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Biomedical subjects

M Piper

Publications and source records attributed to M Piper.

49 records · Page 3Linked to original sources
PubMed1981

Prenatal diagnosis for the detection of Down syndrome: why are so few eligible women tested?

Postpartum women greater than or equal to 33 years were interviewed about their attitudes to and knowledge and use of prenatal diagnosis. Overall, 68 per cent had heard of prenatal diagnosis: nevertheless, only 30 per cent of those greater than or equal to 35 had actually been tested. The only significant difference between eligible women who were tested and those who were not was maternal age. Of those tested, half requested it for themselves; conversely, only two thirds of women requesting the procedure actually received it. Among women not tested, 82 per cent were never offered the procedure by the physician. Expressed attitudes to prenatal diagnosis were strongly positive among all women, with 75 per cent continuing to want testing after learning both their age-specific risk of having an affected child and the possible risks of amniocentesis. The data document a potential demand for amniocentesis far in excess of current use and present service facilities. They suggest, moreover, that underuse may reflect professional hesitation and underreferral more than consumer lack of demand or reluctance to be tested.

Adult↗
PubMed1981

Clinical and laboratory profile information in the prediction of death in elderly patients.

A study of prognosis over the first six weeks following admission to a department of geriatric medicine compared the predictive value of a clinical assessment at admission with other more objective parameters such as profile investigations, mental test score and assessment of dehydration and constitutional upset. A total of 739 patients were studied prospectively. The clinical assessment proved to be by far the strongest predictor of six-week mortality. In men the prediction it gave was not improved significantly by addition of the other factors. In women serum albumin, blood urea and assessment of constitutional upset added significantly to the prediction, thought the overall improvement in classification was small and mental test score made a borderline contribution only.

Aged↗
PubMed1980

Isolation of chromosomal origins of replication in yeast.

Origins of replication have been identified in the DNA of viruses, mitochondria, bacterial plasmids and the bacterial chromosome. However, origins of replication of eukaryote chromosomes have remained elusive because of the large size and sequence complexity of chromosomes and in particular for want of a suitable assay for their detection. Recent development of techniques for genetic transformation of yeast by autonomously replicating cytoplasmic plasmids now makes it possible to search for eukaryote origins in a manner analogous to that used for bacteria. Here we describe the construction and properties of a plasmid which contains no effective eukaryote replication origin and whose efficiency of replication in yeast is greatly enhanced by insertion of certain fragments of yeast chromosomal DNA. We believe these to contain replication origins, since yeast transformants are shown to contain copies of the transforming plasmids.

Base Sequence↗
PubMed1979

Prediction of outcome of patients admitted to a geriatric department.

The reliability of a clinical prognosis of outcome at six weeks has been investigated in a series of 1092 consecutive admissions to a geriatric department. The prognosis was made within a day of admission and made use only of the history and clinical findings. The results for discharge were good but categorization of patients who died or who stayed longer than six weeks was less reliable. Unpredicted deaths were often sudden or related to disease with developed after assessment. Other errors were due to over-optimism in forecasting response to medical treatment or rehabilitation. In other cases progressive deterioration had not been clearly recognized at our assessment based on a single point in time.

Aged↗
PubMedDate not supplied

Reduction in hospital readmission stay of elderly patients by a community based hospital discharge scheme: a randomised controlled trial.

STUDY OBJECTIVE: To compare a community support scheme using care attendants with standard aftercare for their effects on independence and morale of elderly patients discharged from hospital and on their use of health and social services. DESIGN: Randomised controlled study of cohort of patients over 75 discharged to their own homes. SETTING: District general hospital and community. PATIENTS: Total of 903 patients (mean age 82, 25% over 85). INTERVENTIONS: Total of 464 patients received support from care attendants on first day at home and for up to 12 hours a week for two weeks. Support comprised practical care, help with rehabilitation, and organising social help. The remaining 439 patients received standard aftercare. END POINT: Difference between two groups of 7% in hospital readmission rates or one point on activities of daily living scale (power 80%, significance level 5%). MEASUREMENTS AND MAIN RESULTS: Three months after the initial discharge 763 patients were interviewed (84%). There were no significant differences between the two groups in physical independence (activities of daily living scale), in measures of morale (Philadelphia scale), or in death rates. Hospital readmission rates within 18 months of discharge, however, were significantly higher in the control group and they spent more days in hospital (mean; control group 30.6 days, support group 17.1 days; p = 0.014). Of the patients living alone who were followed up for 18 months 21 (15%) receiving standard aftercare were readmitted more than twice compared with 6 (5%) supported by care attendants (p less than 0.01). CONCLUSIONS: If the findings are confirmed, and the policy extended to all patients over the age of 75 living alone, an average health district might expect either to save about 23 hospital beds at a net annual saving of about pounds 220,000 in the short term or to increase available beds by this number.

Activities of Daily Living↗