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Biomedical subjects

C S Probert

Publications and source records attributed to C S Probert.

At least 55 records · Page 3Linked to original sources
PubMed1992

Epidemiological study of ulcerative proctocolitis in Indian migrants and the indigenous population of Leicestershire.

A retrospective epidemiological study of ulcerative colitis (UC) and proctitis was performed in Leicestershire from 1972-89. Potential cases were identified from hospital departments of pathology, endoscopy, and medical records and from general practitioners. The county population includes more than 93,000 South Asians. There were 573 cases of UC and 286 of proctitis in Europeans and 115 cases of UC and 29 of proctitis in South Asians. The standardised incidence of UC in Europeans and South Asians was stable, except in Sikhs in whom it had increased rapidly. The relative risk of UC to South Asians was 2.45. The standardised incidences of UC in South Asians during the 1980s were: 10.8/10(5)/year in Hindus (95% confidence interval (CI) 7.4-14.1 cases/10(5)/year) 16.5/10(5)/year in Sikhs (95% CI 7.9-25.2 cases/10(5)/year), and 6.2/10(5)/year in Muslims (95% CI 1.6-10.9 cases/10(5)/year). There was no difference in incidence between Asians from East Africa and India. The standardised incidence of UC in Europeans was 5.3/10(5)/year (95% CI 4.3-6.3 cases/10(5)/year). The standardised incidences of proctitis were 3.1/10(5)/year (95% CI 1.9-2.5 cases/10(5)/year) in South Asians and 2.3/10(5)/year (95% CI 1.8-2.4 cases/10(5)/year) in Europeans. Ethnic groups had a similar disease distribution, except Sikhs in whom it was less extensive. Despite the similar disease distribution, South Asians had fewer operations and complications from UC than Europeans. There was a bimodal age specific incidence in Europeans, but not in other ethnic groups. First and second generation South Asians were at similar risk. Hindus and Sikhs have a significantly higher incidence of UC than Europeans in Leicestershire.

Adolescent↗
PubMed1992

Epidemiological study of abdominal tuberculosis among Indian migrants and the indigenous population of Leicester, 1972-1989.

A retrospective, epidemiological study of abdominal tuberculosis in the city of Leicester from 1972 to 1989 is reported. Potential cases were identified from hospital medical records and endoscopy lists, in addition to the county notification register. The city population of 280,000 included over 75,000 South Asians. There were 146 cases among South Asians and six in Europeans, four of whom were British. The standardised incidence of abdominal tuberculosis in South Asians decreased significantly from 22.3 cases/10(5)/year during the 1970s to 9.2 cases/10(5)/year in the 1980s (chi 2 = 42, p < 0.001). The incidence during the 1980s was 10.7/10(5)/year in Hindus, 8.7/10(5)/year in Sikhs, and 4.6/10(5)/year in Muslims. The relative risk to Hindus was 2.3 fold greater, and for Sikhs 1.9 fold greater, than that for Muslims, a finding similar to that in pulmonary tuberculosis. The standardised incidence in Europeans was 0.2/10(5)/year and they had significantly less abdominal tuberculosis than South Asians (Z = 8.6, p < 0.001 and relative risk = 46). The standardised mortality ratio was significantly increased in Europeans (standardised mortality ratio = 755, 95% confidence interval 90-2730, chi 2 = 11.4, p < 0.001), but not in South Asians (standardised mortality ratio = 68, 95% confidence interval 20-160). Resection rates were similar between the two ethnic groups. Abdominal tuberculosis still occurs among migrants, and clinicians should remain alert to this in South Asians.

Adolescent↗
PubMed1992

Mortality from Crohn's disease in Leicestershire, 1972-1989: an epidemiological community based study.

Mortality among 610 people with Crohn's disease identified in a population based study from 1972-89 was assessed. In Europeans the overall mortality was not increased, the standardised mortality ratio (SMR) was 71.8 (95% confidence interval (CI) 49 to 101). The SMR in South Asians was 0, (95% CI 0 to 1590). The SMR varied with the site of disease (chi 2 (4) = 10.5, p < 0.05) and was highest in those with duodenal and jejunal involvement (SMR = 210, 95% CI 44 to 621). Survival curve comparisons showed that colonic disease carried a worse prognosis than terminal ileal disease (chi-2 = 9, p < 0.01) or mixed site disease (chi-2 = 4.7, p < 0.05). Mortality was particularly high during the first six years. It was increased in patients who had undergone more than one resection (SMR = 137, 95% CI 28 to 401) or an ileoanal anastomosis (SMR = 357, 95% CI 9 to 1070), although no difference was significant. Mortality did not change significantly during the study. Such information needs to be made available, not just to patients, their families, and their doctors, but perhaps more importantly, to actuaries, insurers, and those advising employers.

Adolescent↗
PubMed1992

Crohn's disease in Bangladeshis and Europeans in Britain: an epidemiological comparison in Tower Hamlets.

The incidence of Crohn's disease in a defined Bangladeshi community was assessed in a retrospective, epidemiological study in the London Borough of Tower Hamlets from 1972 to 1989. The borough population of 164,000 includes over 28,000 Bangladeshis. Potential cases were identified from hospital pathology and medical records. There were 99 cases of Crohn's disease during the study period, of which five were Bangladeshi. The mean standardized incidence in Bangladeshis was 1.2/10(5)/year in the 1970s and 2.3/10(5)/year in the 1980s compared with 3.8/10(5)/year and 4.1/10(5)/year in Europeans, and 4.6/10(5)/year and 5.4/10(5)/year in West Indians, respectively. None of the changes with time was statistically significant. There were no cases amongst Hindus. The relative risk to Europeans, compared to Bangladeshis, was 2.5 during the 1970s and 2.0 in the 1980s. The difference between European incidence and that of other ethnic groups was not statistically significant; however, the number of Bangladeshi cases was small (five), and diminishes the power of the study. The apparent similarity of the incidences of Crohn's disease in Bangladeshis and Europeans contrasts with findings in other South Asians. Further investigations of the differences in incidence of Crohn's disease in South Asians is needed.

Adolescent↗
PubMed1992

Management of coeliac disease: a changing diagnostic approach but what value in follow up?

OBJECTIVE: To assess the management of patients with coeliac disease in relation to a change in diagnostic method from jejunal suction biopsy to endoscopic biopsy. DESIGN: 16 item questionnaire survey of consultant members of the British Society of Gastroenterology. SUBJECTS: 359 consultant physician and gastroenterologist members of the society. MAIN MEASURES: Type of routine biopsy; repeat biopsy after gluten withdrawal; gluten rechallenge; follow up measurements; screening for malignancy; and methods of follow up, including special clinics. RESULTS: 270(70%) members replied; 216(80%) diagnosed coeliac disease routinely by endoscopic duodenal biopsy, 30(11%) by jejunal capsule biopsy, and the remainder by either method. Only 156(58%) repeated the biopsy after gluten withdrawal, though more did so for duodenal than jejunal biopsies (134/216, 62% v 13/30, 43%; p < 0.02). Follow up biopsies featured more duodenal than jejunal biopsies (133/156, 82% v 23/156, 15%; p < 0.02). Regular follow up included assessments of weight (259, 96%) and full blood count (238, 88%) but limited assessment of serum B-12 and folate (120, 44%) and calcium (105, 39%) concentrations. Routine screening for malignancy is not performed, and there are few specialist clinics. 171(63%) respondents thought that patients should be followed up by a hospital specialist and 58(21%) by family doctors. CONCLUSIONS: The practice of diagnosing coeliac disease varies appreciably from that in many standard texts. Many patients could be effectively cared for by their family doctor. IMPLICATIONS: The British Society of Gastroenterology should support such management by family doctors by providing clear guidelines for them.

Biopsy↗
PubMed1992

Low incidence of ulcerative colitis and proctitis in Bangladeshi migrants in Britain.

To assess the incidence of ulcerative colitis and proctitis in a defined migrant population, a retrospective, epidemiological community study was performed in the London Borough of Tower Hamlets from 1972 to 1989. The population of 164,000 includes 28,000 Bangladeshis. Potential cases were identified from hospital departments of pathology and medical records. There were 107 cases of ulcerative colitis in Europeans and 5 in Bangladeshis. There were 74 and 2 cases of proctitis in these communities, respectively. The mean standardised incidence of ulcerative colitis in Bangladeshis (1.8 cases/10(5)/year) was marginally lower than in Europeans (6.2 cases/10(5)/year, Z = 0.7, n.s.). The mean standardised incidence of proctitis in Bangladeshis was 0.6 cases/10(5)/year and in Europeans 3.2 cases/10(5)/year (Z = 0.6 n.s.). Anatomical extent of colitis was similar in all ethnic communities, although complications were less likely in minority groups. These findings suggest that the incidence of ulcerative colitis and proctitis in Bangladeshis, in Britain, is amongst the lowest in the world.

Age Factors↗
PubMed1992

Sexual dysfunction amongst women with Crohn's disease: a hidden problem.

The sexual problems of 50 women with Crohn's disease, of whom 45 had a stable relationship, were investigated by structured interview and compared with age-matched controls. Twenty-four percent patients had either infrequent or no intercourse compared with 4% of controls (chi 2 = 8.3, p < 0.005). However, amongst patients and controls who were sexually active, the frequency of intercourse was similar. Reasons for sexual inactivity included abdominal pain (24%), diarrhoea (20%) and fear of faecal incontinence (14%). Dyspareunia was common in patients (chi 2 = 6.5, p < 0.01) and this was irrespective of the site of disease (large vs. small bowel chi 2 = 0.85, NS). Women with perianal disease and fistulae were more likely to have dyspareunia than women with neither (chi 2 = 4.2, p < 0.05), although this was not so for less extensive involvement with only perianal disease (chi 2 = 2.8, NS) or fistulae (chi 2 = 0.8, NS). Vaginal candidiasis was more common in patients (chi 2 = 5.8, p < 0.02), and on occasions this may have contributed to dyspareunia. Women with Crohn's disease experience sexual problems much more than healthy controls and they need support, sympathetic investigation and management.

Adult↗
PubMed1992

Education and young people with inflammatory bowel disease.

Children and their parents are often anxious that chronic disease may interfere with examination performance. The provision within schools for children with inflammatory bowel disease (IBD) was investigated by a postal survey of headteachers of 98 schools with over 48,000 pupils in Leicestershire and Cardiff. Headteachers in Cardiff were more likely to have heard of ulcerative colitis (95%) than those in Leicestershire (70%), (X2 = 4.5, p less than 0.05). They knew of 16 children with inflammatory bowel disease. The majority of heads provide easy access to lavatories during examinations and would tell the examining body of a child's medical problem. While most heads would like more information about inflammatory bowel disease, few have facilities to inform teachers about chronic illness in young people. Most think healthy young people should be provided with information about chronic diseases, which they would like provided by nurses. Inflammatory bowel disease (IBD) affects over 1200 children in the United Kingdom. Children and their parents are concerned that these conditions will interfere with schooling, taking examinations and their employment (Rees et al 1983, Wyke et al 1988). Provisions by schools for children with IBD were investigated.

Adolescent↗
PubMed1992

Dietary fats and inflammatory bowel disease in Asians.

Chemically processed, hydrogenated fats, such as margarine, have been implicated in the aetiology of inflammatory bowel disease. Toxic by-products may occur in their production or during frying and cooking. A survey of dietary oil usage was conducted among Asians in Leicester, comparing inflammatory bowel disease patients with healthy controls. Two groups were comparable for age, sex, religion, place of birth, number of years spent in Britain and vegetarian status. There were no significant differences in actual oils used between healthy controls and patients with ulcerative colitis or Crohn's disease (chi 2 = 0.142 and 1.803 respectively, p greater than 0.50). However patients with Crohn's disease were found to recycle their cooking oil significantly more often than age and sex-matched colitics (p less than 0.05) and particularly age and sex-matched controls (p less than 0.01). A similar study needs to be conducted in India where the incidence of inflammatory bowel disease is low. If this difference is confirmed a programme of health education in cooking habits could lower the incidence of Crohn's disease.

Dietary Fats↗
PubMed1992

Epidemiology of Crohn's disease in Indian migrants and the indigenous population in Leicestershire.

A retrospective, epidemiological community study of Crohn's disease was performed in Leicestershire from 1972 to 1989. The county population of 930,000 includes 93,000 South Asians. Potential cases were identified from hospital departments of pathology, endoscopy and medical records, in addition to general practitioners. There were 582 cases in Europeans and 28 in South Asians. The incidence of Crohn's disease in Europeans and South Asians has increased, particularly in Muslims. The standardized incidence in South Asians during the 1980s was 2.4/10(5)/year in Hindus, 3.4/10(5)/year in Sikhs and 5.4/10(5)/year in Muslims. The standardized incidence in Europeans has risen significantly to 4.7/10(5)/year from 3.4/10(5)/year in the 1970s (chi 2 = 8.1, p less than 0.005). In Leicester this increase can be accounted for entirely by new cases of colonic disease. All ethnic groups had a similar disease distribution. Small bowel disease was inversely associated with age, whilst colonic disease increased with age. However, the difference in age-specific incidence of Crohn's disease for different age bands at various sites was not significant. Overall, Hindus have a much lower incidence of Crohn's disease than Europeans.

Adolescent↗
PubMed1991

Achalasia and diet: assessment of the effect of achalasia on the diet of patients and their spouses.

The effect of achalasia on the diet of patients and their spouses was investigated using a validated questionnaire. The discordance between the diet of the patients and their respective spouses was compared with matched controls. There is no statistically significant difference between the discordance of case couples and control couples. Patients with achalasia, and their spouses, eat a normal diet.

Adult↗
PubMed1991

Are we wasting time in out-patients departments?

Patients and people accompanying them to out-patient departments face an inevitable wait. We investigated the time people have to wait and if they would be interested in health education during that period. We discovered that patients want health education in the form of both videos and leaflets, but not posters. Patients and those accompanying them are particularly interested in heart disease and its prevention.

Data Interpretation, Statistical↗
PubMed1991

Information requirements and sedation preferences of patients undergoing endoscopy of the upper gastrointestinal tract.

Patients' attitudes to sedation and their information needs before undergoing endoscopy were investigated using a questionnaire. One hundred and two patients completed the study; 32 had undergone endoscopy before. Sixty-six (94%) of the new patients and all follow-up patients knew why they were undergoing the procedure; 65 (93%) new and 28 (88%) follow-up patients understood how the procedure was carried out. Forty-one percent of the new and 25% of the follow-up patients wanted an information booklet about their disease and its management. Most patients chose to be sedated during the endoscopy. The proportion wishing to be sedated did not differ significantly between the new and follow-up patient groups. Sedation and information should be offered to all patients undergoing endoscopy.

Attitude to Health↗