Biomedical subjects
N Gordon
Publications and source records attributed to N Gordon.
Cervical carcinoma in the Grampian region (1980-1991): a population-based study of survival and cervical cytology history.
OBJECTIVES: To study survival in women treated for cervical carcinoma in Grampian region, to identify clinical and pathological prognostic factors, and to correlate survival with cytology history. DESIGN: A retrospective study of all cases of cervical carcinoma using a prospectively gathered database. Data validated by 1 in 10 randomised retrospective case note sampling. SETTING: Aberdeen Royal Infirmary. SUBJECTS: Three hundred and sixty-three women resident within Grampian diagnosed as having cervical carcinoma between 1980 and 1991, with five-year survival data on the 206 diagnosed by the end of 1986. MAIN OUTCOME MEASURE: Five-year survival rates. RESULTS: The mean annual incidence of cervical carcinoma in our population was 11.2 per 100,000 women, with an overall five-year survival of 67% in those under 40 years of age and 60% in those aged 40 years and over. On univariate analysis, survival was significantly adversely affected by tumour stage, grade and absence of previous smears. On multivariate analysis, the effect of previous smear history was lost, but stage and grade remained strong independent risk factors for survival. There was no significant difference in five-year survival by age or tumour type. CONCLUSIONS: The prognosis of cervical carcinoma in Grampian region was independently affected only by stage of disease and tumour grading and cervical smear history.
Chinese paralytic syndrome or acute motor axonal neuropathy.
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Whole saliva in systemic lupus erythematosus patients.
Whole saliva composition and flow rate were examined in 22 patients with systemic lupus erythematosus and compared with matched healthy controls. Significantly lowered salivary flow rate was observed in patients with systemic lupus erythematosus unrelated to the subjective complaint of xerostomia. Salivary sodium, calcium, and magnesium concentrations were significantly higher in the SLE patients with systemic lupus erythematosus, whereas potassium and total protein concentrations and amylase activity did not differ significantly from the controls. Salivary IgA and IgM levels were significantly higher in the patients than in controls. IgA, IgG, IgM, C3, C4, antinuclear antibody, and anti-DNA antibody levels were measured in serum of the patients with systemic lupus erythematosus and correlated with salivary immunoglobulins. The only significant correlation between saliva and serum was found between levels of salivary IgG and serum anti-DNA antibody. The altered salivary composition might indicate a subclinical involvement of salivary glands in the patients.
The recent origins of paediatric neurology in the UK.
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Hereditary spastic paraplegia. A diagnostic reminder.
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Toxoplasmosis: a preventable cause of brain damage.
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Factors associated with early presentation of acute stroke.
BACKGROUND AND PURPOSE: Patients with stroke symptoms commonly delay many hours before seeking medical attention. We sought to explore the factors associated with early presentation of stroke patients to physicians. METHODS: We prospectively studied 100 consecutive acute stroke patients presenting to three large, urban medical centers. Using a standardized, structured interview and chart review, we assessed patient education about stroke, risk factors, clinical features of the stroke, source of stroke recognition, and timing of presentation. We did not study the distance from the site of stroke onset to the site of physician contact. RESULTS: Stroke onset time was known in 96 of the patients. Mean patient age was 71.3 years, 79% had at least one stroke risk factor, 26% had prior transient ischemic attack, 19% had prior stroke, 74% had some high school education, and 86% had regular physicians. Only 8% had been previously educated about stroke symptoms. Eighty one percent of strokes were ischemic. The mean time to physician contact was 13.4 +/- 2.3 hours (median, 4.0 hours) and to neurologist contact was 21.2 +/- 2.9 hours. A skewed distribution of presentation times accounts for the mean-median differences. A small number of patients presenting very late could have an effect on the correlations between presentation time and the variables studied. Early presentation time was associated with increased age, the sudden onset of a stable deficit, and recognition that the symptoms signified stroke. Only the sudden onset of a stable deficit correlated independently with early presentation time (P = .0048). There was no correlation between presentation time and prior transient ischemic attack or stroke, headache, vomiting, loss of consciousness or seizures at onset, or stroke subtype, but a type II error could not be excluded. CONCLUSIONS: Despite their education level, regular health care, and risk factors, especially prior stroke and transient ischemic attack, these patients were not knowledgeable about stroke and delayed many hours before contacting physicians. The course of symptoms and recognition that they signified stroke were associated with earlier presentation. Patient education focused on groups at risk may hasten the presentation and treatment of acute stroke.
Development and execution of a biomolecule purification method.
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Startle disease or hyperekplexia.
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The more unusual sleep disturbances of childhood.
The sleep patterns of children often cause anxiety to their parents. Some disturbances are unusual, and therefore may cause diagnostic difficulties. Sleep walking and night terrors can be confused with epileptic seizures. The sudden sleep of narcolepsy can lead to false accusations, when in fact the episodes are beyond the child's control. The associated phenomena of cataplexy, hypnogogic hallucinations and sleep paralysis can be particularly alarming, especially if they occur in the absence of narcolepsy. The overlap between narcolepsy and the Kleine-Levin syndrome is confirmed. Although of a different nature the sleep apnoea syndrome is equally important from the point of view of diagnosis and treatment.
Children with developmental dyscalculia.
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Chronic progressive epilepsia partialis continua of childhood: Rasmussen syndrome.
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Ethics rounds at the nursing home: an alternative to an ethics committee.
The increased attention in US medicine to medical ethics reflects in large part the "new" demography of a growing elderly population and the conflict of whether decisions regarding medical care should be based on cost-effectiveness or "human-effectiveness." Currently, about 40 percent of the nation's elderly end up in nursing homes where they confront ethical and legal dilemmas that would not arise in their own homes. In the nursing home, difficult medical-ethical decisions generally rely on two approaches: the often used but frequently invalid concept of informed consent and little used ethics committees. At The Jewish Home and Hospital for Aged in New York City we have developed a program of "ethics rounds" as an alternative to ethics committees. We conduct the rounds in the open style of a forum or clinical conference rather than with the aura of a decision-making group. We encourage the participation of patients and family and seek to educate the staff, any one of whom may choose to attend. The rounds consist of a multidisciplinary case presentation, an interview of patient and/or family, a discussion by the staff, and an overview by an ethicist. Staff response to the educational and interdisciplinary aspects of the rounds has been remarkably positive.
Integration of care and caring. Could you provide information on what the role of social services should be in long-term care facilities?
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George Eliot and specific learning disorders.
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Specific learning disorders: the possible role of brain damage.
The causes of many of the more subtle disorders of cerebral function are often obscure. Are they due to impaired development of the brain or to damage to the brain? Particularly if there is no definite evidence of the latter, and when talking to parents, it is better to use such terms as "minimal cerebral dysfunction". However this must not lesson in any way the constant search for the etiology of these disorders. There is no doubt about their frequency, and in one form or another, about one in ten children have special educational needs. There is therefore a major medical contribution to be made to the problems of these children, especially in terms of prevention. A review of the literature shows, among other causes, how often episodes during pregnancy and birth can lead to learning problems during school life. In the future the development of new neuroradiological, and other techniques, will help to explain these common disabilities.