PubMed Health⌕ Search

Biomedical subjects

D Brook

Publications and source records attributed to D Brook.

At least 19 recordsLinked to original sources
PubMed2006

Two-view mammography at the incident round has improved the rate of screen-detected breast cancer in Wales.

AIM: To investigate whether pre-invasive and invasive cancer detection rates were improved in Wales after the introduction of two views at incident screens. METHODS: The records of women attending follow-up screening for 2 years before and 2 years after the introduction of two-view incident screening were analysed. Cancer detection rates were compared before and after introduction of two view screening. RESULTS: At the incident round 98,752 women had one and 95,464 had two views. Five hundred and fifty-five cancers were detected with one view and 744 with two, an increased detection rate from 5.6 to 7.8 cancers per 1000 women screened (p=0.01). Two hundred and thirty-nine small cancers were detected with one view and 323 with two, increasing the detection rate from 2.4 to 3.4 per 1000 women screened (p=0.05). CONCLUSIONS: Two-view mammography at incident rounds detects more cancers and more favourable prognosis small cancers than single-view mammograms.

Breast Neoplasms↗
PubMed2004

A case-control study to estimate the impact on breast cancer death of the breast screening programme in Wales.

OBJECTIVES: The aim of this study was to estimate the effect of service screening, as provided by the NHS breast screening programme, on breast cancer mortality in Wales. Furthermore, we wished to ascertain whether a reduction in breast cancer mortality consistent with that observed in the randomised screening trials was being achieved. SETTING: The NHS Breast Screening Programme in Wales, managed by Breast Test Wales, with headquarters in Cardiff. METHODS: A case-control study design with 1:2 matching. The cases were deaths from breast cancer in women aged 50-75 years at diagnosis who were diagnosed after the instigation of screening in 1991 and who died after 1998. The controls were women who had not died of breast cancer or any other condition during the study period. One was from the same GP practice and the other from a different GP practice within the same district, matched by year of birth. RESULTS: Based on 419 cases, the odds ratio for risk of death from breast cancer for women who have attended at least one routine screen compared to those never screened was 0.62 (95% confidence interval [CI] 0.47-0.82, p=0.001). After excluding cases diagnosed prior to 1995 and adjusting for self-selection bias, the estimated mortality reduction was 25% (odds ratio=0.75, 95% CI 0.49-1.14, p=0.09). CONCLUSION: The Breast Test Wales screening programme is achieving a reduction in breast cancer mortality of 25% in women attending for screening, which is consistent with the results of the randomized controlled trials of mammographic screening.

Aged↗
PubMed2002

The relevance of reported symptoms in a breast screening programme.

AIM: Although the National Health Service (NHS) Breast Screening Programme is aimed at asymptomatic women, inevitably patients attending screening report symptoms. The study aim was to assess the usefulness of recall based on clinical symptoms. MATERIALS AND METHODS: Information on breast symptoms is recorded at screening and radiologists can make recall decisions based on mammography and symptom history. We identified 1394 women with significant symptoms, between 1991 and 1996. The majority (54%) complained of a lump, 21% had breast distortion, 18% breast pain alone and 6% reported nipple discharge. RESULTS: Of the 1394 women, 262 were recalled because of mammographic suspicion and of these, 45% had breast cancer. The other 1132 women had symptoms and benign mammograms and 44% of these were recalled. Seven breast cancers were diagnosed; all had complained of a breast lump. In two the cancer would have been seen on two-view mammography. Of 638 not recalled, five women went on to develop an interval cancer. CONCLUSION: The results indicate that collecting details on symptoms is useful given the high rate of breast cancer in those with mammographic abnormality. When mammography is benign, however, the low rate of cancer detection means recall should be selective based on only the most relevant symptoms.

Breast Neoplasms↗
PubMed2001

Results from 10 years of breast screening in Wales.

OBJECTIVE: To present results from 10 years of breast screening in Wales, including rates of interval cancers. SETTING: All women aged 50-64 years in Wales; approximately 250,000 in each screening round. METHODS: Breast Test Wales (BTW) began mammographic screening in 1989 as part of the National Breast Screening Programme. Two view mammography was introduced at the inception of the Welsh programme for all prevalent screens. Single view mammography was subsequently performed for incident screens. Interval cancers were identified by matching details from the BTW administrative screening database with the BTW database of all incident breast cancers for residents in Wales. RESULTS: For the first and second round prevalent screens, the cancer detection rate was 8.6 per 1000 and 7.4 per 1000 screened, respectively. The interval cancer rates following round one were 4.9 per 10,000 in the first 12 months, 9.0 per 10,000 between 12 and 24 months, and 11.6 per 10,000 between 24 and 36 months after screening. For the second round incident screens the detection rate was 4.6 per 1000 and the standardised detection ratio was 0.89, but the interval cancer rates in the first year after incident screens were not statistically different from those following prevalent screens. There was no change in the proportion of invasive breast cancers which were < 15 mm in diameter, or in the grades of invasive cancer between the first and second rounds, prevalent or incident screens. CONCLUSIONS: Breast Test Wales has achieved the standards set by the National Health Service Breast Screening Programme. Taking two views at the prevalent screen gave high sensitivity and may have resulted in the low standardised detection ratio at subsequent incident screens.

Breast Neoplasms↗
PubMed2001

Network therapy for addiction: bringing family and peer support into office practice.

Network therapy was developed as a specialized type of combined individual and group therapy to ensure greater success in the office-based treatment of addicted patients by using both psychodynamic and cognitive-behavioral approaches to individual therapy while engaging the patient in a group support network composed of family members and peers. This article outlines the role of group cohesiveness as a vehicle for engaging patients in this treatment; the patient's family and peers are used as a therapeutic network, joining the patient and therapist at intervals in therapy sessions. This network is managed by the therapist to provide cohesiveness and support, to undermine denial, and to promote compliance with treatment. The author presents applications of the network technique designed to sustain abstinence and describes means of stabilizing the patient's involvement. Some specific techniques discussed include ambulatory detoxification, disulfiram and naltrexone administration, relapse prevention, and contingency contracting. Also discussed are recent research on the use of psychiatric residents and counselors for treatment, and use of the Internet in dissemination.

Adult↗
PubMed1995

Office abortion services for women: private physician providers.

Research suggests that private physician providers of office abortions and the women who seek their services are not included in nationwide surveys of abortion statistics. This study describes the demographic characteristics of private physicians and the prevalence of abortions performed in their offices in Los Angeles County, California, a state in which office abortions are prohibited by law. Factors that influence physicians' decisions to provide the service, as well as the age and ethnicity of the office abortion recipients, are examined. Of 1,004 California Medical Association members who practiced obstetrics and gynecology in Los Angeles County during 1990, 49% returned anonymous, confidential surveys. Seventy percent of physicians had performed at least one abortion in California, and 29% were currently providing this service in their offices. Physician gender, age, ethnicity, and religion were associated with performing abortions. The average abortion patient was not young and ethnic, but White, middle-class, and in her mid- to late twenties. The implications of these findings are discussed.

Abortion, Legal↗
PubMed1992

Characterization of a YAC and cosmid contig containing markers tightly linked to the myotonic dystrophy locus on chromosome 19.

Myotonic dystrophy (DM) is caused by a defect in an unknown gene that maps to 19q13.3, flanked by the tightly linked markers ERCC1 on the proximal side and D19S51 on the distal side. We report the isolation and characterization of overlapping YAC and cosmid clones around D19S51 for the construction of a physical map around this locus. The resulting contig contains the markers D19S51 and D19S62 (another new marker tightly linked to the DM locus) and the distal breakpoint of a radiation hybrid cell line used in the physical mapping of the DM region. We have compared the restriction maps of the YACs and cosmids with that of the genome to investigate the fidelity of these clones.

Base Sequence↗
PubMed1992

Temporal effects of plasmapheresis on serum proteins in horses.

The temporal response of blood and serum proteins to chronic plasmapheresis was determined in 8 horses used in a commercial antibody enterprise. Plasmapheresis of between 4 and 11 L induced significant decreases in total protein, albumin, and IgG values. With the exception of a high hematocrit value for the first postplasmapheresis blood sample, there were no changes in erythrocyte or leukocyte measurements, and no changes in the proportions of serum protein in an electrophoretic profile. Regression equations generated for recovery of proteins after plasmapheresis indicated a return to preplasmapheresis values of total protein and albumin at approximately 1 month. Complications of repeated plasmapheresis were not detected when plasma extractions were done between 7 and 19 times at 30-day intervals.

Animals↗
PubMed1991

Human glandular Kallikrein genes: genetic and physical mapping of the KLK1 locus using a highly polymorphic microsatellite PCR marker.

We describe a highly polymorphic microsatellite repeat sequence, KLK1 AC, which is located 3' to the human glandular kallikrein gene (KLK1) at 19q13.3-13.4. A multiplex PCR was developed to simultaneously genotype the KLK1 AC repeat length polymorphism and a similar repeat at the adjacent APOC2 locus at 19q13.2. Genotypes from these two loci in the 40 large kindred pedigrees from the Centre d'Etude du Polymorphisme Humain were used in conjunction with the background genetic map to establish a multipoint linkage map. The KLK1 locus was also localized physically using somatic cell hybrid DNA templates for polymerase chain reaction analysis. Both genetic and physical mapping studies are consistent with the assignment cen-APOC2-KLK1-D19522-qter. The linkage map places KLK1 approximately 10 cM distal to APOC2. These markers therefore flank the myotonic dystrophy gene and may be useful for diagnosis.

Alleles↗
PubMed1986

Four restriction fragment length polymorphisms revealed by probes from a single cosmid map to chromosome 19.

We have discovered and characterized a compound polymorphic locus on chromosome 19, defined by an arbitrary genomic DNA segment cloned into a cosmid vector. Four different restriction fragment length polymorphisms with minor allele frequencies equal to or greater than 10% are revealed by Southern hybridization of subclones of cosmid 1-13 with TaqI, MspI, BamHI, and HindIII digests of human DNAs. Seventy-two percent of unrelated individuals are heterozygous at one or more loci, and seven of the 24 possible haplotypes occur with frequencies of 3%-38%. Using a somatic cell hybrid panel, we have mapped this locus to 19p13.2----19q13.3, whereas in situ hybridization suggests the probe is on 19p. Taken together, these results suggest localization to 19p13.2----19cen. The locus revealed by probes from cosmid 1-13 has been designated D19S11.

Animals↗
PubMed1985

Bilateral laryngeal paralysis in the horse.

Four two-year-old Thoroughbreds suffered an acute gastrointestinal illness shortly after dosing with mineral oil which was thought to have been contaminated with an organophosphate compound. Three weeks later all four were noted to be dyspnoeic and endoscopic examination showed that they had developed bilateral laryngeal paralysis. Two of the horses died during severe bouts of dyspnoea six and eight months later and the third was killed shortly thereafter. Examination of the left and right recurrent laryngeal nerves from these horses showed a severe loss of myelinated fibres distally, especially in the left nerve. A similar but less severe lesion was seen in other long peripheral nerves, including the phrenic and digital nerves of the third horse. The spinal cord in two horses showed evidence of mild axonal degeneration which was not related to a particular tract or location. The fourth horse had bilateral laryngeal paralysis two years later. The acute clinical signs and delayed neurological sequelae seen in these horses were strongly suggestive of accidental organophosphate toxicity.

Animals↗
PubMed1984

Uterine culture in mares.

A guarded, sterile swab is used to obtain samples for uterine culture. With the mare in stocks, the tail bandage and the perineum washed, the culture rod is introduced into the vagina with a gloved hand. After the rod is guided through the cervix, the guard cap is dislodged and the swab is rubbed along the endometrium, after which the rod is extracted. Samples for uterine culture should only be obtained during full estrus. Swabs should be directly plated onto agar within 2 hours of collection. Blood agar is appropriate for initial screening, but use of specialized types of agar expedites identification of microbes. Plates are incubated at 37 C and inspected for growth every 12 hours. The type and number of bacterial colonies should be coupled with the history and clinical signs in deciding on the necessity and type of treatment. Pure, heavy bacterial growth is usually accompanied by clinical signs of infection. Interpretation of the significance of moderate bacterial growth may be aided by cytologic examination of endometrial smears, made by rolling the swab onto a glass slide and staining with Diff - Quik . Large numbers of neutrophils indicate the need for antibiotic therapy. Mixed bacterial growth and variable numbers of neutrophils usually indicate faulty sampling technic. Microaerophilic or anaerobic cultures may aid diagnosis in cases of equivocal aerobic culture results.

Animals↗
PubMed1983

Depressive mood in male college students. Father-son interactional patterns.

This study was designed to investigate the interrelationship of sets of paternal and adolescent factors in explaining depressive mood in normal male adolescents. Two hundred forty-six male college students and their fathers were administered separate, written questionnaires assessing the personality attributes of both fathers and sons and the socialization practices of the fathers. Results of regression analyses indicated that of three hypothesized models (independent, mediational, interdependent) the mediational model was consistent with the data. Thus, we found that the father's personality attributes and his socialization techniques are related to the son's personality, which, in turn, is related to the son's depressive mood. In addition, certain personality attributes of the son interacted synergistically with those of his father to produce more frequent reports of depressive mood in the son.

Adult↗
PubMed1979

Pre-renal azotaemia in a pony with an oesophageal obstruction.

A case of pre-renal azotaemia is described in a 12 year old pony resulting from oesophageal obstruction of 8 days duration. Blood urea nitrogen, creatinine, calcium, inorganic phosphate, sodium, potassium, chloride and bicarbonate concentrations were monitored throughout the recovery period. After relief of the obstruction normal blood concentrations were quickly restored.

Animals↗