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Biomedical subjects

D Jerwood

Publications and source records attributed to D Jerwood.

6 recordsLinked to original sources
PubMed1992

The influence of an academic representative on prescribing by general practitioners.

1. The effect of providing information about medicines by a short 'sales' interview between individual general practitioners and an 'academic representative' on prescribing was investigated. 2. The promotional campaign was designed to encourage a rational approach to prescribing of non-steroidal anti-inflammatory agents in an intervention group of 101 general practitioners selected at random from the Leeds Family Practitioner Committee (FPC). The remaining general practitioners in the Leeds FPC acted as a reference group. 3. The prescribing data for each group for 5 months immediately prior to and 5 months following intervention were compared. 4. Intervention produced a significant increase (P less than 0.005) in the prescribing cost of ibuprofen, the non-steroidal promoted as first choice agent, which was sustained for at least 5 months. 5. Prescribing of the second choice agent, piroxicam, decreased in the reference group but not in the intervention group. 6. There was a decrease in the average prescribing cost of pounds 6.60 per doctor per month in the intervention group compared with the reference group.

Costs and Cost Analysis↗
PubMed1984

Modelling the migration of Onchocerca volvulus in simuliids, using a simple compartmental process.

A simple compartmental process, which is time-homogeneous and has differing transition rates between compartments, is discussed. When such a process is hierarchical, with all individuals released into the first compartment, the resulting distribution of individuals over the various compartments is multinomial. This process is applied to the migration of Onchocerca volvulus in simuliids and appears to represent successfully the early migration from the stomach through the abdomen to the thorax, provided that allowances are made for the engorgement period and the encapsulation of the blood meal by a peritrophic membrane.

Animals↗
PubMedDate not supplied

Modelling endemic onchocerciasis in man in the presence of vector controls.

A stochastic model for a parasitic disease is proposed which describes the acquisition of infectious material from an external source and the subsequent deterioration of the host reacting to the internally produced parasite. The model considers the endemic situation, where the disease is uncontrolled and the structure is both hierarchical and irreversible. The resulting compartmental model can be modified to incorporate piecewise-constant migration rates to respond to possible geographical and sociological fluctuations, which could affect the epidemiological dynamics. The model is illustrated using onchocerciasis prevalence data collected from nine West African village communities in 1975 and 1981, before and after the implementation of widespread larvacide controls as part of the O.C.P. in the Upper Volta region. Significance of the sex effects within onchocerciasis transmission is investigated and the effectiveness of controls is discussed.

Adolescent↗
PubMedDate not supplied

Predicting the potential for recovery within 24 hours of a head injury.

A linear discriminant model is applied to clinical and radiological signs from 492 consecutive head injuries transferred to a neurosurgical unit over a period of four years. Unstable discriminators may be eliminated and those remaining transformed to interval scales in order to release their full prognostic potential. Patient selection criteria included being in coma, judged in the accident and emergency (A & E) department to be susceptible to developing a complicating secondary event, having a depressed fracture and presenting evidence of leakage of cerebrospinal fluid. These criteria are considerably less restrictive than in most other head injury series. The study is also ambitious in attempting prognosis after only 24 hours. The virtues of early and accurate prognosis include counselling of relatives, patient selection for new forms of treatment and to provide an aid towards medical audit. Neither the relaxed attitude towards patient selection nor the speed of prognosis is found to jeopardize the overall efficiency of allocation which is as high as 91.5%. In fact misallocation is only slightly increased if prognosis is attempted within 60 minutes of admission to the A & E department.

Adult↗
PubMedDate not supplied

An assessment of the relative importance of the components of CYVADIC in the treatment of soft-tissue sarcomas using regression meta-analysis.

The CYVADIC combination has enjoyed popular medical support for over a decade in the treatment of soft-tissue sarcomas, and there is much documented evidence in the literature of the relative success of this and related regimens. A multivariate regression meta-analysis has been undertaken of the collective experience of this group of regimens, to assess statistically the relative importance of each component of CYVADIC using the intensities of the four components to predict objective tumour response. This analysis demonstrates that the tumour response to a specific regimen may be reasonably predicted from an expression that is highly sensitive to the dacarbazine dose intensity, with a significant additional contribution being introduced by the level of vincristine administered. There is convincing statistical evidence that, when administered as part of a CYVADIC chemotherapeutic regimen, the presence of doxorubicin (with an intensity of about 0.8) will produce a significant optimal effect on tumour responses. In such situations there is no detected significant benefit from increasing the dose of doxorubicin beyond this critical level of intensity. These findings suggest that it is dacarbazine and not, as is customarily argued, doxorubicin that is the most sensitive component in the CYVADIC treatment of soft-tissue sarcomas. The veracity of this conclusion should be tested by prospective studies designed specifically to escalate the intensity of decarbazine treatment, whilst holding the level of doxorubicin at below standard intensity.

Antineoplastic Combined Chemotherapy Protocols↗