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Biomedical subjects

R M Pickering

Publications and source records attributed to R M Pickering.

42 records · Page 3Linked to original sources

Relative risks of low birthweight in Scotland 1980-2.

Routinely collected data for 187,000 Scottish singleton livebirths in 1980-2 were used to relate the risk of birthweight below 2500 g, 2000 g, 1500 g, and 1000 g to sex of infant and nine maternal factors. Maternal height was a major predictor of birthweight below 2500g but was less important in predicting birthweight in the lower intervals. A history of prenatal death and spontaneous abortion was important for all four intervals and was associated with most extreme risks for birthweight below 1000 g. The analysis confirms that the patterns of risk of birthweight below 2500g and 2000 g associated with social class, marital status, and maternal age and height found among the women of the 1958 cohort of British births are still applicable in the early 1980s.

Body Height↗

Risks of preterm delivery and small-for-gestational age infants following abortion: a population study.

We examined hospital discharge records in 1980-81 for singleton third trimester deliveries in Scotland. We compared 3000 women who had previously experienced induced termination of pregnancy, and 4000 who had experienced spontaneous abortion with primigravidae and with women in their second pregnancy, their first having resulted in a livebirth. Two aspects of low birthweight were examined: delivery before the 37th completed week of gestation, and low birthweight for gestational age. Our comparisons were further controlled for maternal height, age, sex of infant, marital status and social class. Women with previous spontaneous abortions experienced significantly increased risk of preterm delivery but not of low birthweight for gestational age. Women with a history of induced abortion also experienced increased risk of preterm delivery, but for women aged 18-24 years, risk of low birthweight for gestational age was significantly reduced compared with primigravidae.

Abortion, Induced↗

A classification of Scottish infants using latent class analysis.

This paper illustrates the use of latent class analysis to classify 50,000 infants into a small number of classes or case types, as a preliminary to a study of the allocation of neonatal hospital resources throughout Scotland. Information, extracted from a detailed neonatal discharge record, was summarized by 11 clinical and diagnostic catagorical variables. Statistical models incorporating 1 to 6 latent classes were then estimated using the EM algorithm. The 4 class model was chosen because it provided a good description of the data and the resulting classes had a medical interpretation. The factors influencing the choice of model are discussed and goodness of fit tests are presented. The stability of the classes was also investigated using random halves of the data and an earlier comparable data set.

Classification↗

Predicting fallers in a community-based sample of people with Parkinson's disease.

BACKGROUND: The risk of people with Parkinson's disease (PD) falling is greater than that of the general population but to date, disease-specific predictors of falling have not been identified. OBJECTIVES: To identify one or more features, which would predict individuals at risk of falling during a 3-month prospective follow-up study. METHOD: A battery of standardised tests administered in the home and the laboratory with a 3-month follow-up telephone interview. RESULTS: Sixty-three people with PD were recruited from GP practices. Eleven interview variables and six gait laboratory variables were used with subsamples (55 and 44 subjects, respectively) to fit predictive models for identifying future fallers. The number of falls in the previous year was the most important variable, without exception, to be selected as a predictor in various logistic regression models. A history of two or more falls had a sensitivity of 86.4% (95% CI 67.3-96.2%) and a specificity of 85.7% (95% CI 71.2-94.2%) in predicting falling in the next 3 months. CONCLUSION: Healthcare workers should be asking their patients with PD regularly and carefully about falling, and should consider instigating programmes of fall management for patients with PD who have fallen two or more times in the previous 12 months.

Accidental Falls↗

Indices of apoptosis and proliferation as potential prognostic markers in non-functioning pituitary adenomas.

OBJECTIVE: Non-functioning pituitary adenomas (NFAs) are a distinct group of pituitary adenomas, which comprise approximately 20% of pituitary adenomas. Although most pituitary adenomas are benign, there is a subset of adenomas that behaves in an aggressive fashion, with either invasion of the surrounding structures or recurrence. The aim of this study was to investigate whether the behaviour of NFAs can be predicted using immunohistochemical markers that label proliferating and apoptotic cells, including a new marker for apoptosis (M30 CytoDEATH). This is the first study to analyse both the proliferation labelling index (LI) and the apoptotic index (AI) in NFAs and to correlate the labelling indices of these histological markers with tumor growth rate as measured by 2 postoperative MRI scans. MATERIAL AND METHODS: 40 patients in total were included in the study. 20 patients with high growth rate and percentage change in the pituitary adenoma volume as assessed on 2 postoperative MRI scans were age/sex matched to 20 patients with low growth rate or percentage change. RESULTS: There is no significant statistical difference of the histological and immunohistochemical indices assessed between cases and controls. CONCLUSION: The routine assessment of the proliferation and the apoptotic markers used in this study in NFAs has no prognostic value.

Adenoma↗