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Biomedical subjects

R Doll

Publications and source records attributed to R Doll.

At least 217 records · Page 12Linked to original sources
PubMed1979

Minor tranquillisers and road accidents.

In a prospective study of 43,117 people, prescriptions issued by general practitioners over two years were linked with records of hospital admissions and deaths. For 57 people injured or killed while driving cars, motorcycles, or bicycles the medicines that had been dispensed in the three months before were compared with those dispensed for 1,425 matched controls. There was a highly significant association between use of minor tranquillisers and the risk of a serious road accident (relative risk estimate 4.9). the increased risk of accidents to drivers given tranquillisers could be due to the known psychomotor effects of these drugs or to effects of the conditions being treated. Whatever the reason, patients taking drugs such as diazepam should be warned that they are at special risk.

Accidents, Traffic↗
PubMed1978

Neoplasia and dysplasia of the cervix uteri and contraception: a possible protective effect of the diaphragm.

Among the 17,032 women included in the Oxford-Family Planning Association contraceptive study, 65 developed biopsy proven cervical neoplasia (including dysplasia) prior to 1 September 1977. The incidence rate in diaphragm users (0.17 per 1000 woman-years of observation) was much lower than the rates in oral contraceptive users or intrauterine device users (0.95 and 0.87 respectively). This difference could not be explained in terms of confounding variables, nor was it attributable to a lower frequency of cervical smearing among diaphragm users within the clinics. Detailed information about age at first intercourse, numbers of sexual partners and the frequency of cervical smearing outside the clinics was obtained from 52 of the women with cervical neoplasia and 139 matched controls. Diaphragm users were less likely to have had coitus at an early age and had had materially fewer sexual partners than users of the other two methods of contraception. After adjusting for the effects of these variables, however, the risk of cervical neoplasia in diaphragm users was still only about one quarter that in the users of the other methods. Patterns of smearing varied little between users of the various contraceptive methods. Smoking emerged as a major "risk factor" for cervical neoplasia in this study. This probably implies that the smoking habit reflects some important aspect of sexual behaviour relevant to the production of the disease that we have been unable to measure.

Adult↗
PubMed1978

Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and lifelong non-smokers.

In a 20-year prospective study on British doctors, smoking habits were ascertained by questionnaire and lung cancer incidence was monitored. Among cigarette smokers who started smoking at ages 16-25 and who smoked 40 or less per day, the annual lung cancer incidence in the age range 40-79 was:0.273X10(-12). (cigarettes/day+6)2. (age--22.5)4.5. The form of the dependence on dose in this relationship is subject not only to random error but also to serious systematic biases, which are discussed. However, there was certainly some statistically significant (P less than 0.01) upward curvature of the dose-response relationship in the range 0-40 cigarettes/day, which is what might be expected if more that one of the "stages" (in the multistage genesis of bronchial carcinoma) was strongly affected by smoking. If a higher than linear dose-response relationship exists between dose per bronchial cell and age-specific risk per bronchial cell, this may help explain why bronchial carcinomas chiefly arise in the upper bronchi, for dilution effects might then protect the larger areas lower in the bronchial tree.

Adolescent↗
PubMed1978

Atmospheric pollution and lung cancer.

Lung cancer is consistently more common in urban areas than in rural. The excess cannot be accounted for by specific occupational hazards but some of it might be due to the presence of carcinogens in urban air. The excess cannot be wholly due to such agents, because the excess in nonsmokers is small and variable. Cigarette consumption has also been greater in urban areas, but it is difficult to estimate how much of the excess it can account for. Occupational studies confirm that pollutants present in town air are capable of causing lung cancer in man and suggest that the pollutants and cigarette smoke act synergistically. The trends in the mortality from lung cancer in young and middle-aged men in England and Wales provide uncertain evidence but support the belief that atmospheric pollution has contributed to the production of the disease. In the absence of cigarette smoking, the combined effect of all atmospheric carcinogens is not responsible for more than about 5 cases of lung cancer per 100,000 persons per year in European populations.

Air Pollutants↗
PubMed1977

The case for recording events in clinical trials.

The value of clinical trials in detecting unwanted effects of new medicines would be enhanced if doctors recorded all adverse events experienced by patients and not just those regarded as adverse reactions to drugs. All events should be reported to the centre co-ordinating the trial and analysed in treated patients and controls. This method might have revealed the ocular toxicity of practolol before the drug was marketed in 1970.

Attitude of Health Personnel↗
PubMed1977

Cancer and fluoride.

Explore the source record for details and available documents.

Black or African American↗
PubMed1977

Mortality among patients with ankylosing spondylitis not given X-ray therapy.

We investigated age-specific mortality rates of 836 patients with ankylosing spondylitis diagnosed during 1935-57. These patients were not given deep x-ray therapy, and thus their mortality was not confounded by possible late effects of radiation. Follow-up observation was to January 1, 1968--on the average, over 13 years from enrollment. Men had higher mortality than women; excess mortality was observed in men for diseases known to be associated with spondylitis, such as ulcerative colitis, nephritis and tuberculosis or other respiratory disease. In addition, their mortality risk relative to the general male population was fourfold for all gastrointestinal disease, nearly twofold for accidents, suicide and cerebrovascular disease and 40 per cent in excess for other circulatory diseases. These results indicate that, at least in men, ankylosing spondylitis has life-threatening consequences related to many organ systems, consistent with systemic vascular degeneration as one long-term consequence of the disease.

Female↗
PubMed1977

Frequency of eye complaints and rashes among patients receiving practolol and propranolol.

Among 71 patients treated with practolol by general practitioners, eye complaints were recorded in the case-notes of 14 (20%) during treatment, compared with 4 (6%) during equal periods before the drug was prescribed. Half the patients with eye complaints also had a rash while receiving practolol. These findings, which were not due to greater numbers of attendances during treatment nor to awareness of the hazards of the drug, suggest that mild eye complaints were relatively common among patients treated with practolol. Among 246 patients treated with propranolol, the numbers with eye complaints before and during treatment were similar, although there was a significant excess of patients with both an eye complaint and a rash during treatment.

Adult↗
PubMed1977

Fluoridation of water and cancer mortality in the U.S.A.

Authoritative statements that fluoridation of public water supplies is not associated with any increase in cancer have been challenged on the basis of data which, it is claimed, show that cancer mortality in the United States rose more sharply in cities with fluoridated water than in those without. However, during the period of study (1950-70) the population structures of these cities changed substantially. When account is taken of age, sex, and ethnic group the ratio between observed cancer mortality and expected cancer mortality fell slightly in the cities with fluoridated water and did not change in the non-fluoridated cities.

Adolescent↗