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Biomedical subjects

C Boyle

Publications and source records attributed to C Boyle.

At least 19 recordsLinked to original sources
PubMed1999

Prevalence and phenotype consequence of FRAXA and FRAXE alleles in a large, ethnically diverse, special education-needs population.

We conducted a large population-based survey of fragile X (FRAXA) syndrome in ethnically diverse metropolitan Atlanta. The eligible study population consisted of public school children, aged 7-10 years, in special education-needs (SEN) classes. The purpose of the study was to estimate the prevalence among whites and, for the first time, African Americans, among a non-clinically referred population. At present, 5 males with FRAXA syndrome (4 whites and 1 African American), among 1,979 tested males, and no females, among 872 tested females, were identified. All males with FRAXA syndrome were mentally retarded and had been diagnosed previously. The prevalence for FRAXA syndrome was estimated to be 1/3,460 (confidence interval [CI] 1/7,143-1/1,742) for the general white male population and 1/4, 048 (CI 1/16,260-1/1,244) for the general African American male population. We also compared the frequency of intermediate and premutation FRAXA alleles (41-199 repeats) and fragile XE syndrome alleles (31-199 repeats) in the SEN population with that in a control population, to determine if there was a possible phenotype consequence of such high-repeat alleles, as has been reported previously. No difference was observed between our case and control populations, and no difference was observed between populations when the probands were grouped by a rough estimate of IQ based on class placement. These results suggest that there is no phenotype consequence of larger alleles that would cause carriers to be placed in an SEN class.

Alleles↗
PubMed1996

Chondromyxoid fibroma of the sternum.

We report the fourth case of chondromyxoid fibroma of the sternum described in the literature. The clinical, radiographic, pathologic and treatment aspects of this case are presented, and the literature on chondromyxoid fibroma in this unusual location is reviewed.

Adult↗
PubMed1996

A prospective study of early pregnancy loss.

The New York State Early Pregnancy Detection Study was a prospective study of early pregnancy loss, between implantation and menses, in 217 women attempting to become pregnant during 1989-1992. Women collected urine samples on three consecutive mornings during the late luteal phase of their menstrual cycle, for up to 12 cycles, contributing samples for 1253 menstrual cycles. Urinary human chorionic gonadotrophin (HCG), measured using an immunoradiometric assay, was the biomarker for pregnancy. We observed a range of early pregnancy loss (EPL) rates, from a low estimate of 11.0% to a high estimate of 26.9%, depending on the definition used and the subgroup analysed. Based on a definition of 3 days of HCG concentration > or = 4.00 pmol/l, 2 days > or = 5.33 pmol/l or the last day of HCG > or = 6.67 pmol/l, we identified 115 positive cycles; 95 cycles were clinically confirmed pregnancies and 20 cycles were EPL, giving an EPL rate of 17.4% [95% confidence interval (CI) 11.0-25.6]. In addition, we observed an EPL rate of 19.5% (95% CI 11.3-30.1) for samples collected within a 15 day window around menses, and a rate of 20.3% (95% CI 11.3-32.2) for samples limited to the first three menstrual cycles. Because studies use urine collection schemes other than daily sampling, the definition of pregnancy will be crucial in defining EPL.

Abortion, Spontaneous↗
PubMed1996

Perceptions of quality in long-term care: a satisfaction survey.

At a 387-bed geriatric hospital in Montreal, Canada, a cross-sectional satisfaction survey was conducted on random samples of patients, families, families of deceased patients, and nursing staff. Using the same pretested structured questionnaire, the subjects were asked to rank (assign importance to) and rate (assign a rate of success to) 15 indicators of quality care. Significant differences both between and within the four groups were found on the perceived importance and rate of success of many of the indicators, supporting the primary hypotheses. Ethnicity and several sociodemographic covariates influenced the importance and rate of success assigned to the key indicators. The article discusses survey methodology issues as well as the integration of a satisfaction survey into an overall quality improvement program.

Aged↗
PubMed1996

Reproductive risk factors for epilepsy among ten-year-old children in metropolitan Atlanta.

The elements of a woman's reproductive history that may be associated with her risk of having a child who develops epilepsy have not been well described. To examine these possible associations, we used a multiple-source case ascertainment method to identify ten-year-old children with epilepsy who were living in the metropolitan Atlanta area in 1985-87; same-age control children were selected from public schools. To obtain reproductive history and other information, we interviewed 107 mothers of children with epilepsy and 408 mothers of control children. Twenty-nine children with a known intrauterine or postnatal aetiology were excluded from the analysis. We computed adjusted odds ratios for reproductive history characteristics, controlling for the race of the child, maternal education, census block group income, maternal pregnancy history and family history of a developmental disability. Our analyses indicated that mothers of children with epilepsy not only had more previous live births, but more previous adverse reproductive outcomes including spontaneous abortions, very low birthweight infants and infants with birth defects. The risk was especially strong for maternal history of a child with a birth defect. The specific types of birth defects reported in excess include central nervous system defects (specifically spina bifida) and Down's syndrome.

Case-Control Studies↗
PubMed1996

Patient surveys in general practice: a randomised trial of an instant lottery ticket to increase return rate.

BACKGROUND: Patient surveys are becoming increasingly common and already are an obligatory activity to qualify for a Better Practice Program Grant. Strategies to increase return rates remain unevaluated in Australian general practice. AIM: To evaluate the effectiveness of an instant lottery ticket as a response-aiding technique in patient surveys. METHOD: A random sample of adult patients was selected from an age-sex-disease register, stratified by sex and randomised to receive an instant lottery ticket with the self-administered questionnaire mailed out in December 1994. RESULTS: There was no significant difference by group either for women (P = 0.68), men (P = 0.88) or both sexes combined (P = 0.68). However, irrespective of inclusion of the lottery ticket, men were significantly less likely to return questionnaires than women (P = 0.02). CONCLUSIONS: Instant lottery tickets do not increase return rates to questionnaires and are not recommended. Other strategies need to be tested, particularly to involve male patients in general practice research.

Adult↗
PubMed1996

Effectiveness of telephone prompts when surveying general practitioners: a randomised trial.

BACKGROUND: Response rates to recent surveys of general practitioners have ranged from 44-95%. The effectiveness of a telephone prompt by a non-medical research assistant in advance of survey mail-out was unknown at the time of this study. OBJECTIVE: To determine the effectiveness of a telephone prompt by a non-medical research assistant to enhance response rates to a lengthy survey. SUBJECTS: 364 randomly selected general practitioners randomised into intervention and control groups. OUTCOME VARIABLE: Cumulative response rate at Day 18 and Day 60. DESIGN: Intervention group received a telephone call in advance of the survey. The control group received conventional mail-outs. Non-responders in both groups were telephoned at Day 28 and sent a reminder letter and questionnaire. RESULTS: 77% of the intervention group responded to the survey compared to 64% of the control group. Intention-to-treat analysis demonstrated a significantly earlier response by Day 18 (continuity corrected chi 2 = 18.15; df = 1; p < 0.001) and a significantly higher overall response by Day 60 (continuity corrected chi 2 = 5.41, df = 1, p < 0.009) from the intervention group. CONCLUSION: A telephone prompt by a non-medical research assistant will accelerate and enhance response rates to a survey of general practitioners although the differential effectiveness of a non-medical researcher compared to a medical practitioner conducting such prompts remains unstudied.

Australia↗
PubMed1995

Gravid students. Characteristics of nongravid classmates who react with positive and negative feelings about conception.

OBJECTIVE: To determine whether gravid classmates affect nongravid students' feelings about conception. METHOD: Cross-sectional survey of a school-based clinic population. We asked 130 nulliparous high school students who were seeking routine health care at an urban school-based clinic to complete an anonymous questionnaire concerning risk factors for and attitudes about teen pregnancy. RESULTS: The respondents were grouped according to the effect that contact with gravid classmates had on their desire for conception: increased desire (n = 13), no change in desire (n = 59), and decreased desire (n = 49). The analysis disclosed no significant group differences for age (mean +/- SD, 16.3 +/- 1.2 years), sex (65% female), welfare use (20%), or living situation (85% lived with a parent). The increased-desire group had significantly more sociodemographic risk factors for teen pregnancy than did the groups with no change and decreased desire. The group with increased desire was significantly more likely than the other two groups to be failing in school (54% vs 44% and 12.2%; P < .001), to have low education goals (15.4% vs 3.4% and 0%; P = .02), to be unhappy with their family support (69.2% vs 27.1% and 29.8%; P = .01), to be concerned about sterility (30.8% vs 8.6% and 6.1%; P = .03), not to be using contraceptives (77% vs 35.6% and 30.6%; P < .01), to want a pregnancy within 2 years (61.5% vs 25.4% and 12.2%; P < .001), and to have a sexual partner who wanted a pregnancy within 2 years (61.5% vs 13.6% and 8.2%; P < .0001). CONCLUSIONS: Our findings support the study hypothesis that that never-pregnant students in the increased-desire group had more sociodemographic risk factors for teen pregnancy than did students in the groups with no change or decreased desire. The results of this study may help to ally concerns about the adverse effect that the increased prevalence of gravid students in American schools might have on the childbearing attitudes of never-pregnant students.

Adolescent↗
PubMed1995

A randomised controlled trial of strategies to prompt attendance for a Pap smear.

OBJECTIVE: To assess the comparative efficacy, by randomised controlled trial, of three interventions designed to encourage "at risk" women to have a Pap smear: an educational pamphlet; letters inviting attendance at a women's health clinic; and letters from physicians. METHODS: Subjects at risk for cervical cancer who had not been adequately screened were identified by a random community survey and randomly allocated to one of the intervention groups or a control group. Six months after intervention implementation, a follow up survey assessed subsequent screening attendance. Self report was validated by comparison with a national screening data base. RESULTS: A significantly greater proportion of women (36.9%) within the group receiving a physician letter reported screening at follow up than in any other group (P = 0.012). The variables most strongly predicting screening attendance were: age, perceived frequency of screening required, use of oral contraceptives, and allocation to receive the physician letter intervention. CONCLUSIONS: The relative efficacy of the GP letter in prompting screening attendance shows that this strategy is worthy of further investigation. There remains a need to examine the barriers to screening for older women, and to develop tailored strategies for this population.

Adolescent↗
PubMed1994

Stroke in the elderly.

The incidence of stroke increases dramatically with advancing age. Progressive carotid atherosclerosis, cardiac arrhythmia and emboli, and vascular changes all contribute to this increasing incidence of stroke in the elderly. Treatment of hypertension and other risk factors have resulted in a decline in stroke over the last 50 years. The decline has been most prominent in the elderly. In recent years, this decline has slowed down or may even be reversing. Early and effective control of risk factors together with comprehensive management of acute stroke in a specialized unit is needed to further improve prognosis. Such an approach is especially important in the elderly, who may suffer from multiple problems. Treatment of hypertension and other risk factors have resulted in a decrease in an overall decline in the incidence of stroke over the last 50 years. This decline has been most apparent in the elderly. In recent years, however, there has been a slowing or possibly a reversal of this trend. Early and effective management of risk factors, aggressive therapy of patients with transient ischemic attacks and comprehensive management of acute stroke patients in specialized units may be required to further improve prognosis.

Aged↗
PubMed1994

Malignant cystosarcoma phyllodes.

UNLABELLED: This study reviewed 26 women who had resection of a malignant cystosarcoma phyllodes. Clinical presentations were palpable mass, 25; pain, 11; and ulceration, 2. Definitive surgical therapy was radical mastectomy (RM), 2; modified radical mastectomy (MRM), 14; total mastectomy (TM), 4; and partial mastectomy (PM), 6. Tumors ranged in size from 1-20 cm (median, 7 cm). Eight patients developed recurrent disease after 10-45 months. Local recurrence was more likely after TM and PM than after MRM and RM (P < 0.05). Patients who developed local recurrence only were treated by wide re-excision, and all such patients are alive with no evidence of disease at 5-25 years. Only one of 16 patients undergoing axillary dissection had involved lymph nodes. Four patients whose tumors ranged from 5-8 cm and who underwent one RM and three MRM developed systemic recurrence; all died of their disease after 15-48 months. CONCLUSION: 1) Although there is a higher local recurrence after PM and TM as compared with MRM and RM for malignant cystosarcoma phyllodes, the local recurrence can be treated with wide excision without affecting long-term survival; 2) systemic recurrence was not related to size or extent of resection; 3) axillary dissection does not predict for or prevent recurrence.

Adult↗
PubMed1992

Computerised infrared thermography and isotopic bone scanning in tennis elbow.

Thirty five cases of tennis elbow (17 unilateral, nine bilateral) were studied with infrared thermography and isotopic bone scanning. A hot focus was visualised in 16 of 17 cases of unilateral tennis elbow (94%) and in all nine cases of bilateral tennis elbow (100%) on infrared thermography, and abnormal increased epicondylar activity seen in 12 of 17 (71%) and eight of 18 (44%) cases respectively with isotopic bone scanning. Unilateral visual cooling (somatosympathetic responses) occurred in seven of 13 cases of unilateral tennis elbow (54%) with infrared thermography, and reduced perfusion in seven of 12 (58%) of similar cases with blood pool isotopic bone scanning. Computerised temperature assessments showed statistically significant side to side temperature differences when 17 active tennis elbows were compared with the opposite normal elbows for spot temperatures, proximal and distal forearm gradients. Similar temperature assessments in 18 bilateral tennis elbows compared with 17 normal elbows showed significant temperature differences for elbow spot temperatures and distal forearm gradients, but not for proximal gradients.

Adult↗