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Biomedical subjects

A L Hansell

Publications and source records attributed to A L Hansell.

7 recordsLinked to original sources
PubMed2004

Medical event profiling of COPD patients.

PURPOSE: This analysis proposes appropriate descriptive and analytical statistical techniques to profile medical events requiring GP consultation using the example of chronic obstructive pulmonary disease (COPD). METHODS: Consultation patterns were examined for 1807 cases with a diagnosis compatible with COPD in 1998 and a group of controls matched by sex, age and practice from the General Practice Research Database, a nationally representative UK primary care database. Consulting patterns by Read code chapter and chapter subdivision were examined using cluster analysis, logistic regression and classification and regression trees (CART). RESULTS: CART and multivariate logistic regression analyses suggested that COPD patients were more likely to consult with pulmonary circulatory disease (multivariate OR: 7.46 (95% confidence intervals: 2.05, 20.01) ), non-COPD respiratory diseases (2.77 (2.28, 3.37)), mycoses (2.0 (1.43, 2.71)), 'symptoms or ill-defined conditions' (1.95 (1.68, 2.29)), or other forms of heart disease (1.84 (1.92, 2.64)), and less likely to consult with hypertensive diseases (0.73 (0.57, 0.96)). Regression also showed positive associations with digestive system diseases (OR: 1.31 (1.02, 1.68)) and negative associations with 'other viral or chlamydial disease' (0.16 (0.03, 0.88)). A borderline significance reduced risk for cancers was seen in univariate logistic regression analyses. Cluster analyses were not useful in discriminating between cases and controls. CONCLUSIONS: These analyses provide information about the natural history of COPD and could be used to help interpret or detect adverse drug reactions if repeated before and after introduction of a treatment. COPD can be considered a multicomponent disease with more frequent comorbidities than age- and gender-matched individuals without COPD.

Aged↗
PubMed2003

What do chronic obstructive pulmonary disease patients die from? A multiple cause coding analysis.

Information on obstructive lung disease (OLD) deaths is generally derived from the underlying cause of death on the death certificate. This neglects information on other conditions mentioned and may underestimate the burden of disease. Descriptive analyses of all conditions mentioned on the death certificate for all decedents where OLD (chronic obstructive pulmonary disease or asthma) was mentioned as a contributing cause of death were conducted for England and Wales for 1993-1999. OLD was mentioned in 312,664 or 8.0% of all deaths. OLD comprised the underlying cause of death in 59.8% of deaths with any mention of OLD. Where OLD was not the underlying cause of death, the leading causes by the International Classification of Disease version 9 chapter were diseases of the circulatory system, neoplasms, and non-OLD diseases of the respiratory system. The top single causes were acute myocardial infarction, other ischaemic heart disease, and lung cancer. The current analysis confirms that using the underlying cause of death underestimates the contribution of obstructive lung disease to mortality in England and Wales, in contrast to myocardial infarction where underlying cause of death captures most (94%) mentions on the death certificate.

Adolescent↗
PubMed1998

An outbreak of Salmonella enteritidis phage type 5a infection in a residential home for elderly people.

The first outbreak of Salmonella enteritidis phage type (PT) 5a infection to be reported occurred after a party in a residential home for elderly people in May 1995. The party was attended attended by 96 residents, staff and guests. S. enteritidis PT5a was isolated from 14 of the 25 clinical cases identified after the party and S. enteritidis PT4 from another clinical case. Two elderly residents with S. enteritidis PT5a infection died. Infection with S. enteritidis PT5a was associated with consumption of prawn in mayonnaise vol-au-vents, sausage rolls, corned beef sandwiches, and sausages. The investigation of this outbreak illustrated the difficulty that elderly people may have in the completion of questionnaires. It also highlighted areas for intervention; such as reminders about basic hygiene precautions to prevent secondary spread and the importance of coordinated reinforcement in the workplace of formal food hygiene training for cooks. The Food Safety Regulations 1995 came into force soon after this outbreak: their implementation would probably have prevented it.

Adolescent↗