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Biomedical subjects

S B Thacker

Publications and source records attributed to S B Thacker.

At least 73 records · Page 4Linked to original sources
PubMed1986

Assessing the diagnostic accuracy and efficacy of selected antepartum fetal surveillance techniques.

Published studies on the contraction stress test (CST), the nonstress test (NST), and monitoring of fetal movement were reviewed to assess the accuracy and efficacy of these techniques. The false-negativity and false-positivity rates, sensitivity, and specificity of these tests were assessed with use of perinatal mortality and various measures of morbidity as outcomes. Both the CST and the NST generally demonstrated low sensitivity and high rates of false positivity. No randomized controlled trials have been conducted that are of sufficient size to demonstrate whether there is a significant difference in outcome following use of the CST or the NST. A single nonrandomized, controlled trial evaluating fetal-movement monitoring suggested clinical benefit. Direct costs of NSTs and CSTs in the United States were estimated to exceed $200 million per year. Yet the CST and the NST have not been demonstrated to be useful diagnostic tests. The CST, the NST, and fetal-movement monitoring are potentially useful screening tests. However, they require critical evaluation, with large randomized, controlled trials, to determine their efficacy and safety before their further diffusion into obstetrical practice.

Costs and Cost Analysis↗
PubMed1986

The French connection.

Explore the source record for details and available documents.

Computer Communication Networks↗
PubMed1986

The incidence of diarrheal disease in a defined population of rural Egypt.

A prospective study of diarrheal illness was conducted for 2 years in 309 families who were part of an epidemiologic research center population in rural Egypt. The rates of illness peaked in the first year of life with between 5 and 6 episodes per person year at risk. Although no seasonal variation in reported diarrhea was demonstrated for the total population, age-specific differences in seasonal occurrence were noted. The incidence did not consistently vary by village size, nor did rates vary by sex.

Adolescent↗
PubMed1985

Quality of controlled clinical trials. The case of imaging ultrasound in obstetrics: a review.

Randomized controlled trials are increasingly used to assess clinical practices in obstetrics and gynaecology. The strength of these studies is that they usually address the issue of selection bias satisfactorily. Yet, as with any form of scientific investigation, the randomized controlled trial has inherent limitations and is subject to flaws in its conduct. Using basic methodological criteria, this report assesses the quality of the four published controlled trials in which a policy of routine imaging ultrasonography in pregnancy was compared with a more restrictive policy. In addition, a pooled analysis using data from all four trials was conducted to illustrate how increasing the sample size may reveal differences between the two policies which remain undetected in trials using small samples. The researchers in these studies reached different conclusions as to the effectiveness of routine ultrasound screening. Taken together, these four trials provide valuable information about routine ultrasound screening but fail to demonstrate adequately the usefulness of imaging ultrasound as a screening procedure for all pregnant women. The assessment criteria presented here could be used by investigators, editors, referees and other readers as a guideline for assessing the quality of therapeutic studies upon which clinical practice should be based.

Clinical Trials as Topic↗
PubMed1984

Epidemiologic investigation of an oil-associated pneumonic paralytic eosinophilic syndrome in Spain.

From May 1 to December 26, 1981, a previously undescribed illness caused 277 deaths and the hospitalization of 12,656 persons in Spain. The disease was characterized by pneumonitis, eosinophilia, and marked loss of muscle mass and function. A succession of case-control studies was done in the town of Las Navas del Marqués (province of Avila) located 47 miles northeast of Madrid and with a population of 4009 people. The studies confirmed the association between illness and consumption of an illegally sold cooking oil. Other risk factors identified in the linear logistic regression analysis included involvement in various kitchen activities, increased average time spent inside the house, and the purchase of cooking oil from a specific street vendor. Although the oil was found to be a mixture of vegetable and animal fats contaminated with aniline and anilide-oil complexes, the specific etiologic mechanism of the disease has not been determined.

Adolescent↗
PubMed1983

Sudden death among Southeast Asian refugees. An unexplained nocturnal phenomenon.

In the period July 15, 1977, through March 30, 1982, there were at least 51 sudden, unexplained deaths in the United States among refugees from Southeast Asia. These deaths involved relatively young (median age, 33 years), previously healthy persons. All except one were male, and all died at night. Available data from studies among young adults in this country suggest that this specific phenomenon has an unusually high incidence among Laotian and Kampuchean refugees and, furthermore, has not previously been observed in the United States. Interviews with families of the decedents and a case-control study have failed to establish causal factors, but emotional stress cannot be ruled out as a contributing element. While reviews of the forensic investigations have confirmed the absence of important common pathological or toxicological findings, preliminary findings of special postmortem cardiac studies, now in progress, suggest that at least some of these deaths may be associated with developmentally abnormal conduction system pathways. Further studies are required to confirm this association, to define the apparently sleep-induced mechanism that triggers these deaths, and to explain the male preponderance in this disorder.

Adult↗
PubMed1983

2,3-butanediol: an unusual metabolite in the serum of severely alcoholic men during acute intoxication.

In a controlled experiment 15 (79%) of 19 severely alcoholic men but only 1 of 22 controls had a serum concentration of greater than or equal to 5 mumol/l 2,3-butanediol after ingestion of distilled spirits. Another diol, 1,2-propanediol, was found in a concentration of greater than or equal to 5 mumol/l in all patients' specimens after drinking; but it was also present in lower concentrations in the reference specimens of most of the patients. These data are consistent with the experimental evidence that ethanol can be metabolised in rats to produce 2,3-butanediol and with the epidemiological hypothesis that severely alcoholic men metabolise ethanol by a different pathway than do control subjects.

Acute Disease↗
PubMed1983

The surveillance of infectious diseases.

Surveillance is the collection, collation, and analysis of data and the dissemination to those who need to know so that an action can result. This article describes the clinician's critical role in disease reporting and outlines the benefits of surveillance to clinical practice. Four commonly used systems of disease surveillance are notifiable disease reporting, laboratory-based surveillance, hospital-based surveillance, and population-based surveillance. We analyze the relative strengths and limitations of each of these systems and present current efforts to evaluate and improve surveillance activities.

Communicable Disease Control↗
PubMed1983

National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 1. Epidemiologic results.

To identify risk factors for the occurrence of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men, we conducted a case-control study in New York City, San Francisco, Los Angeles, and Atlanta. Fifty patients (cases) (39 with Kaposi's sarcoma, 8 with pneumocystis pneumonia, and 3 with both) and 120 matched homosexual male controls (from sexually transmitted disease clinics and private medical practices) participated in the study. The variable most strongly associated with illness was a larger number of male sex partners per year (median, 61 for patients; 27 and 25 for clinic and private practice controls, respectively). Compared with controls, cases were also more likely to have been exposed to feces during sex, have had syphilis and non-B hepatitis, have been treated for enteric parasites, and have used various illicit substances. Certain aspects of a lifestyle shared by a subgroup of the male homosexual population are associated with an increased risk of Kaposi's sarcoma and pneumocystis pneumonia.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Benefits and risks of episiotomy: an interpretative review of the English language literature, 1860-1980.

The benefits and risks of episiotomy in labor and delivery as recorded in the English language literature in over 350 books and articles published since 1860 are reviewed and analyzed. Episiotomy is performed in over 60 per cent of all deliveries in the United States and in a much higher per cent of primigravidas. Yet, there is no clearly defined evidence for its efficacy, particularly for routine use. In addition, although poorly studied, there is evidence that postpartum pain and discomfort are accentuated after episiotomy, and serious complications, including maternal death, can be associated with the procedure. Therefore, carefully designed controlled trials of benefit and risk should be carried out on the use of episiotomy.

Anal Canal↗
PubMed1982

Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, Mo.

The morbidity and mortality associated with the 1980 heat wave in St Louis and Kansas City, Mo, were assessed retrospectively. Heat-related illness and deaths were identified by review of death certificates and hospital, emergency room, and medical examiners' records in the two cities. Data from the July 1980 heat wave were compared with data from July 1978 and 1979, when there were no heat waves. Deaths from all causes in July 1980 increased by 57% and 64% in St Louis and Kansas City, respectively, but only 10% in the predominantly rural areas of Missouri. About one of every 1,000 residents of the two cities was hospitalized for or died of heat-related illness. Incidence rates (per 100,000) of heatstroke, defined as severe heat illness with documented hyperthermia, were 26.5 and 17.6 for St Louis and Kansas City, respectively. No heatstroke cases occurred in July 1979. Heatstroke rates were ten to 12 times higher for persons aged 65 years or older than for those younger than 65 years. The ratios of age-adjusted heatstroke rates were approximately 3:1 for nonwhite v white persons and about 6:1 for low v high socioeconomic status. Public health preventive measures in future heat waves should be directed toward the urban poor, the elderly, and persons of other-than-white races.

Adult↗
PubMed1982

Risk factors for heatstroke. A case-control study.

To identify risk factors associated with heatstroke, a case-control study in St Louis and Kansas City, Mo, was conducted during July and August 1980. Questionnaire data were gathered for 156 persons with heatstroke (severe heat illness with documented hyperthermia) and 462 control subjects matched by age, sex, and neighborhood of residence. A stepwise linear logistic regression procedure was used to identify factors significantly associated with heatstroke. Alcoholism, living on the higher floors of multistory buildings, and using major tranquilizers (phenothiazines, butyrophenones, or thioxanthenes) were factors associated with increased risk. Factors associated with decreased risk were using home air conditioning, spending more time in air-conditioned places, and living in a residence well shaded by trees and shrubs. Being able to care for oneself, characteristically undertaking vigorous physical activity, but reducing such activity during the heat, and taking extra liquid were also associated with decreased risk. Our findings also suggest effective preventive measures. During a heat wave, the greatest attention should be directed toward high-risk groups, and relief efforts should include measures shown to be associated with reduced risk.

Air Conditioning↗