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P Fayers

Publications and source records attributed to P Fayers.

At least 37 records · Page 2Linked to original sources
PubMed1995

Quality of life.

Explore the source record for details and available documents.

Clinical Trials as Topic↗
PubMed1995

MRC quality of life studies using a daily diary card--practical lessons learned from cancer trials.

The UK Medical Research Council (MRC) Daily Diary Card for quality of life (QOL) assessment was first designed over ten years ago, and since then has been in continuous use in cancer clinical trials organized by the MRC Cancer Trials Office. However, clinical trials using this technique have only reached maturity since 1989 and later. Thus it is timely to review the experiences gained by use of this method of assessing QOL. Results from a series of clinical trials confirm that the Daily Diary Card appears to be a valid, reliable and sensitive instrument which is able to detect the transient changes in health and QOL which occur on a day to day basis during therapy for cancer. However, in early studies we also encountered a number of problems which were addressed during later MRC trials; we believe that many of these are of general importance to any investigation of QOL in patients, many of the issues raised remain controversial, and the practical lessons learned from applying the Diary Card will be of relevance to those planning future studies of QOL assessment.

Clinical Trials as Topic↗
PubMed1995

UKCCCR Register of U.K. Cancer Trials.

The UKCCCR Register of U.K. Cancer Trials comprises an on-line database of all randomized trials of cancer therapy, whether phase III or randomized phase II trials. Both current or open trials, and closed or completed trials, are included. Abstracts of any publications associated with the trials are also included. The UKCCCR Register is the initial component of a larger European register of trials. This article describes the structure and content of the database, the PC program for data entry, and the Unix-based browsing software for interactive access over networks. Problems of ensuring complete and comprehensive registration of trials, and sources of information, are also reviewed.

Clinical Trials, Phase II as Topic↗
PubMed1992

Blood pressure in first 10 years of life: the Brompton study.

OBJECTIVES: To determine the normal range of blood pressure and its pattern of change in the first 10 years of life. To estimate at what age (if any) children consistently appear in one part of the blood pressure distribution and at what age familial correlations in blood pressure become significant. DESIGN: Longitudinal cohort study. SETTING: South east England. SUBJECTS: 2088 children of both sexes born consecutively in Farnborough Hospital, Kent, and their parents. MAIN OUTCOME MEASURE: Blood pressure measured by Doppler ultrasonography and sphygmomanometry. RESULTS: Systolic blood pressure rose from a mean of 88.5 mm Hg at age 6 months to 96.2 mm Hg at 8 years measured with a 8 cm cuff and from 89.1 mm Hg at age 5 years to 94.3 mm Hg at age 10 years measured with a 12 cm cuff. The larger cuff gave blood pressure readings about 6 mm Hg lower. This effect was independent of body weight and arm circumference. Diastolic blood pressure rose from 57.8 mm Hg at 5 years to 61.8 mm Hg at 10 years (12 cm cuff). There was only about 1 mm Hg difference between sexes. Blood pressure was correlated with weight, weight adjusted for height, height, and arm circumference at all ages studied. The correlation coefficient of repeated yearly measurements increased steadily with age from 0.28 at 2 years to 0.59 at 10 years. The correlation coefficients between child's blood pressure and mother's average blood pressure increased from 0.1 at age 1 year to 0.23 at age 10. CONCLUSIONS: Blood pressure changes relatively little between the ages of 6 months and 10 years. Yet because of the increasing strength of between occasion and family correlations, children are more consistently occupying a specific part of the blood pressure distribution as they grow older. Studies in children should help determine why some adults have hypertension and others do not.

Aging↗
PubMed1988

Intermediate to late term results of Mustard's procedure for complete transposition of the great arteries with an intact ventricular septum.

Overall survival after Mustard's operation was assessed in 130 patients with complete transposition of the great arteries and an intact ventricular septum who were operated on at the Brompton Hospital in the 12 year period from January 1974 to December 1985. Actuarial analysis showed a survival at five years of 79.1% (25 deaths in 130 patients). Half the deaths occurred within a month of operation and half up to five years later. Operation under the age of three months carried a greater mortality (six deaths in 11 patients). Statistical analysis showed that these survival figures were consistent throughout the series and did not alter with the year of operation. In the light of recent trends in treatment of this lesion, it is concluded that for neonates an arterial switch procedure is now likely to carry the best chance of long term success. For the patient who presents after the age of three months, however, there may still be a place for the Mustard procedure.

Age Factors↗
PubMed1987

Survival after balloon atrial septostomy for complete transposition of great arteries.

Mortality before surgery must be taken into account when comparing the surgical mortality of atrial redirection procedures (Mustard's or Senning's operation) and the arterial switch operation for patients with complete transposition. This is because the switch operation is usually performed within the neonatal period or early infancy but Mustard's or Senning's operation usually after 4 months of age. The outcome of balloon atrial septostomy was therefore assessed in all 102 infants with transposition of the great arteries (plus or minus associated anomalies) who underwent the procedure at our hospital in the 10 years from January 1975 to December 1984. We considered the procedure to have been unsuccessful if the patient died from any cause (including other surgical procedures) between the septostomy and subsequent interatrial repair (Mustard's operation) or arterial switch operation. Eighteen patients died, although in only two was this as a direct result of the septostomy. Statistical analysis showed that low weight, presence of a persistent arterial duct, and coarctation of the aorta were significant risk factors. Early survival of infants with transposition of the great arteries has been dramatically improved after the introduction of balloon atrial septostomy. Nevertheless, there is considerable attrition before definitive repair, which must be included in the prediction of overall outcome.

Body Weight↗
PubMed1986

The fetal phonogram: a measure of fetal activity.

In 12 pregnant mothers fetal sounds and infrasounds were recorded by means of a new compliance matched transducer and compared with a simultaneous ultrasound record of fetal activity. A defined pattern on the fetal phonograph correlated with 86% of the total fetal breathing detected with ultrasound, and a further distinctive pattern was associated with 90% of fetal movements. Examination of the fetal phonocardiogram when the fetus was breathing showed a significant increase in the short-term variability of both the systolic and diastolic times when compared with non-breathing episodes. The median amplitude variabilities for both the first and the second heart sounds were also significantly increased during fetal breathing. Measurement of fetal sounds and infrasounds with a compliance matched transducer offers a non-invasive method for assessment of fetal activity for long periods of time.

Auscultation↗
PubMed1983

Randomised controlled comparative study of methyldopa and oxprenolol in treatment of hypertension in pregnancy.

One hundred pregnant women with hypertension (defined as diastolic blood pressure at or above 95 mm Hg) were allocated at random to treatment with methyldopa or oxprenolol and were compared with nonhypertensive controls matched according to parity and gestation at delivery. The patients were also stratified into those entering the study early (before 32 weeks' gestation) and those entering late (after 32 weeks' gestation). Although there were no differences in diastolic blood pressure between the hypertensive groups before or during treatment, in the early entry group the systolic blood pressure at entry of those allocated to oxprenolol was significantly higher than that of those receiving methyldopa; this difference remained throughout the treatment period. Also in the early entry group further increments of drug treatment were required to control blood pressure of patients receiving oxprenolol than in those receiving methyldopa. The eventual fetal outcome for all patients treated with methyldopa was the same as that for those treated with oxprenolol; birth weight, placental weight, head circumference, and Apgar score were not significantly different and there were no stillbirths in either group.

Adult↗
PubMed1980

Value of repeated blood pressure measurements in children--the Brompton study.

Systolic blood pressure were measured in 1797 infants aged 4 days and then repeated at 6 weeks, 6 months, 1 year and then yearly until 4 years of age. The mean pressure rose from 76 mm Hg at 4 days to 96 mm Hg at 6 weeks but did not vary appreciably between subsequent measurements. Serial correlation coefficients of blood pressure adjusted for weight and degree of consciousness were calculated, comparing measurements at each age. At ages under 1 year the correlation coefficients were relatively weak, though most were significant (r < 0.2). As the children grew older these serial correlations became stronger, so that the correlation coefficient in blood pressure between ages 3 and 4 years was 0.47. These observations suggest that "tracking" for blood pressure starts at about 1 year and is much stronger by 4 years. Taken in conjunction with the findings of other long-term follow-up studies in older children, this suggests that children develop blood pressures indicative of their adult values between 1 and 4 years.

Aging↗
PubMed1980

Blood pressure in the first 6 weeks of life.

Systolic blood pressure was measured at frequent intervals during the first 6 weeks of life in 99 normal neonates. Blood pressure rose from a mean of 70 mmHg at age 2 days, to 93 mmHg at age 6 weeks in babies awake; the majority of this rise (14 mmHg) took place in the first 2 weeks of life. The blood pressure measured when infants were asleep was lower than in those awake, but increased in a similar manner. Blood pressure of infants at 2 days was not significantly affected by method of delivery, or by the anaesthesia or analgesia that the mothers received in labour. It was not related to the Apgar score at one or five minutes.

Apgar Score↗
PubMed1980

Systolic blood pressure in a population of infants in the first year of life: the Brompton study.

Systolic blood pressure (BP) was measured by the Doppler technique and random zero sphygmomanometer in a sample of infants between the ages of 4 days (n = 1,740) and 1 year (n = 1,338). Mean systolic BP rose from 76 mm Hg at age 4 days to 96 mm Hg at age 6 weeks in babies awake, and showed little further variation at 6 months and 1 year. The BP was approximately 6 mm Hg higher in babies awake than asleep. Blood pressure was nearly normally distributed at all ages and the 95th percentile for BP of babies awake was 95 mm Hg at 4 days and 113 mm Hg between 6 weeks and 1 year. A comparison of intra-arterial and Doppler BP confirmed that both inflation bag length and cuff width are important for accurate measurement.

Age Factors↗
PubMed1977

Effect of feeding habit on weight in infancy.

A population study of 758 infants born at the same hospital showed that weight at the ages of six week and six months was not significantly related to breast or bottle feeding, the early introduction of solids, or the sodium content of bottle feeds. Weight at six weeks was related to the volume and energy content of the feeds which were examined in those bobies that were bottle-fed alone. Although analysis of a single feed showed that mothers mixed feeds incorrectly, there was no evidence that mixing of overstrength feeds leads to obesity.

Age Factors↗
PubMed1976

Blood pressure survey in a population of newborn infants.

Systolic blood pressure in the arm was measured in infants at the ages of 4 to 6 days and 5 to 7 weeks by the Doppler ultrasound technique. At the age of 4 to 6 days the mean blood pressure (+/- SE of mean) in 469 sleeping infants was 70-7 +/- 0-3 mm Hg, rising at 5 to 7 weeks to 89-7 +/- 0-9 mm Hg (in 144 infants). In 252 infants awake at 5 to 7 weeks blood pressure was 96-8 +/- 0-6 mm Hg. In 391 infants in whom measurements were made on both occasions blood pressure at 4 to 6 days was significantly related to blood pressure at 5 to 7 weeks. Thus those infants with relatively high blood pressures at 4 to 6 days showed a weak tendency to have relatively high blood pressures at 5 to 7 weeks. In this trend continues with age it would suggest that the tendency to develop hypertension may already be demonstrable at the age of 4 to 6 days.

Blood Pressure↗