponentially as venous drainage diverts to non-occluded channels such as the vertebral venous plexus. At the instant of jugular occlusion the rate of skull volume increase is representative of the rate of flow in the jugular vessels prior to occlusion, and so provides an index of the relative magnitude of the intracranial blood flow. The method thus allows changes in intracranial blood flow to be followed. When occlusion is released cranial volume decreases, initially rapidly, but slowing exponentially as resting volume is regained. 5. A theoretical model of the events occurring during the inflow and outflow phases has been developed, and a formula derived which allows an estimation to be made of the flow of blood through uncompressed channels. The measured value of jugular blood flow can then be augmented to an estimate of total intracranial flow. 6. The mean cerebral blood flow of sixteen normal babies was estimated to be 40 ml. 100 g-1.min-1 (S.D. = +/- 11.63).

Brain↗