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Biomedical subjects

S M Montgomery

Publications and source records attributed to S M Montgomery.

48 records · Page 3Linked to original sources
PubMed1998

Factors affecting patient tolerance of upper gastrointestinal endoscopy.

Doctors are optimistic in their perception of how acceptable endoscopy is for patients. We analyzed elements that contribute to a poor experience for the patient and the agreement between the perceptions of endoscopists and patients. Eighty-four out-patients who had undergone gastroscopy completed questionnaires (response rate of 73%) 48 to 96 hours after the procedure. The endoscopist completed a similar questionnaire. Questions concerned overall tolerance, swallowing, retching and vomiting, sedation, duration, diagnosis, age, and sex. Data from both doctor and patient were available in 84 cases. The type of sedation, administration of hyoscine or Xylocaine (Astra Pharmaceuticals Ltd., Kings Langley, UK), diagnosis, and expression of need for more sedation were not statistically significantly related to the overall patient score. The largest contribution to a poor overall tolerance score arose from difficulty in swallowing the endoscope, followed by the duration of the procedure. A total of 8.3% of patients reported some overall difficulty which was not recognized by the endoscopist. In relation to retching and vomiting, 11.9% of patients had difficulty with retching and vomiting, which went unrecognized by the doctor, and 18% had difficulty in swallowing the endoscope. There was fair agreement between the assessments of overall acceptability of both endoscopists and patients. Difficulty in intubation, however, is the major contributor to a poor tolerance of gastroscopy and also the issue on which doctors and patients disagreed the most.

Anesthesia, Local↗
PubMed1997

Family conflict and slow growth.

AIMS: Having previously observed that slow growth in childhood is associated with subsequent labour market disadvantage, an attempt was made to determine whether family conflict is associated with slow growth to age 7 years, independently of material disadvantage. METHODS: A total of 6574 children born between 3 and 9 March 1958 who were members of the British National Child Development Study were used in these analyses. Slow growth at age 7 years was indicated by short stature defined as the lowest fifth of the height distribution. In multivariate analysis, adjustment was made for fully attained adult height as a measure of genetically predetermined height. RESULTS: A total of 31.1% of children who had experienced family conflict were of short stature compared with 20.2% of those who had not, representing relative odds of 1.79 (95% confidence interval (CI) 1.39 to 2.30). After adjustment for social class, crowding, sex, and predetermined height, the relative odds were slightly reduced to 1.62 (95% CI 1.18 to 2.23). A total of 44.0% of children from the most crowded households were of short stature compared with 16.4% of those from the least crowded. The unadjusted relative odds were 3.99 (95% CI 2.94 to 5.41) and after adjustment for the potential confounding variables they were 3.07 (95% CI 2.08 to 4.51). Low social class was also a risk for short stature at age 7 years, but this was not statistically significant after adjustment for the other confounding factors. CONCLUSIONS: Family conflict during childhood was independently associated with slow growth to age 7 years.

Body Height↗
PubMed1996

Health and social precursors of unemployment in young men in Great Britain.

OBJECTIVE: To identify health and socioeconomic factors in childhood that are precursors of unemployment in early adult life and to examine the hypothesis that young men who become unemployed are more likely to have accumulated risks to health during childhood. DESIGN: Longitudinal birth cohort study. The amount of unemployment experienced in early adult life up to age 32 years was the outcome measure used. Exposure measures to indicate vulnerability to future ill health were: height at age 7 years and the Bristol social adjustment guide (BSAG) at age 11 years, a measure of behavioural maladjustment. Socioeconomic measures were: social class at birth, crowding at age 7, qualifications attained before labour market entry, and region of residence. SETTING: Great Britain. SUBJECTS: Altogether 2256 men with complete data from the national child development study (NCDS). The NCDS has collected data on all men and women born in one week in 1958 and has followed them up using interviews, self completion questionnaires, and medical examinations at birth and at ages 7, 11, 16, 23 and 33 years. RESULTS: A total of 269 men (11.9%) experienced more than one year of unemployment between ages 22 and 32 years. Poor socioeconomic conditions in childhood and a lack of qualifications were associated with an increased risk of unemployment. Geographical region was also significant in determining the risk of unemployment. Men with short stature and poor social adjustment in childhood were more likely to experience unemployment in adult life, even after controlling for socioeconomic background, education, and parental height. These differences remained when those with chronic childhood illnesses were excluded from the analysis. The adjusted relative odds for experiencing more than one year of unemployment between ages 22 and 32 years for men who were in the top fifth of the BSAG distribution (most maladjusted) compared with those in the bottom fifth were 2.36 (95% CI 1.49, 3.73). The adjusted relative odds for experiencing more than one year of unemployment between ages 22 and 32 years for men who were in the bottom fifth of the distribution of height at age 7 years (indicating slowest growth) compared with those in the top fifth, were 2.41 (95% CI 1.43, 4.04). Adult height was not significantly associated with unemployment. CONCLUSION: The relationship between unemployment and poor health arises, in part, because men who become unemployed are more likely to have accumulated risks to health during childhood, reflected by slower growth and a greater tendency to behavioural maladjustment. Short stature in childhood is a significant indicator of poor socioeconomic circumstances in childhood and reflects earlier poor development.

Adult↗
PubMed1995

Is measles vaccination a risk factor for inflammatory bowel disease?

Measles virus may persist in intestinal tissue, particularly that affected by Crohn's disease, and early exposure to measles may be a risk factor for the development of Crohn's disease. Crohn's disease and ulcerative colitis occur in the same families and may share a common aetiology. In view of the rising incidence of inflammatory bowel disease (Crohn's disease and ulcerative colitis), we examined the impact of measles vaccination upon these conditions. Prevalences of Crohn's disease, ulcerative colitis, coeliac disease, and peptic ulceration were determined in 3545 people who had received live measles vaccine in 1964 as part of a measles vaccine trial. A longitudinal birth cohort of 11,407 subjects was one unvaccinated comparison cohort, and 2541 partners of those vaccinated was another. Compared with the birth cohort, the relative risk of developing Crohn's disease in the vaccinated group was 3.01 (95% CI 1.45-6.23) and of developing ulcerative colitis was 2.53 (1.15-5.58). There was no significant difference between these two groups in coeliac disease prevalence. Increased prevalence of inflammatory bowel disease, but not coeliac disease or peptic ulceration, was found in the vaccinated cohort compared with their partners. These findings suggest that measles virus may play a part in the development not only of Crohn's disease but also of ulcerative colitis.

Adult↗
PubMed1993

Determinants of decline in resting metabolic rate in aging females.

We considered the association of several metabolic and lifestyle variables as modulators of the decline in resting metabolic rate (RMR) and fat-free weight (FFW) in 183 healthy females (18-81 yr). RMR showed a curvilinear decline with age, which was significant in women aged 51-81 yr but not in women aged 18-50 yr. FFW showed a curvilinear decline with age, which was significant (P < 0.01) in women 48-81 yr but not in women 18-47 yr. The decline in RMR was primarily associated with the loss of FFW (r2 = 72%), whereas the decline in FFW was explained primarily by differences in maximal O2 consumption (VO2max), age, leisure time physical activity, and dietary protein intake (total r2 = 46%). We conclude that RMR and FFW showed a curvilinear decline with age which was accelerated beyond the middle-age years. Second, the age-related decline in RMR was primarily associated with the loss of FFW. Third, the loss of FFW was partially related to a decrement in VO2max and nutritional factors. Therapeutic interventions designed to increase VO2max by elevating physical activity may preserve fat-free weight and thus offset the decline of RMR in aging women.

Adolescent↗
PubMed1992

Resting energy metabolism and cardiovascular disease risk in resistance-trained and aerobically trained males.

The objectives of this study were (1) to examine differences in resting metabolic rate (RMR) and cardiovascular risk factors among aerobically trained (n = 36), resistance-trained (n = 18), and untrained (n = 42) young males; and (2) to investigate the influence of body composition, dietary intake, and VO2max as possible modulators of differences in cardiovascular risk among groups. Results showed that RMR, adjusted for differences in fat-free weight (FFW), was 5% higher in aerobically trained males compared with resistance-trained males (P < .01), and 10% higher than that in untrained males (P < .01). Plasma levels of cholesterol and low-density lipoprotein cholesterol (LDL-C) were comparable between resistance-trained and aerobically trained males, but were lower (P < .05) than those in untrained males. (The percent intake of dietary fat was related to plasma cholesterol [r = .32, P < .01] and LDL-C [r = .30, P < .01].) When compared with untrained males, fasting triglyceride (TG) levels were 39% and 43% lower (P < .01) in resistance-trained and aerobically trained males, respectively. When compared with untrained males, the fasting insulin to glucose ratio (I/G) was 45% and 53% lower (P < .01) in resistance- and aerobically trained males, respectively. Mean arterial pressure (MAP) was 7% lower (P < .01) in aerobically trained compared with untrained males. Statistical control for differences in percent body fat or percent intake of dietary fat diminished the differences among the groups for plasma lipids, blood pressure, and the I/G ratio. We conclude that aerobically trained and resistance-trained males have higher resting energy requirements independent of FFW compared with untrained males. Aerobically trained and resistance-trained young males have comparable and favorable cardiovascular disease risk profiles compared with untrained males, and this appears to be related to their low level of adiposity and low intake of dietary fat.

Adolescent↗
PubMed1979

Depressive symptoms in acute schizophrenia.

1. The incidence of psychopathological symptoms rated by the CPRS was compared in 54 English depressed patients and 52 Swedish depressed patients. 2. A new rating scale for depression was created from the 10 items shown to be most sensitive to treatment change. The Montgomery and Asberg Depression Rating Scale (MADRS) was found to be more sensitive to treatment change than the Hamilton Rating Scale (HRS). 3. The incidence of psychopathological symptoms was assessed using the full Comprehensive Psychopathological Rating Scale (CPRS) in 50 patients with unequivocal acute schizophrenia. 36 patients were rated again after treatment and a 12 item rating scale for schizophrenia was derived from the items best able to discriminate between responders and non responders. 4. The schizophrenia scale was found to be a more sensitive discriminator between responders and non responders than the Brief Psychiatric Rating Scale (BPRS) in the 25 patients rated on both scales simultaneously. 5. There was a relatively high incidence of depressive symptoms rated on the MADRS in acute schizophrenia suggesting that depressive symptoms are a commoner presenting feature of acute unequivocal schizophrenia than is normally acknowledged.

Depression↗