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Biomedical subjects

V Siskind

Publications and source records attributed to V Siskind.

At least 55 records · Page 3Linked to original sources
PubMed1991

Prediction of survival from resuscitation: a prognostic index derived from multivariate logistic model analysis.

Despite advances in resuscitation, the ability to predict survival at cardiac arrests remains unsophisticated. We identified the factors determining outcome of all cardiopulmonary resuscitations performed at our institution over a 4-year period, and used a Cox multivariate regression model to design prognostic indices to assess the probability of successful resuscitation and hospital discharge. Cardiac arrests (710) were studied, and 193 (28%) were successfully resuscitated. The most influential variables, judged by the size and significance of their logistic regression coefficients, were rhythm, resuscitation delay, and age (for successful resuscitation), and rhythm, performance of intubation and defibrillation, defibrillation delay, and age (for survival until discharge). The combination of these in a prognostic index reliably predicted both outcome (area under the receiver operating curve of 0.78), and survival until discharge (area under the curve of 0.80).

Aged↗
PubMed1991

Shared antenatal care in Brisbane.

The prevalence of antenatal care shared between general practitioner (GP) and public hospital services in Brisbane, and its acceptability to patients was assessed. Responses to questionnaires put to women in the immediate puerperium of the public wards of 2 major teaching hospitals are presented. Antenatal shared-care was undertaken in 54% of pregnancies. Indications of advantages for women to undergo antenatal shared-care were identified with convenience of appointment time, and decreased travel and waiting time. An important cooperation between GP and hospital obstetric services appears to have evolved in the area of antenatal care that provide benefits at least for patients' convenience.

Adult↗
PubMed1991

Dialyser reprocessing with Renalin.

We evaluated the dialyser reprocessing agent Renalin in a 6-month prospective study of 2,759 dialyses on 59 patients. Dialysers were withdrawn after a maximum of 6 uses, and the average number of uses achieved was 4.5 Dialyser survival varied with the type of dialyser but was unaffected by the dialysate base. In vivo clearances of urea, creatinine and phosphate were not altered by reuse, but there was a small decrease in ultrafiltration characteristics of used dialysers. No clinically significant adverse event was attributed to reuse. Blood pressure was better preserved with used dialysers, and patients experienced significantly fewer intradialytic symptoms. Savings of over +A 25,000 were achieved during the study.

Acetates↗
PubMed1991

A profile of Australian women practicing breast self-examination.

Breast self-examination (BSE) and medical breast examination practices were studied in a group of 1,103 women without diagnosed breast cancer, randomly sampled to conform in age and social status with breast cancer cases from the population of Brisbane, Australia between 1981 and 1985. Relationships between these practices and sociodemographic factors, breast cancer risk indicators, health related behaviors and source of knowledge about BSE were analyzed. Overall, 63% of women reported performing BSE. BSE was practiced frequently (monthly or more). BSE frequency was only weakly associated with breast cancer risk indicators. It was more strongly linked with age, the 20-44 year group being more likely to examine their breasts occasionally and the women 65 years and over being less likely to examine their breasts. Married women were the most likely to practice BSE frequently and widowed or single women most likely never to practice. Women who underwent cervical smear testing were more likely to perform BSE than those who did not have smear tests. Women who learned BSE from their doctors as opposed to other sources practiced BSE more frequently and were more likely to practice BSE exactly as taught.

Adult↗
PubMed1991

Viral-like characteristics of particle aggregates in a lymphoblastic cell line.

A lymphoblastic cell line (K45) established from a child with acute lymphoblastic leukemia (ALL) is characterized by a profusion of intracytoplasmic particle aggregates (PA) similar in morphology to those occurring in fresh childhood ALL cells. The PA in K45 cells were examined for morphology and capacity for nucleic acid synthesis to test the hypothesis that they are identical to those in fresh ALL cells, and also to identify characteristics which might distinguish PA from cell organelles and which might determine if they are viral-like. In contrast to cell organelles, the PA in both K45 and ALL cells were found to be characterized by a localized thickening of the particle wall. Furthermore, autoradiography of K45 cells showed uptake by PA of 3H uridine rather than 3H thymidine indicating an RNA composition. The presence of PA in profusion was associated with, but preceded necrotic death of K45 cells. These combined features suggest that the PA in K45 and in ALL cells are identical, that they are distinct from cell organelles, are not formed as a consequence of the initiation of cell death and that, while their exact nature remains unknown, a viral origin cannot be excluded.

Autoradiography↗
PubMed1991

Case-control evaluation of a school-age BCG vaccination programme in subtropical Australia.

In 1956 a programme was initiated to vaccinate all children aged 12-14 years who were attending schools in Queensland, Australia. In view of the declining incidence of tuberculosis in Australia as a whole, there was a need to evaluate the effectiveness of the programme and its procedures. We therefore carried out a case-control study of Queensland's population, excluding certain known high-risk groups. Cases were Queensland residents with notified tuberculosis and of the appropriate age; two controls per case were chosen from the electoral roll. Information on vaccination status was obtained mainly from questionnaires and school records, where available. The results show that at best BCG vaccination had a modest protective effect, approximately 30% when the patients were diagnosed, which was on average 15 years after they had been vaccinated in the school programme. In the north the climate of Queensland is tropical, while in the more heavily populated south it is subtropical. A substantial proportion of the school records reported weak positive reactions to preliminary tuberculin testing, believed to be due largely to atypical mycobacteria. A similar phenomenon has been observed in other tropical regions, and may help to explain the apparent absence of a strongly protective effect for BCG vaccination.

Adolescent↗
PubMed1990

A randomized, controlled, double-blind, cross-over, clinical trial of Q fever vaccine in selected Queensland abattoirs.

A limited, randomized, blind, placebo-controlled trial of Q fever and influenza vaccines has been conducted in three Queensland abattoirs on a sequential analysis design. Ninety-eight subjects were given Q fever vaccine and 102 influenza vaccine. Q fever cases were observed in unvaccinated workers in all three abattoirs during the period of observation. A total of seven Q fever cases in one group, one more than the number required to achieve statistical significance between the two vaccine groups, was reached after 15 months with the cases coming from two of the abattoirs. These Q fever cases were in the group which had been given influenza vaccine and none in that given Q fever vaccine. Symptomless seroconversion rates of 24% were found in the remaining influenza virus vaccinees, and those without immunity were given Q fever vaccine.

Abattoirs↗
PubMed1989

Melanocytic nevi in schoolchildren in Queensland.

In a group of 211 schoolchildren in Queensland less than 12 years of age, the mean total melanocytic nevus (mole) count was 28 (median 19), and the mean count for raised nevi was 11 (median 8). The upper aspect of the back and chest were the most commonly affected sites, with the neck being the third. Boys had significantly (p less than 0.01) more melanocytic nevi than girls, and prevalence was highest in children with pale skin and light-colored hair. Nonwhite heritage had a protective effect independent of pigmentary characteristics. Total numbers of nevi on children also were related to maternal tendency to large numbers of moles and to family history of melanoma. The only significant association observed for the presence of large (greater than 5 mm) nevi on children was a family history of melanoma. The children studied come from a general population that has the highest known risk of melanoma. In Australia they have been shown to have the highest prevalence of nevi ever reported in the prepubertal age group. These descriptive data, together with the specific pigmentary and family associations described, extend the known links between benign nevi and malignant melanoma.

Child↗
PubMed1989

Breast cancer and breastfeeding: results from an Australian case-control study.

A case-control study of breast cancer, diet, and lactational history was carried out in Brisbane, Australia, between 1981 and 1985. Cases were recruited from both the private and the public health care sectors. The breastfeeding histories of 459 cases and 1,091 controls selected from the electoral roll were analyzed. An odds ratio of 0.85 (95% confidence interval 0.55-1.30) for any lactation versus no lactation was observed, with no suggestion of a monotonic trend with increasing duration. This estimate was only slightly altered by multiple logistic regression analysis. A statistically significant nonlinear association was noted for breastfeeding of the first liveborn child (chi 2 = 14.8, df = 6; p less than 0.05), with a slightly elevated odds ratio for lactations of less than one month, a lowered odds ratio for lactations of one month to three months, and a weakly elevated odds ratio in women breastfeeding for more than nine months. Results for premenopausal women were very similar to those for postmenopausal women. Taken together with other recent studies, these results suggest that lactation may play a modest direct or indirect part in reducing the risk of breast cancer.

Breast Feeding↗
PubMed1988

Adverse effect of early high-dose adrenaline on outcome of ventricular fibrillation.

Resuscitation for cardiac arrest was monitored over 4 years to examine the effect on survival of a change in the ventricular fibrillation (VF) protocol to include the routine early use of "high-dose" intravenous or transbronchial adrenaline. A significant reduction in the immediate survival of patients with VF was seen when the protocol was changed (22% after the change, 43% before). Prior predictors of poor response were similar in each group, except for the number of witnessed arrests, delay until cardiopulmonary resuscitation, and occurrence of endotracheal intubation, but multiple logistic regression showed the use of adrenaline to be an independent predictor of outcome. Early high-dose adrenaline was associated with a reduction in immediate survival in patients with persistent VF.

Aged↗
PubMed1988

Major upper gastrointestinal tract bleeding. Relation to the use of aspirin and other nonnarcotic analgesics.

In a hospital-based case-control study, the risk of a first episode of major upper gastrointestinal tract bleeding in subjects now known to be predisposed was assessed in relation to the use of nonnarcotic analgesics. For aspirin use within the week before the onset of symptoms, the rate ratio estimates, adjusted for potential confounding, were 15 (95% confidence interval, 6.4 to 34) for regular use (at least four days a week) and 5.6 (confidence interval, 2.7 to 12) for occasional use. For aspirin use discontinued at least one week earlier, the estimate was 1.6 (confidence interval, 0.6 to 4.2). There was no evidence that acetaminophen use increased the risk. For the regular use of other analgesics in the week before onset, the adjusted rate ratio estimate was 9.1 (confidence interval, 2.7 to 31); there were insufficient data to evaluate occasional use. The findings suggest that the risk of bleeding is increased substantially by aspirin, even when used occasionally. With the exception of acetaminophen, other nonnarcotic analgesics may also increase the risk, but they remain to be evaluated individually.

Acetaminophen↗
PubMed1988

Analysis of the responding and stimulating cells in the AMLR of patients with rheumatoid arthritis using limiting dilution.

Plastic adherent and non-adherent mononuclear cells derived from synovial fluid were found to stimulate peripheral blood mononuclear cells of patients with rheumatoid arthritis (RA) in an autologous mixed lymphocyte reaction (AMLR). Stimulation produced by adherent cells was consistently greater than that produced by non-adherent mononuclear cells. CD11 enriched cells were not significant stimulators in the AMLR, however their presence was required for a significant reaction to occur. Limiting dilution studies revealed that the most plausible model involved two or more cells of the same type in each of the stimulator and responder populations for the AMLR to occur.

Arthritis, Rheumatoid↗
PubMed1987

Differences in mortality from acute myocardial infarction between coronary care unit and medical ward: treatment or bias?

To analyse the effectiveness of coronary care units in reducing mortality from myocardial infarction 18 hospitals ranging from large urban teaching hospitals to small country hospitals were stratified into four levels of care. Previous analysis had failed to show significant differences in the overall mortality in hospital among levels. There were significant differences in mortality, however, between those patients allocated to be cared for in the coronary care unit and those in the medical wards in the more advanced hospitals. The differences were largest in the hospitals with the most elaborate facilities (level 1) and non-existent in those with the least (level 4). Several analytical approaches to these observed differences indicated that they were: (a) reduced by adjustment for age and severity of infarction; (b) paralleled by differences in coexisting disease recorded on death certificates; (c) no longer significant at level 1 after allowing for differences in coexisting disease; and (d) not significant at any level after exclusion of patients first diagnosed at necropsy. These findings suggest that the observed differences in mortality between coronary care units and medical wards are largely due to bias in selection and diagnosis.

Age Factors↗
PubMed1987

Trends in coronary heart disease in Queensland, 1971-1980. An interpretation.

Routine data on mortality and hospital activity were used to estimate changes in coronary heart disease mortality, case fatality, and hospitalizations in the Australian state of Queensland over the decade 1971-1980. Acute myocardial infarction (International Classification of Diseases (ICD) 410) and other ischemic heart disease (ICD 411-414) were considered separately. For acute myocardial infarction, age-adjusted total mortality declined by about one fourth in both men and women; in-hospital mortality decreased somewhat more and deaths out of hospital correspondingly less. The age-adjusted case fatality ratio fell by the same amount (29%), in both sexes. Similar trends occurred at all ages. Admission rates decreased 11% in men and 18% in women. Similar patterns were evident for other ischemic heart disease except for admissions, which rose 23% among men and remained at the same level in women. These findings suggest that both declining incidence, particularly in the form of fewer deaths out of hospital, and improvements in care may have contributed to the general decline in coronary heart disease mortality in this community. Without direct measures of incidence or changing disease severity, the relative contributions of each factor cannot be examined.

Age Factors↗
PubMed1986

Respiratory function in aboriginal children.

One hundred and fifty-one Aboriginal school children and 246 non-Aboriginal children, all aged between 11 and 15 years, performed lung function tests with a Vitalograph spirometer. The results showed that the mean forced vital capacity was 20% larger in non-Aboriginal children of both sexes. Similar differences were found for the one-second forced expiratory volume, which was 15% larger for the non-Aboriginal boys and 17% larger for the non-Aboriginal girls. Comment is made on their smoking practices.

Adolescent↗