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Biomedical subjects

C C Patterson

Publications and source records attributed to C C Patterson.

At least 19 recordsLinked to original sources
PubMed1992

Incidence of childhood-onset insulin-dependent diabetes mellitus: the EURODIAB ACE Study.

EURODIAB ACE is a collaborative European study that was set up to assess incidence of childhood insulin-dependent diabetes mellitus (IDDM) in Europe, test the proposal of a south-north gradient, and to gather information to determine the causes and pathogenesis of the disease. Here, the basic epidemiological results are reported. Newly diagnosed cases of IDDM in children aged up to 15 years were identified prospectively in twenty-four geographically well-defined study regions in Europe and Israel (a total of 16.8 million children) during 1989 and 1990. 3060 cases were identified with estimated ascertainment rates exceeding 90% in all study regions. Age-standardised and sex-standardised incidence rates varied widely, ranging from 4.6 (northern Greece) to 42.9 (two regions in Finland) cases per 100,000 per year. Rates in southern Europe were generally higher than previously assumed, and there was an unexpectedly high incidence in Sardinia, which had the second highest rate (30.2 cases per 100,000 per year) recorded in Europe. Eastern European regions had generally low rates. The collaborative network now established provides a framework for further studies to examine the complex interaction between genetic and environmental factors in the cause and pathogenesis of IDDM.

Adolescent↗
PubMed1992

Serum copper and zinc in random samples of the population of Northern Ireland.

Serum copper and zinc concentrations (mumol/L) were measured in nonfasting subjects aged 25-64 y participating in two independent population surveys in Northern Ireland. In 1983-84, copper in 1144 males was 17.2 +/- 3.1 (mean +/- SD) and zinc was 12.1 +/- 1.7 (SD). Copper in 1055 females, neither pregnant nor taking estrogens or progestogens, was 19.0 +/- 3.9 and zinc was 11.6 +/- 1.4. In 1986-87 copper in 1142 males was 17.9 +/- 3.3 and zinc was 13.2 +/- 2.1. Copper in 1034 females was 20.1 +/- 3.9 and zinc was 12.7 +/- 2.0. Zinc but not copper concentrations decreased from early morning to late afternoon; both were unaffected by reported postprandial time. There was a positive relationship between copper and age for both sexes but zinc showed only a slight upward trend with age. A positive relationship between copper and the aggregation of classical risk factors for coronary heart disease was demonstrated.

Adult↗
PubMed1992

Synergistic interaction between midazolam and propofol.

We gave either midazolam or propofol for induction of anaesthesia to 140 ASA I or II female patients (18-60 yr). ED50 values were obtained by probit analysis for three clinical end-points: loss of response to command; loss of eyelash reflex; failure to respond to application of an anaesthetic face mask delivering 1% isoflurane. Propofol ED50 values (95% confidence intervals) were 1.25 (0.99-1.48) mg kg-1, 1.61 (1.29-1.94) mg kg-1 and 1.51 (1.20-1.82) mg kg-1, respectively. ED50 values for midazolam were 0.26 (0.20-0.37) mg kg-1, 0.29 (0.23-0.47) mg kg-1 and 0.25 (0.20-0.32) mg kg-1, respectively. An additional 92 similar patients received one of nine dose combinations of midazolam and propofol for induction of anaesthesia, propofol being administered 2 min after midazolam. Success of induction was based on the clinical end-point of loss of response to command. Administration of 25% of the ED50 of midazolam followed by 50% of the ED50 of propofol resulted in loss of response to command in 50% of patients, while 50% of the ED50 of midazolam, followed by 25% of the ED50 of propofol had the same effect. A probit regression model specifying a synergistic interaction between midazolam and propofol fitted the data significantly better than a model specifying no interaction.

Adolescent↗
PubMed1992

Urban/rural and deprivational differences in incidence and clustering of childhood diabetes in Scotland.

Scottish hospital discharges were monitored during the period 1977-1983 for new cases of diabetes in children aged 18 years or under. An estimated ascertainment rate of 94% was obtained by validation against an independent register of cases. The postcode sector at the time of admission was available for 2125 (97%) of the 2183 cases, and was used as the basis for a small-area analysis of urban/rural and socioeconomic differences in incidence and to test for clustering. Incidence rates standardized for age and sex showed important differences between the 16 Scottish postcode areas. At the sector level, the standardized rate was 20% lower in urban sectors compared to rural sectors, but this could be explained by area to area differences and by socioeconomic effects within areas. In contrast, significant socioeconomic differences in incidence were evident within areas which could not be explained by urban/rural effects, the children in deprived sectors having 80% of the risk of those in other sectors. Rates were particularly low among children in deprived urban sectors. Nevertheless, significant variations in incidence remained between the 16 areas which could not be explained by either urban/rural or socioeconomic differences, indicating the existence of other important factors. Tests for clustering of cases both within postcodes sectors and across adjacent postcode sectors were also performed. Although clusters could be identified, they were no more common than would be expected by chance. Tests for space-time clustering were also negative.

Adolescent↗
PubMed1991

Poor prognosis for malignant melanoma in Northern Ireland: a multivariate analysis.

All cases of cutaneous malignant melanoma, CMM, diagnosed in Northern Ireland between 1974-1978 were reviewed, classified and followed up until the end of 1984. The overall 5 year survival is 54%, among the worst reported in recent literature. Multivariate analysis of these cases confirms some previous findings from other studies, but also reveals features not apparent in univariate analysis. Prognosis worsens with increasing thickness and the presence of ulceration. Likewise histopathological type has an independent effect on survival, ALM having the worst prognosis. Tumour profile emerges as a significant feature affecting prognosis, flat lesions having the poorest outlook, given their thickness. Survival is worse with increasing age. Anatomical site is less important than suggested by previous univariate analysis. Sex has little influence on prognosis when adjusted for the other variables. Cell type and pigmentation are of no prognostic value. Several features including diagnostic delay contribute to the poor overall survival for CMM in Northern Ireland. Educational intervention is essential if this trend is to be reversed.

Female↗
PubMed1991

A sibling-controlled study of intelligence and academic performance following Reye syndrome.

The authors compared the intellectual, cognitive and academic abilities of 22 survivors of Reye syndrome attending normal schools with the sibling nearest in age as control. The British Ability Scales, visual and verbal IQ, short-term memory scales and attainment tests were administered to all children. Reye syndrome children as a group differed significantly from the controls only on the basic number skills test. However, children with severe encephalopathy and those whose illness occurred in infancy had significant deficits on many of the tests. 18 children recovered without requiring 'additional educational provision'; the mean IQ of the 22 Reye syndrome children was 101. Nonetheless, these children's poor performance on the basic number skills test has important implications for teachers, and careful monitoring of future educational performance is essential.

Achievement↗
PubMed1991

Prognosis in familial non-polyposis colorectal cancer.

Familial cases of non-polyposis colorectal cancer have attracted much interest but little is known of their natural history. Using a population based study we have determined whether a positive family history of bowel cancer is an independent prognostic factor. All patients under 55 years with histologically confirmed colorectal cancer in Northern Ireland during the period 1976-8 were studied. The family history was validated in 95% of all nonpolyposis cases (n = 205). Medical history or cause of death were verified for 98% of 1811 first degree relatives. The strength of the family history was assessed using a score that compares the mortality from bowel cancer in the family against the average population mortality, taking account of family size and age structure. The family history score was not predictive of survival neither in univariate analysis or in a Cox's proportional hazards multivariate analysis controlling for age, sex, stage, site, and duration of symptoms. In conclusion, a positive family history does not independently influence prognosis in patients with bowel cancer.

Cause of Death↗
PubMed1991

Histologic characteristics and outcome of familial non-polyposis colorectal carcinoma.

Familial cases of non-polyposis colorectal cancer have recently attracted much interest. Little is known about the characteristic histology or natural history of disease in such cases. Our aim was to determine, through a population-based study, whether mucin-secreting tumours were associated with a positive family history and whether 'familiality' was an independent prognostic variable. All patients under 55 years of age with histologically verified colorectal cancer in Northern Ireland during 1976-78 were studied. The family history was validated in 95% of all non-polyposis cases (n = 205), and the proband's histologic specimen reviewed in over 99%. Mucin-secreting tumours were significantly associated with a positive family history, but familiality was not found predictive of survival in a multivariate analysis controlling for age, sex, stage, site, symptom duration, differentiation, and histologic type.

Adenocarcinoma, Mucinous↗
PubMed1991

Geographical variations and recent trends in cancer mortality in Northern Ireland (1979-88).

Cancer mortality in the 35-74 year age-range for selected sites during the period 1979-88 was investigated for the 26 district council areas of Northern Ireland. Trends in rates during the period were also studied and compared with trends in an earlier period, and with trends reported from the rest of the United Kingdom. Statistically significant differences between the age-standardised death rates in the 26 areas were observed for stomach cancer (women only), pancreatic cancer (women only), lung cancer (men and women) and for all cancers (men and women). Some evidence of spatial aggregation of rates was apparent for ovarian cancer even though rates in the 26 areas did not differ significantly. The patterns are illustrated with maps and some difficulties of interpretation are discussed. Mortality rates for oesophageal cancer increased during the period in both sexes while rates for stomach cancer decreased. Colon cancer rates increased significantly only in men, while an increase in lung cancer rates was confined to women. The mortality from all cancers increased significantly during the period by 0.8% per annum in men and 0.9% per annum in women. These trends were found to be broadly comparable with those reported elsewhere in the United Kingdom.

Adult↗
PubMed1990

On the use of a logistic risk score in predicting risk of coronary heart disease.

Many studies over the last 20 years have used logistic regression to model the relationship between the risk of developing coronary heart disease (CHD) and the levels of risk factors such as high blood pressure, high serum cholesterol, and cigarette smoking. Subsequently, several investigators have proposed the use of some of the published estimated logistic risk functions to predict risk in new populations. Because of great variation in definition of event, duration of follow-up, population characteristics, definition of risk variables, and selection of other variables in the logistic functions, direct use of such established functions would generally not have validity for the prediction of absolute risk levels. A review of fifteen of these studies indicates on the one hand generally similar results in direction and order of magnitude of effects of the major risk factors, confirming the importance of these risk factors of CHD. On the other hand the reviews indicate sufficient variation to suggest that extrapolation to new populations even to predict relative risk is not justified.

Age Factors↗
PubMed1990

Incidence, delay and survival in the Belfast MONICA Project coronary event register.

During the 1983-85 period, the Belfast MONICA Project registered coronary events in 2,512 individuals (1,913 men and 599 women). The attack rates in men and women per 1,000 person years were 5.9 and 1.7 respectively, and the corresponding mortality rates were 2.4 and 0.61; both rates were heavily age-dependent. There were statistically significant differences in the age and sex-standardised rates for the 107 electoral wards of the Study. The median delay time from onset to delivery of care was 2 hours 30 minutes and 3 hours 2 minutes for men and women, respectively. Delays were shorter in younger and married individuals, and in those with previous infarctions. Unmarried individuals and those with chronic ischaemic heart disease were at significantly increased risk of pre-care death. Sixty per cent of deaths within 28 days of onset occurred before the patient could be admitted to hospital. Sixty-four per cent of males and 67% of females were alive at 28 days. Manual workers and their spouses had a poorer survival at 28 days. Married men and women were at lowest risk of death in the first 28 days, and this could not be attributed to the effects of age.

Adult↗
PubMed1990

Sources of fat in the northern Irish diet.

The Belfast MONICA Project carried out the joint European Economic Community WHO MONICA Project nutrition study (EURONUT) in 1985-1986 in 401 males subjects (45-64 years) using 3-day weighed records. This resulted in 356 reliable records which were analysed. The mean energy intake was 2369 Kcals (9.9 MJ) with 38% of energy (including alcohol) derived from fat (16.5% from saturated fat, 14.0% from monounsaturated fat, 4.8% from polyunsaturated fat), 14.2% from protein, 43.2% from carbohydrate and 4.0% from alcohol. The mean total fat was 100.3 g (saturated fat 43.5 g, monounsaturated fat 36.9 g, polyunsaturated fat 12.5 g), with a P:S ratio of 0.32. The sources of the different kinds of fat and cholesterol are presented as cumulative percentages of the total. This is a useful way of identifying those foods which contribute chiefly to fat in the diet, and it should have important implications for the monitoring of progress towards meeting dietary guidelines.

Cholesterol, Dietary↗
PubMed1990

Incidence and site distribution of colorectal cancer in Northern Ireland.

Death rates from colorectal cancer in Northern Ireland are higher than in most of the rest of the United Kingdom. Although local surgeons have recognised this problem for some time it has remained unclear whether this reflects a greater underlying incidence or a worse mortality. We have reviewed all histological diagnoses of colorectal cancer in the province over a three year period and we report the incidence and site distribution for this disease in this population of one and a half million. With the exception of rectal cancer in females the incidence of colorectal cancer, whether histologically diagnosed or registered, is higher than in England, Wales or Scotland. The site distribution accords with that in other high risk countries. These results indicate that Northern Ireland has the highest underlying incidence of colorectal cancer in the United Kingdom.

Adult↗
PubMed1990

Validation of two methods of long-term epidemiological follow-up.

Two methods of long-term epidemiological follow-up were compared by using each to study the survival of 1622 myocardial infarction patients registered by the Belfast MONICA Project. Length of follow-up ranged between 3 and 5 years during which time 277 deaths were recorded. A computer-based method for linking MONICA Project registration records with the Registrar General's death certification data identified 273 of the 277 deaths. Follow-up supplied by the Northern Ireland Central Services Agency through the flagging of patients in their master patient index identified 271 deaths; four of the six deaths which were missed occurred before computerisation of the index was complete. The study illustrates the value of computer-based linkage with death certification data and of flagging in the Central Services Agency master patient index.

Computer Communication Networks↗