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S Moss

Publications and source records attributed to S Moss.

At least 73 records · Page 4Linked to original sources
PubMed1998

Calculating appropriate target cancer detection rates and expected interval cancer rates for the UK NHS Breast Screening Programme. Interval Cancer Working Group.

OBJECTIVES: To enable better monitoring of interim outcome measures in the NHS Breast Screening Programme by providing revised targets for cancer detection rates, and revised expected interval cancer rates. DESIGN AND SETTING: Expected detection rates of invasive cancers at prevalent screen are calculated, using estimates of the underlying England and Wales incidence rates and age specific prevalence incidence ratios from the Swedish Two County Study. Expected interval cancer rates are also derived from this study, and are used to calculate expected detection rates at rescreening. RESULTS: The expected invasive cancer detection rates at first screen for women aged 50-52 is 3.6 per 1000. The expected rate at rescreening for women aged 53-64 is 4.0 per 1000. Expected interval cancer rates for women screened from 1995/6 onwards are 0.45 per 1000, 0.65 per 1000, and 1.2-1.3 per 1000 for the periods within 0-<12, 12-<24, and 24-<36 months of screening. CONCLUSIONS: The target cancer detection rates and expected interval cancer rates for the NHS Breast Screening Programme have been revised in the light of more recent data. Monitoring of the extent to which the programme is meeting these revised targets will give a more accurate indication of the potential to meet the Health of the Nation target of a 25% reduction in breast cancer mortality by the year 2000.

Breast Neoplasms↗
PubMed1997

Bovine leukemia virus-gp51 antigen expression is associated with CD5 and IgM markers on infected lymphocytes.

Cows that develop a persistent lymphocytosis (PL) as a result of bovine leukemia virus (BLV) infection develop massive proliferation of B-lymphocytes expressing both IgM and CD5 markers. The association of these two markers on peripheral blood mononuclear cells (PBMC) derived from BLV-infected cows and also expressing BLV-gp51 antigen marker on these cells was determined by three-color cytometric analysis. After in vitro cultivation of PBMC in the presence of PHA for 24 h, the mean percentages of marker-reactive cells of five PL+ cows were as follows; 43% +/- 4.5 of the PBMC expressed BLV-gp51 antigen; 90% +/- 1.6 of these cells expressed both IgM and CD5 at the same time, whereas but 7.5% +/- 1.9 expressed only IgM and 2.9% +/- 0.4 expressed only CD5. The PBMC, IgM positive cells accounted for 77.8% +/- 6.8, while both CD5 and BLV-gp51 were detected simultaneously on 52.0% +/- 2.4 of the IgM+ cells, while the CD5 marker and BLV-gp51 antigen were detected independently on 35.0% +/- 1.9 and in 9.0% +/- 3.1, respectively of the IgM+ cells. Of the CD5+ cells (equivalent to 75.5% +/- 9.0 of the PBMC), 54.7% +/- 4.7 expressed simultaneously IgM and BLV-gp51, while BLV-gp51 and IgM were expressed separately by 3.0% +/- 0.5 and 37.8% +/- 3.3, respectively. An association between the B-cell phenotype and BLV tropism might exist. It is also possible that cells bearing both IgM and CD5 markers are the main target cells for BLV infection.

Animals↗
PubMed1997

A single serine residue confers tetrodotoxin insensitivity on the rat sensory-neuron-specific sodium channel SNS.

Sensory neurons express a sodium channel (SNS) that is highly resistant to block by tetrodotoxin (IC50 = 60 microM). SNS is 65% homologous to the cardiac sodium channel, in which a single hydrophilic residue in the SS2 segment is critical for tetrodotoxin resistance. By site-directed mutagenesis, we have substituted phenylalanine for serine at the equivalent position in SNS: this mutated (S356F) SNS channel is functionally similar to wild-type SNS when expressed in Xenopus oocytes, but is potently blocked by tetrodotoxin and saxitoxin with IC50s of 2.8 nM and 8.2 nM, respectively. These data provide clues to the rational design of selective blockers of SNS with potential as analgesic drugs.

Animals↗
PubMed1997

Reliability of the ICD 10 version of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD).

The Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD) is a semi-structured clinical interview designed for use with respondents who have learning disability. The first version was based on the Present State Examination. The revised version was derived from the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), and makes ICD 10 diagnoses using the SCAN diagnostic program. This current version has a 4-point scale of severity, compared with the 3-point scale of the first version. It also has a new module relating to psychotic disorders. The sample consisted of 40 individuals representing a spectrum of neurotic, depressive and psychotic disorders. Videotapes of 40 PAS-ADD interviews were re-rated by trained interviewers who had not been involved in the original study in which the videotapes were produced. The mean Kappa across all individual item codes was 0.65, ranging from 0.94 to 0.35. The mean Kappa agreement on item groups was 0.66. Correlation between total symptom scores was 0.74. Agreement on index of definition was Kappa 0.70. We concluded that, agreement was generally lower than for the ICD 9 version. This was probably due mainly to the increase in the severity categories from three to four. However, the new items (most of which related to psychosis) were of comparable reliability to other items.

Adult↗
PubMed1997

Validity of the PAS-ADD for detecting psychiatric symptoms in adults with learning disability (mental retardation).

The Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD) is a semi-structured interview for use with respondents who have learning disability and for key informants. This report investigates the ability of the instrument to detect symptoms that had been found to exist during routine clinical assessment of the patients. Field trials involved 95 referred patients with learning disability and a key informant for each sample member. Clinical opinions of the referring psychiatrists were sought using a symptom checklist. Referrer checklist symptoms and PAS-ADD data were both factor analysed. Validity testing involved (a) computation of correlations between PAS-ADD factors and checklist data and (b) comparison of PAS-ADD and referrers' diagnoses. Results indicated good validity for the PAS-ADD in relation to psychotic symptoms and depressive symptoms. Anxiety symptom identification was not well validated, probably due to small numbers. Expansive mood identified by the referrers was not detected by the PAS-ADD because there is currently no corresponding section in the interview. Where the PAS-ADD produced a diagnosis (in 58 members of the sample), 44 were in agreement with the referrer. Probability of diagnosis by PAS-ADD increased with the number of relevant active symptoms identified by the referrer. The PAS-ADD has been shown in a previous report to have the sensitivity to detect mental disorders not known to psychiatric services. For psychotic and depressive conditions, our results showed that symptom detection was in good agreement with the information provided by the referring psychiatrists on their patients. The PAS-ADD needs a section on hypomania and further investigation of its detection of anxiety disorders.

Adolescent↗
PubMed1997

Haloperidol, lorazepam, or both for psychotic agitation? A multicenter, prospective, double-blind, emergency department study.

Rapid tranquilization is a routinely practiced method of calming agitated psychotic patients by use of neuroleptics, benzodiazepines, or both in combination. Although several studies have examined the efficacy of the three approaches, none have compared these treatments in a prospective, randomized, double-blind, multicenter trial. Ninety-eight psychotic, agitated, and aggressive patients (73 men and 25 women) were prospectively enrolled during an 18-month period in emergency departments in five university or general hospitals. Patients were randomly assigned to receive intramuscular injections of lorazepam (2 mg), haloperidol (5 mg), or both in combination. Patients in each treatment group received 1 to 6 injections of the same study drug within 12 hours, based on clinical need. They were evaluated hourly after the first injection until at least 12 hours after the last. Efficacy was assessed on the Agitated Behavior Scale (ABS), a modified Brief Psychiatric Rating Scale (MBPRS), Clinical Global impressions (CGI) scale, and an Alertness Scale. Effective symptom reduction was achieved in each treatment group with significant (P < .01) mean decreases from baseline at every hourly ABS evaluation. Significant (P < .05) mean differences on the ABS (hour 1) and MBPRS (hours 2 and 3) suggest that tranquilization was most rapid in patients receiving the combination treatment. Study event incidence (side effects) did not differ significantly between treatment groups, although patients receiving haloperidol alone tended to have more extrapyramidal system symptoms. The superior results produced by the combination treatment support the use of lorazepam plus haloperidol as the treatment of choice for acute psychotic agitation.

Adolescent↗
PubMed1997

Dementia in older people with intellectual disability: symptoms of physical and mental illness, and levels of adaptive behaviour.

Detailed data on health and functional ability of 101 people with intellectual disability over 50 years of age are presented. Using a combination of informant interviewing, observation and measurement of cognitive change over a 3-year period, 12 of these individuals were identified as suffering from dementia. Their data are compared to those of the non-dementia sufferers. The people suffering from dementia had a greater number of chronic physical health problems and chronic disability resulting from physical health problems. Their capacity for self-directed activity was lower. The subjects had a reduced capacity to enjoy things, and were more irritable and more prone to violence. However, the outlook is somewhat different from a strategic perspective. The population of people with intellectual disability shows considerable epidemiological changes across the lifespan because of the effects of differential survival. The interaction of these factors tends to mask the impact of dementia-related skill loss in this population.

Adaptation, Psychological↗
PubMed1997

Mental disorders and problematic behaviours in people with intellectual disability: future directions for research.

In recent years there has been a major growth of interest in the field of mental health and intellectual disability. This article outlines some of the issues that will be important to address in the coming years. The issues discussed include: the interaction of biological and environmental factors in the aetiology of behavioural and psychiatric disorders; diagnosis and classification; epidemiology; dementia; recognition of mental illness in the community; treatment; service provision; and training.

Conduct Disorder↗
PubMed1997

Levels and role of cytokines in bovine leukemia virus (BLV) infection.

Bovine leukemia virus belongs to a small subfamily of exogenous retroviruses that includes the human retroviruses HTLV-1, HTLV-II and the simian virus, STLV-1. Like other retroviruses, infection with BLV results in deregulation of the host immune system at both humoral and cellular levels. An approach which might help in the elucidation of some immune impairment phenomena is the investigation of the role that cytokines play in the pathogenesis and immune response of BLV infected animals. Here we describe our findings on IL-6 and TNF. We have found that the levels of IL-6 in the sera of BLV infected cows which show persistent lymphocytosis (BLV+ PL+) were significantly higher than those of BLV infected with no lymphocytosis (BLV+ PL-) or BLV negative cows (BLV-). The same results were obtained by measuring the spontaneous production of IL-6 in peripheral blood mononuclear cells (PBMC). Furthermore, PBMC derived from BLV+PL+ cows secrete higher levels of IL-6 and TNF alpha than those derived from BLV+PL- and BLV- ones following in vitro exposure to the BLV gp51 antigen, bacterial endotoxins (LPS) and ConA. Similar results were obtained when supernatants from stimulated adherent (monocytes, macrophages) and non-adherent cells (B and T lymphocytes) were tested. When exogenous IL-6 and TNF alpha were added to BLV infected cells in vitro, the expression of viral antigens was strongly suppressed. Thus, the possibility exists that the elevated production of IL-6 and even more than that of TNF alpha play a role as contributing factors to the latency of the clinical expression in BLV infection.

Animals↗
PubMed1996

The association between tumour necrosis factor-alpha, interleukin-6 and microbiological findings in the synovial fluid of aborted and neonatal calves.

Tumour necrosis factor-alpha (TNF alpha) and interleukin-6 (IL-6) were detected in the intra-carpal synovial fluids collected from aborted and recently dead young calves. Five out of seven TNF-alpha positive joint fluids were bacteriologically positive and two were sterile. Only one out of 20 TNF-alpha negative joint aspirates was infected (P = 0.0014). Sixteen of the synovial fluid samples were examined for the presence of IL-6. In 12 samples IL-6 was detected, six of which were bacteriologically contaminated. Four out of the 16 samples were IL-6 negative. These findings indicated the possible association between TNF-alpha and the intra-articular inflammatory processes in young calves, which in the present study were either found in combination with or without IL-6.

Abortion, Veterinary↗
PubMed1996

Counselling for an HIV test.

Doctors may feel uncomfortable with the prospect of discussing a human immunodeficiency virus (HIV) antibody test with their patient. This is in part because they do not enquire about high risk activity as part of a medical history. With increasing medical and public awareness of both the clinical manifestations and social implications of HIV infection, it is important that all doctors receive guidance on how to deal with these issues. Counselling is not the usual term used to describe obtaining informed consent. In the general medical setting, tests for hepatitis B and syphilis are routinely carried out without specific consent even though results of these tests may have profound effects on both the patient and their sexual partners. However society and ethical considerations have made HIV testing different. HIV testing will inevitably become more widespread, and thus become a more routine part of patient investigation and management.

Confidentiality↗
PubMed1996

Validity of the schizophrenia diagnosis of the psychiatric assessment schedule for adults with developmental disability (PAS-ADD).

BACKGROUND: First rank symptoms are central to the diagnosis of schizophrenia, but their complexity makes it difficult to validly detect them in people with learning disability. This report investigates ability of PAS-ADD to detect schizophrenia, validated against expert clinical opinion. METHOD: The sample consisted of 98 patients with learning disabilities and a key informant for each sample member. Clinical opinions of the referring psychiatrists were sought using a symptom checklist. Reportage of remission, and the number of core schizophrenia symptoms identified, were used to estimate level of symptom activity at time of interview. RESULTS: The proportion of schizophrenia cases detected by PAS-ADD increases with the number of active core symptoms identified by the referrer. Where two or more core symptoms were indicated, PAS-ADD detected 71% cases. The most frequently fulfilled criterion was third-person auditory hallucinations. Six schizophrenia diagnoses disagreed with the clinician, four of which were referred as being hypomania. Overall symptom frequency detected by PAS-ADD was positively correlated with IQ. CONCLUSIONS: Results suggest there may be scope for modifying the ICD-10 diagnostic algorithm for use with learning disability, particularly in relation to the delusions and negative symptoms criteria.

Adolescent↗
PubMed1996

The health needs of adults with learning disabilities and the Health of the Nation strategy.

Studies of mortality and morbidity relating to people with learning disabilities are reviewed within the context of the five Health of the Nation Key Areas. It is concluded that the Key Areas have become increasingly relevant as a result of increased longevity and changing lifestyles. For example, both cardiovascular disease and cancers appear to be more common than before, and a high proportion of people with learning disabilities carry one or more risk factors associated with morbidity and mortality from these causes. However, there are a range of other health needs in this population which should not be overlooked by an undue focus on the five Key Areas, and these are also discussed. The efficacy of programmes seeking to limit the risk factors of obesity and poor fitness are reviewed. There is a need for further evaluation of such programmes, particularly in community settings. The literature relating to primary health care services suggests that professional training and access to services need to be improved for this group, in order to address health needs both within and without the Health of the Nation priorities.

Aging↗