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Biomedical subjects

S E Sutherland

Publications and source records attributed to S E Sutherland.

44 records · Page 3Linked to original sources
PubMed1988

Cyclosporine therapy for steroid-resistant nephrotic syndrome. A controlled study.

We have conducted a controlled trial on the efficacy of cyclosporine in eight patients with steroid-resistant nephrotic syndrome (four with idiopathic minimal lesion nephrotic syndrome and four with focal segmental glomerulosclerosis). Patients were randomly allocated to a cyclosporine (5 mg/kg/d) or a control group. After eight weeks of therapy and one month without cyclosporine therapy, patients in the control group were given cyclosporine for eight weeks and those in the cyclosporine group became controls. Before the initiation of treatment, there was no difference between the groups with regard to proteinuria and serum albumin levels. Proteinuria remained unchanged in the cyclosporine group, while there was a significant increase in proteinuria in the control group. There were no significant changes in serum albumin levels in either group during the trial. This study does not support the use of cyclosporine at the dose of 5 mg/kg/d in patients with steroid-resistant minimal lesion nephrotic syndrome or focal segmental glomerulosclerosis.

Adolescent↗
PubMed1988

Postbiopsy pneumothorax: estimating the risk by chest radiography and pulmonary function tests.

Pulmonary function tests and chest radiographs of 160 patients who had had percutaneous needle biopsy of lung lesions were reviewed to determine the value of these examinations in estimating the risk of postbiopsy pneumothorax. Chest radiographs were evaluated subjectively for changes of obstructive and restrictive airway disease and for size and depth of lesion. Pulmonary function tests, consisting of simple spirometry (forced vital capacity, percentage of predicted forced vital capacity, forced expiratory volume in 1 sec, percentage of predicted forced expiratory volume in 1 sec, and [forced expiratory in 1 sec/forced vital capacity] X 100), and the pulmonologist's interpretation were evaluated. Pneumothorax developed in 46% (31/67) of patients who had obstructive airway disease according to the results of pulmonary function tests and in 42% (34/81) of those who had obstructive airway disease according to changes on chest radiographs, compared with 19% (10/53) and 25% (17/67) of those who had normal pulmonary function tests and chest radiographs, respectively. Pneumothorax developed in 46% (23/50) of patients who had findings of obstructive airway disease on both pulmonary function tests and on chest radiographs, compared with 7% (2/28) of patients who were classified as normal by both criteria. None of the patients who had normal pulmonary function tests required placement of a chest tube, whereas 19% (13/67) of those who had obstructive airway disease required chest tubes. Decreasing size of lesion and increasing depth of lesion were associated with a significant increase in the risk of pneumothorax. We conclude that the results of chest radiographs and pulmonary function tests are useful parameters for estimating the risk of postbiopsy pneumothorax.

Adult↗
PubMed1986

Developmental approach to preventing the sexual abuse of children.

Child sexual abuse is a common and potentially damaging experience. Preventing and detecting abuse should be a part of primary care pediatric practice. A protocol is presented the goal of which is to teach children and parents reasonable protective behaviors.

Adolescent↗
PubMedDate not supplied

Evidence-based dentistry: Part IV. Research design and levels of evidence.

Previous papers in this series on evidence-based dentistry have discussed the first 2 steps in seeking answers to clinical problems formulating a clear question and strategically searching for evidence. The next step, critical appraisal of the evidence, is made easier if one understands the basic concepts of clinical research design. The strongest design, especially for questions related to therapeutic or preventive interventions, is the randomized, controlled trial. Questions relating to diagnosis, prognosis and causation are often studied with observational, rather than experimental, research designs. The strongest study design should be used whenever possible. Rules have been established to grade research evidence. This paper, the fourth in the series, presents an overview of research methodology most commonly used in the dental literature.

Case-Control Studies↗
PubMedDate not supplied

Clinical practice guidelines in dentistry: Part I. Navigating new waters.

Clinical Practice Guidelines (CPGs) are tools, developed by and for practitioners, to assist in clinical decision making. They are designed to enhance, not replace, clinical judgement and expertise. Well-developed guidelines use the evidence-based approach. The research evidence related to a topic is assembled in a systematic, comprehensive and unbiased manner. Recommendations are made based on the evidence and practitioner feedback is sought prior to formulating the final practice guideline. There are many misperceptions about CPGs and some dentists are wary about their development and use. In this paper, we explore some of the reasons for these misperceptions, review the benefits of sound guidelines, and discuss some of the challenges for guideline development in dentistry in Canada

Canada↗
PubMedDate not supplied

Serum cholesterol--risk factor for coronary disease mortality in younger and older blacks and whites. The Charleston Heart Study, 1960-1988.

Serum total cholesterol (> or = 6.7 mmol/L) measured in 1960 in the Charleston Heart Study cohort was found to be a risk for mortality from coronary heart disease during the period of 1960 to 1988 in white men (relative risk [RR] 1.5; 95% confidence interval [CI]: 1.1, 2.2), white women (RR 1.7; 95% CI: 1.1, 2.7), and black women (RR 1.6; 95% CI: .9, 2.9) after age, systolic blood pressure, smoking status, education level, obesity, and diabetes were considered. For black men, the relative risk was .96 (95% CI, .39, 2.39). Only among white women was the relative risk (RR 2.4; 95% CI, 1.2, 4.5) increased among those in the older ages (55 to 74) in 1960. The evidence for cholesterol as a risk factor for coronary disease mortality in black men is inconclusive and requires further study.

Adult↗
PubMedDate not supplied

Comparison of methods to assess coronary heart disease prevalence in South Asians.

BACKGROUND: Migrants from the Indian subcontinent (South Asian migrants) in the United Kingdom have high mortality from coronary heart disease (CHD) in comparison to the indigenous population. Few studies have assessed the prevalence of CHD in South Asians, and the applicability of conventional survey methods in this population is not known. In this pilot random population survey of South Asian men and women living in West London, the prevalence of CHD as judged by the Rose questionnaire, past cardiac history, cardiologist and resting electrocardiogram were compared. METHODS: Subjects aged 30-64 years from randomly selected households were invited for a cardiological assessment. A lay person administered the Rose questionnaire and recorded the past cardiac history. A cardiologist also made an independent assessment and a 12-lead electrocardiogram was recorded and analysed according to the Minnesota code. RESULTS: Three hundred and seventy-six individuals (192 men and 184 women) were assessed. The prevalence of angina in men and women, respectively, was 3.1% and 4.9% by the Rose questionnaire; 2.6% and 2.2% by past cardiac history; and 4.2% and 0.5% according to the cardiologist. The prevalence of myocardial infarction in men and women, respectively, was 5.2% and 2.2% by the Rose questionnaire, 3.6% and zero by past cardiac history and 3.6% and 0.5% by the cardiologist. Q/QS codes were present in 1.6% men and 0.5% women and ischaemic codes in 13% men and 14% women. Ischaemic changes were not associated with any cardiac history in 72% of men and 92% of women. For a diagnosis of CHD in men, there was poor agreement between the Rose questionnaire and either the past cardiac history or the cardiologist's assessment, but moderate agreement between the past cardiac history and the cardiologist. Agreement was poor between all three methods for a positive diagnosis of CHD in women. CONCLUSION: Current accepted epidemiological methods for assessing CHD prevalence may be inaccurate in South Asians, especially women. Electrocardiogram abnormalities suggestive of ischaemia are common in South Asians and are usually not associated with evidence of CHD. Thus, their value as indicators of CHD is questionable.

Adult↗