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Biomedical subjects

M Alderson

Publications and source records attributed to M Alderson.

11 recordsLinked to original sources

Ventricular function in snorers and patients with obstructive sleep apnea.

We hypothesized that intermittent hypoxemia and increased ventricular afterload due to obstructive apnea during sleep (OSA) would cause chronic left ventricular dysfunction. Overnight polysomnography, M-mode and two-dimensional echo-Doppler studies while awake were performed on 51 consecutive snorers, 30 with OSA and 21 without apnea. Patients with previous myocardial infarction, awake hypoxemia or hypercapnia, or other causes of nocturnal hypoxemia were excluded. Echo-Doppler measurements included end-diastolic right and left ventricular dimensions and wall thickness, indices of left ventricular systolic performance (fractional shortening, ejection fraction and ejection time and diastolic performance, (isovolumic relaxation time, ratio of peak early [E] to late [A] diastolic transmitral flow and mitral pressure half-time). Both OSA patients and nonapneic snorers were of similar age. Although OSA patients were heavier, had a greater apnea-hypopnea index, and significant nocturnal hypoxemia, their echo-Doppler measurements were within normal limits and were not significantly different from nonapneic snorers. It is concluded that isolated obstructive sleep apnea does not cause chronic left ventricular dysfunction.

Adult

Hysterectomy rates and their influence upon mortality from carcinoma of the cervix.

Cumulative hysterectomy rates for women in England and Wales have been estimated from data in the Hospital In-Patient Enquiry, and the effect of hysterectomy operations on mortality from cancer of the cervix has been calculated. About six to seven per cent of women born at about the turn of the century have had an hysterectomy by the age of 70, and this proportion could rise to about 19% for women born in the 1940s if present operation rates continue. The time trends in mortality from cancer of the cervix between generations of women are not at present distorted by correction for women without a cervix. Operation rates and their effect on cervical cancer mortality rates are much smaller in England and Wales than in the United States of America.

Adult

Mortality from respiratory disease at follow-up of patients with asthma.

Over a 20-year period 765 men and 1127 women with asthma were followed up; 272 men and 282 women died compared with expected deaths of 165 men and 185 women. As anticipated there was an appreciable number of deaths attributed to asthma but an even higher absolute excess of deaths attributed to bronchitis when compared with the expected numbers. The relative excess from asthma and bronchitis was highest in the younger subjects. Mortality from all other causes was lower than expected.

Adult

A review of the National Health Service's computing policy in the 1970s.

The health service computer policy is reviewed in this paper particularly the potential contribution of some systems to information gathering. The paper begins with a brief description of the computer applications thought suitable for the medical field in the late 1960s, and two views of the future that were published in 1968. Two reports on computing and information systems in Scotland are then described; the general philosophy and specific proposals on the use of population files are contrasted with the initial Department of Health and Social Services' (DHSS) experimental computer program. The subsequent changes in English policy are revealed in the reports of three reviews published by the DHSS. The present development of a master patient index in Tayside is noted and the potential applications in management and planning of information stemming from such systems are discussed. It is suggested that lack of work in this field is a major gap in the programme of activity in England.

Computers

Consecutive primary carcinomas of the breast.

The incidence of consecutive primary carcinoma of the breast in 1489 women was 1 percent per year and remained constant for 20 years. The age of women with bilateral carcinomas was 6 years younger than those who had single tumors. Survival after the second tumor tended to be better in women less than 50 years. Patients who developed metastases had a shorter interval between the first and second tumors than those who remained free from the disease. Prognosis was the same in those with nonsynchronous carcinomas as in those with single tumors, and the incidence of positive nodes was the same in both groups. The prognosis was poorest in those who developed synchronous tumors. Prophylactic postoperative radiotherapy did not affect the incidence of consecutive breast carcinomas and did not alter prognosis. The results stress the importance of observing carefully the remaining breast, especially in younger women.

Adult

Relationship between month of birth and month of death in the elderly.

A special analysis of mortality data for England and Wales fof 1972 has been used to examine the relationship between month of birth and month of death. For persons 75 and over in eight subgroups (by sex and marital status) there was a consistent trend in deaths with an excess in the birth month and the following three months. This excess was of the order of only 1% of all deaths in the year but statistically significant for each subgroup. The method of analysis was adjusted for the nonsynchronous monthly variation in births and deaths, but a systematic error in recording the month of birth could not be excluded. A wide range of studies on the relationship between stress, morbidity, and mortality are briefly reviewed; it is suggested that in the elderly a birthday may in some subtle way influence the general morale of an individual. Further studies have been planned to test whether 'birthday stress' is a realistic explanation, or if a number of other hypotheses need to be invoked.

Age Factors