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Biomedical subjects

S M Moss

Publications and source records attributed to S M Moss.

67 records · Page 4Linked to original sources
PubMed1989

Randomised, controlled trial of faecal occult blood screening for colorectal cancer. Results for first 107,349 subjects.

To assess the effectiveness of screening by faecal occult blood tests, 107,349 people without symptoms of colorectal disease identified from general practitioner records have been randomly allocated to test and control groups. 53,464 test subjects were invited to carry out the screening test; 27,651 (53%) of the 52,258 who received the tests did so. Further investigation of the 618 (2.3%) with positive tests showed 63 cancers (52% stage A) and 367 adenomas (266 subjects). Rescreening of subjects with negative results every 2 years (9510 first rescreen, 3639 second) has shown a significant fall in the rate of positive results (1.7% of 7344; 0.3% of 2906). Cancers have also been diagnosed in 20 subjects presenting in the interval between a negative test and rescreening, and in 83 non-responders. The incidence of cancer in the control group (123 subjects; 10.6% stage A) was 0.72 per 1000 person-years. Cancers detected by screening were at a less advanced pathological stage, but it is too early to show any effect of screening on mortality from colorectal cancer.

Adenocarcinoma↗
PubMed1989

Comparison of intracranial pressure between spina bifida patients and normal subjects using a non-invasive pressure assessment technique.

A comparison of mean intracranial pressure (ICP) between 36 spina bifida patients and 24 patients with clinically normal ICP was undertaken. A new non-invasive method of assessing ICP was used throughout this study. The technique relates tympanic membrane displacement to ICP and has been shown to be a reliable measure of mean ICP by comparison with direct measures via ventricular catheters and reservoirs, subdural catheters and lumbar punctures. Using this non-invasive method the results of this study indicated that the patients with spina bifida and without a ventricular shunt have a higher than average mean ICP. The results demonstrated a significant difference (99.9%) in the measures of ICP between the spina bifida and normal populations. A significant difference (99.9%) in the ICP was also found between patients with spina bifida and with and without ventricular shunts, and thus presumably those with and without diagnosed hydrocephalus. It is suggested that patients with spina bifida and without ventricular shunts probably have higher than average mean ICP when compared with the normal population.

Adolescent↗
PubMed1989

Observer variability in histopathological reporting of cervical biopsy specimens.

Sections from 100 cervical biopsy specimens were studied by 12 consultant histopathologists to determine the robustness of the existing pathology terminology and classification. Analysis by kappa statistics showed good agreement in the diagnosis of CIN 3 and squamous carcinoma but an inability to distinguish accurately between the lesser grades of CIN. It is recommended that the classification be changed to low grade (present CIN 1 and 2) and high grade (present CIN 3) categories alone. There was very poor agreement in the identification of cellular changes associated with human papilloma virus (HPV) infection.

Biopsy↗
PubMed1988

Rapidly progressive cervical cancer: is it a real problem?

The appearance, in younger women, of a rapidly progressive form of cervical carcinoma has been suggested. This, together with evident deficiencies in the provision and technique of screening services, has been taken to indicate a need for more frequent screening. We show that a substantial increase in the observed number of such rapidly progressive cancers would be expected simply on the basis of changes in population structure, a general increase in cervical cancer rates and increases in the proportion of women screened.

Adolescent↗
PubMed1988

A comparison of methods for increasing compliance within a general practitioner based screening project for colorectal cancer and the effect on practitioner workload.

Screening for colorectal cancer by testing for faecal occult blood (FOBT) is effective for early diagnosis, but the success of a screening programme also depends on compliance. The aims of this study were to assess the effect of health education on compliance and to assess any addition to general practitioner workload that resulted. Altogether 3860 patients were recruited and randomly allocated to test or control group. The test group was further divided into subgroups, some of which received health education. Compliance with FOBT was 54.7% (210/384) in the subgroup receiving only the doctor's letter, which fell to 48.1% (743/1544) in the group receiving health education. General practitioner consultation rates were similar in test and control groups.

Aged↗
PubMed1986

An evaluation of screening policies for cervical cancer in England and Wales using a computer simulation model.

Several screening policies have been recommended for implementation in England and Wales in the last 20 years, although no evidence as to their relative effectiveness or efficiency has been provided. Using a computer simulation model, the outcomes expected from those policies had they been implemented over a 30 year period (1961-90) have been examined. The original policies based on five-yearly testing of women aged over 35 appear to be the most cost-effective, and extension of screening to younger age groups leads to loss of efficiency. Attempts to use non-screening health care contacts in order to take cervical smears (eg, during pregnancy, family planning, at gynaecology clinics) produce few advantages and considerably complicate the establishment of regular testing for the individual. The achievement of higher attendance rates is as important to the outcome of screening as concentration on more intensive or complex policies.

Adult↗
PubMed1985

A case-control study of cervical cancer screening in north east Scotland.

To estimate the relative risk of invasive cervical cancer in each succeeding year after a negative screening result the screening records of all women tested in the north east of Scotland were examined as the basis for a case-control study. The cases consisted of 115 women in whom invasive cervical cancer had been diagnosed in 1968-82 and who had appeared in the screening records at least once before diagnosis. For each patient five controls were selected from women of the same age who appeared in the screening records before the date of diagnosis in the patient. If the patient's cancer had been detected by screening the controls were chosen from women of the same age screened the same year. A comparison was made between cases and controls of the number of negative smears taken before the diagnosis. The results showed a high relative protection (inverse of the relative risk) in the first two years after a negative test, falling steadily as time since the last negative test elapsed. Even after 10 years, however, a considerable residual effect was observed.

Adult↗
PubMedDate not supplied

Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS).

BACKGROUND: Women genetically predisposed to breast cancer often develop the disease at a young age when dense breast tissue reduces the sensitivity of X-ray mammography. Our aim was, therefore, to compare contrast enhanced magnetic resonance imaging (CE MRI) with mammography for screening. METHODS: We did a prospective multicentre cohort study in 649 women aged 35-49 years with a strong family history of breast cancer or a high probability of a BRCA1, BRCA2, or TP53 mutation. We recruited participants from 22 centres in the UK, and offered the women annual screening with CE MRI and mammography for 2-7 years. FINDINGS: We diagnosed 35 cancers in the 649 women screened with both mammography and CE MRI (1881 screens): 19 by CE MRI only, six by mammography only, and eight by both, with two interval cases. Sensitivity was significantly higher for CE MRI (77%, 95% CI 60-90) than for mammography (40%, 24-58; p=0.01), and was 94% (81-99) when both methods were used. Specificity was 93% (92-95) for mammography, 81% (80-83) for CE MRI (p<0.0001), and 77% (75-79) with both methods. The difference between CE MRI and mammography sensitivities was particularly pronounced in BRCA1 carriers (13 cancers; 92%vs 23%, p=0.004). INTERPRETATION: Our findings indicate that CE MRI is more sensitive than mammography for cancer detection. Specificity for both procedures was acceptable. Despite a high proportion of grade 3 cancers, tumours were small and few women were node positive. Annual screening, combining CE MRI and mammography, would detect most tumours in this risk group.

Adult↗
PubMedDate not supplied

Effects of heterogeneous layers of composite and time on composite repair of porcelain.

Bond strengths of porcelain/composite resin repair samples, some homogeneous of conventional, hybrid, and microfill materials, some heterogeneous, made by incremental build-up of two of these composites, were evaluated. Samples were allowed to set without disturbance. After storage in 37 degrees C water for intervals of one day, seven days, and 28 days, the test samples were subjected to tensile force until fracture. There were significant differences in bond strengths of homogenous and heterogeneous samples after different storage periods. All mean repair bond strengths were significantly less at seven days than at one or 28 days. Heterogeneous repairs with larger-particle-size composite at the porcelain interface and overlayed with smaller-particle-size composites resulted in higher bond strengths than the homogeneous small-sized composite repairs. Failures of the repairs occurred at the porcelain/composite interface in a statistically significant number, implying that technique exactness at the interface plays an important role in the success of the technique.

Composite Resins↗