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Biomedical subjects

D Jolley

Publications and source records attributed to D Jolley.

At least 19 recordsLinked to original sources
PubMed1992

Incidence of cancers of the larynx and lung near incinerators of waste solvents and oils in Great Britain.

The Small Area Health Statistics Unit (SAHSU) is a new independent facility for the investigation of disease near industrial installations in the UK. SAHSU analysed the incidence of cancers of the larynx and lung near the incinerator of waste solvents and oils at Charnock Richard, Coppull, Lancashire (which operated between 1972 and 1980) and nine other similar incinerators in Great Britain, after reports of a cluster of cases of cancer of the larynx near the Charnock Richard site. Postcoded cancer registration data were available for 1974-84 in England and Wales and 1975-87 in Scotland. Lag periods of 5 and 10 years were used between start-up (or first registration) of the incinerators and cancer incidence. Standardised observed/expected (O/E) ratios were assessed within 3 km and 3-10 km of each site and then aggregated over all sites. Expected values were based on national rates (regionally adjusted) with and without stratification by Carstairs' index, a measure of the socioeconomic profile of areas that uses census data for enumeration districts. Data were also assessed over a range of circles up to 10 km to test for trend in O/E ratios with distance. For Charnock Richard, none of the O/E ratios within 3 km or from 3-10 km differed significantly from unity, for either cancer or lag period. In the analysis of all sites with stratification by Carstairs' index, none of these O/E ratios differed significantly from unity for the two cancers. There was no evidence of decreasing risk with distance from the sites of either cancer. We conclude that the apparent cluster of cases of cancer of the larynx reported near Charnock Richard was unlikely to be due to its former incinerator.

Cluster Analysis↗
PubMed1992

Visualizing age-period-cohort trend surfaces: a synoptic approach.

Mortality data from 1950 to 1986 in Australia have been used to exemplify a method of displaying trends by age and cohort in populations over time. The visual summary or synoptic method illustrated here is similar to a topographic map with age and calendar time as its ordinates. This method is complementary to conventional analyses of age-period-cohort data which lack a summary graphic view other than that provided by the trend in age-standardized rates or a three dimensional perspective plot. Mortality from ischaemic heart disease (IHD), lung cancer and motor vehicle accidents are used as examples of the method and illustrate its utility when dealing with different forms of mortality trend e.g. cross-sectional cohort, and mixed trends.

Age Factors↗
PubMed1992

Effects of follicle-stimulating hormone on inhibin release by different testicular compartments in the adult ram.

The aim of this study was to determine the bidirectional release of immunoreactive inhibin-alpha (irINH-alpha) by different testicular compartments in the adult ram and to assess the effects of FSH on the distribution of inhibin in the testis. Immunoreactive INH-alpha was measured by RIA in fluid samples collected concurrently from the three testicular compartments--the seminiferous tubules, the interstitium, and the vascular system--through catheters inserted surgically into the rete testis, testicular lymphatic duct system, and spermatic veins, respectively. Overall, the concentration of irINH-alpha in rete testis fluid was 25 times the level in testicular lymph and over 500 times the concentration in peripheral blood. The pattern of irINH-alpha concentration in rete testis fluid was inversely related to that in testicular lymph, but i.v. administration of FSH had a decoupling effect on this relationship by depressing inhibin concentration in testicular lymph without affecting inhibin levels in rete testis fluid. Nevertheless, increased flow of testicular lymph more than compensated for the transient fall in irINH-alpha concentration so that, overall, the total output of inhibin via the testicular lymphatic duct system (and the vascular system) increased significantly. No persistent or significant changes were observed in the flow rate of rete testis fluid or concentration of irINH-alpha in the fluid after administration of FSH. The time frame for the response of the testis to FSH is indicative of the involvement of a mediator. Electrophoretic analysis of serially collected testicular lymph samples consistently revealed an FSH-induced release of a series of proteins in the M(r) range of 30,000-32,000.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Chemoprophylaxis against malaria in Papua New Guinea: a trial of amodiaquine and a combination of dapsone and pyrimethamine.

A placebo-controlled chemoprophylaxis trial was carried out in 1980 in 318 semi-immune school children in the Madang area of Papua New Guinea, where there was a high prevalence of strains of Plasmodium falciparum resistant to 4-aminoquinolines. Since prophylaxis with amodiaquine at 5 mg/kg weekly had failed, amodiaquine at a dose of 10mg/kg weekly and Maloprim (half a tablet or one tablet depending on body weight, which gave ranges of dapsone of 1.7-3.3mg/kg and pyrimethamine 0.2-0.4 mg/kg) weekly were tried. Neither regimen was completely successful in preventing parasitaemia, though after 13 weeks of prophylaxis the slide positivity rate was 16% for the amodiaquine group and 2% for the Maloprim group, which was in each case significantly lower than the normal baseline rate in the controls of 42%. Amodiaquine was completely successful in suppressing Plasmodium vivax infections. Breakthrough parasitaemia occurred, with either P. falciparum or P. vivax, in 5% of subjects on Maloprim at some time during the 13-week period of prophylaxis. Significantly more children in both the amodiaquine and Maloprim groups than in the placebo group showed a reduction in spleen size. All groups showed an unexplained fall in haemoglobin level over the study period but the fall was significantly less in both the prophylaxis groups. There was no adverse effect on white cell counts by either drug regimen. Chemoprophylaxis as a component of an integrated malaria control program should not be overlooked, provided that compliance can be maintained. However, in this particular case the principal purpose of the study had been to evaluate the proposed chemoprophylactic regimens in school children before embarking on an intervention study in young children. As a result of this study it was decided not to go ahead with the chemoprophylactic intervention in young children but to adopt an approach based on early presumptive treatment.

Antimalarials↗
PubMed1991

Prognosis of depression in the elderly.

Fifty-six consecutively admitted elderly (65 and over) patients with depression were assessed on mental, physical and social states. They were followed up and assessed at home one year later. A group of 24 depressed in-patients aged under 65 years admitted to the same ward during the same period was also assessed. Outcome was different for the two groups, with 68% of the elderly 'well' at one year, against 50% of the younger group. The younger group were more likely to have 'poor' outcome (41%) than the elderly (16%). However, there were more deaths than expected, particularly in the elderly. These findings differ from some previous studies, and indicate an excellent prognosis for depression in the elderly. Outcome in younger patients is less good.

Adult↗
PubMed1990

Slow euthanasia? The deaths of psychogeriatric patients.

Psychogeriatric services reach out to people who are suffering from psychiatric disorders which may persist until death and may bring forward death. It has been suggested that these services should aim at avoiding admitting patients for hospital care whose lives may be ended by the upset of admission or prolonged by inappropriate nursing and medical interventions. A review of the characteristics of patients dying during one year while under the care of a psychogeriatric service showed that one in three died as a psychogeriatric inpatient, the remainder dying at home or as inpatients in a general hospital. Those dying as psychogeriatric inpatients differed in their clinical and social characteristics from those dying elsewhere and it seemed unlikely that they could have been cared for humanely without the resources of the hospital ward. Psychogeriatric practice has many similarities to the work of hospices with other terminally ill patients, but the duration of the terminal illness and the needs arising from it are often more prolonged. Probably the management of dying among psychogeriatric patients will be improved if lessons learnt from other hospice practices are adopted.

Aged↗
PubMed1990

The role of childhood exposure to sunlight in the development of solar keratoses and non-melanocytic skin cancer.

The age-standardized proportion of persons with solar keratoses in 1232 Australian-born persons who were aged 40 years and older was 44.5% compared with a proportion of 15.7% in 1332 British persons who had migrated to Australia at various ages. Stratification of the British migrants into those who had arrived in Australia between one and 20 years of age and those who had arrived in Australia after the age of 20 years revealed that the proportion of persons with solar keratoses in the latter group never reached the proportion in Australian-born persons of the same age, in spite of many years in Australia after migration. Those persons who arrived in Australia between one and 20 years of age showed a lower proportion with solar keratoses in the younger age-groups, but with increasing age the proportion with solar keratoses equalled or exceeded that which was seen in Australians. These results suggest that a reduction in exposure to sunlight in childhood will reduce substantially the incidence of solar keratoses, and by implication, squamous-cell carcinomas, in adulthood.

Adult↗
PubMed1989

The incidence of non-melanocytic skin cancers in an Australian population: results of a five-year prospective study.

Two thousand, six hundred and sixty-nine persons who were aged 40 years and older attended for examination of the light-exposed areas of the head and neck, forearms and dorsa of the hands during a skin-cancer survey of the population of Maryborough, which was conducted annually for five years from 1982-1986 inclusive. Sixty (2.25%) persons--12 persons each with a squamous-cell carcinoma and 48 persons with a total of 51 basal-cell carcinomas--had at least one non-melanocytic skin cancer at the first examination. One thousand, nine hundred and eighty-one (74% of the study population) persons were seen on more than one occasion, which allowed for 6288 person-years of follow-up for the determination of the incidence of new cancers. The findings showed a calculated minimal age-standardized incidence rate of 873 non-melanocytic skin cancers/100,000 population each year. The minimal incidence rate for basal-cell carcinomas was 672 cases/100,000 population each year and for squamous-cell carcinomas was 201 cases/100,000 population each year. The rate ratio of the incidence of basal-cell carcinomas to that of squamous-cell carcinomas was 3.34 to one. Age, sex, skin reaction to sunlight and occupation all were significant factors in the determination of the risk of developing non-melanocytic skin cancers. The enormous costs that are involved in the treatment of non-melanocytic skin cancers and related lesions suggest that more time, effort and money need to be spent to reduce what has become a major public-health problem in Australia.

Adult↗
PubMed1989

Behavioral effects of iron supplementation in infants in Madang, Papua New Guinea.

The effect of iron supplementation on attending behavior of 96 1-y-old infants was assessed in a double-blind, randomized, controlled trial of iron dextran in Papua New Guinea. The treatment group received an injection of iron dextran at 2 mo; the controls received a placebo injection. Because many children had malarial parasitemia at testing, presence of malaria was used in the analysis. A significant interaction was found between iron and malaria infection on total fixation time: iron-supplemented groups and placebo-treated parasitemic children showed significantly higher total fixation scores than did placebo-treated aparasitemic children. Blood analysis of iron status showed similar results, with lowest iron status evident in the placebo-treated aparasitemic group. There was no effect of treatment on rate of habituation or dishabituation. Supplemental iron treatment has a significant effect on attention but the direction of the effect depends on the presence of malaria infection.

Anemia, Hypochromic↗
PubMed1988

Self examination of the breast: is it beneficial? Meta-analysis of studies investigating breast self examination and extent of disease in patients with breast cancer.

The question whether the aggregated published research suggests that breast self examination is beneficial was explored in a meta-analysis of 12 studies including a total of 8118 patients with breast cancer that related the practice of breast self examination to regional lymph node state or tumour diameter. Based on the six studies for which data were available, 39% of patients (1115/2852) who reported having done breast self examination at least once before their illness had evidence of cancer in the lymph nodes compared with 50% of women (1348/2713) who had not done the examination. Logistic regression analysis showed this difference to be significant (odds ratio 0.66, confidence interval 0.59 to 0.74). Combining six studies which reported the circumstances of detection disclosed that 42% of women (272/652) who found their tumour while doing breast self examination had evidence of cancer in the nodes compared with 46% of women (871/1901) who found the tumour accidentally; this difference was not significant. Analysis of eight studies which used the diameter of the tumour to indicate the extent of disease tended to confirm the findings on lymph node state, in particular the benefit of premorbid breast self examination. Significantly fewer women who had practised the examination before the illness (56%; 1205/2137) had tumours of 2 cm or more diameter compared with women who had not practised the examination (66%; 1500/2260). The combined odds ratio for that analysis was 0.56, confidence interval 0.38 to 0.81. These findings appear to be good evidence of the benefit of encouraging women to practise self examination of the breasts regularly.

Breast↗
PubMed1986

The epidemiology of malaria in a population surrounding Madang, Papua New Guinea.

Malaria is prevalent throughout coastal and lowland Papua New Guinea. Recent changes, including a shift from predominance of Plasmodium vivax to Plasmodium falciparum, appearance of chloroquine-resistant P. falciparum and decreased effectiveness of vector control programs have been observed. Epidemiological features of malaria were studied through four six-month surveys of a population of 16,500 in Madang Province from 1981-1983. Baseline data on parasitology, splenic enlargement, serology, hemoglobin levels, prevalence of 4-aminoquinolines, utilization of mosquito nets and incidence of fever were collected for use in future evaluation of malaria control measures including possible field trials of an antimalarial vaccine. Prevalence of parasitemia (all species, all ages) varied from 35.0% to 42.7% over the four surveys each of which covered a random sample of 25% of the population. The ratio of parasite species was: P. falciparum 70:P. vivax 25:P. malariae 5 in the dry seasons, shifting slightly in favor of P. falciparum during the wet seasons. Intense year-round transmission was indicated by decreasing parasite prevalence and splenic enlargement with age, low density asymptomatic parasitemias and high prevalence of antimalarial antibodies (i.e., greater than 80% of the population over five years of age was ELISA-positive). Levels of endemicity varied geographically, presence of 4-aminoquinolines in urine samples was relatively common (12.7% positive) and chloroquine resistance was widespread (81.6% in vitro, 46.6% in vivo).

Adolescent↗
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Geriatric Psychiatry↗