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D N Leitch

Publications and source records attributed to D N Leitch.

10 recordsLinked to original sources
PubMed2005

Lung cancer in Teesside (UK) and Varese (Italy): a comparison of management and survival.

BACKGROUND: The survival of lung cancer patients in the UK is lower than in other similar European countries. The reasons for this are unclear. METHODS: Two areas were selected with a similar incidence of lung cancer: Teesside in Northern England and Varese in Northern Italy. Data were collected prospectively on all new cases of lung cancer diagnosed in the year 2000. Comparisons were made of basic demographic characteristics, management, and survival. RESULTS: There were 268 cases of lung cancer in Teesside and 243 in Varese. Patients in Teesside were older (p<0.05), were more likely to have smoked (p<0.001), had a higher occupational risk (p<0.001), higher co-morbidity (p<0.05), and poorer performance status (p<0.001). Fewer patients in Teesside presented as an incidental finding (p<0.001) and the histological confirmation rate was lower than in Varese (p<0.01). In Teesside there were more large cell carcinomas (p<0.001), more small cell carcinomas (p<0.05), and fewer early stage non-small cell lung cancers (p<0.05). The resection rate was lower in Teesside (7% v 24%; p<0.01) and more patients received no specific anti-cancer treatment (50% v 25%; p<0.001). Overall 3 year survival was lower in Teesside (7% v 14%; p<0.001). Surgical resection was the strongest multivariate survival predictor in Varese (HR = 0.46) and Teesside (HR = 0.31). Co-morbidity in Teesside resulted in a significantly lower resection rate (p<0.001). CONCLUSIONS: Patients with lung cancer in Teesside presented at a later stage, with more aggressive types of tumour, and had higher co-morbidity than patients in Varese. As a result, the resection rate was significantly lower and survival was worse.

Carcinoma, Non-Small-Cell Lung↗
PubMed2005

Relation of expired carbon monoxide to smoking history, lapsed time, TLCO measurement and passive smoking.

We quantified the influence of lapsed time, measurement of gas-transfer factor (TLCO), and passive smoking on expired carbon monoxide (CO) levels, and then evaluated the accuracy of smoking histories against expired CO measurements in patients newly attending 'occupational' compared with 'general' chest clinics. Expired CO levels had an estimated average rate of decline of 3.4 ppm/h in the presumed absence of further smoking, though individual rates depended necessarily on the initial levels (2.1, 3.9, 5.7 and 7.5 ppm/h, respectively, when the initial levels were 10, 20, 30 and 40 ppm). TLCO measurement was associated with a median increase in expired CO of 4.0 ppm, but passive exposure to tobacco smoke in non-smokers had negligible effect. Expired CO levels indicative of current smoking (> 8 ppm) were noted much more commonly in the current cigarette smokers (88%) than those who claimed to be current non-smokers (6.0%), but without significant difference between the non-smokers attending the occupational and general clinics (6.6% vs 5.3%). We conclude that the lapse of 1 h and the measurement of TLCO exert mild but important influences on the expired CO level, but that passive smoking does not. 'Occupational' and 'general' patients give similarly false declarations of current non-smoking when presenting initially for clinical evaluation.

Adult↗
PubMed2000

Effect of inhaled fluticasone propionate on airway responsiveness in treatment-naive individuals--a lesser benefit in females.

A randomized double-blind placebo-controlled parallel group study with inhaled fluticasone propionate over 6 weeks, designed to quantify the beneficial effect on airway responsiveness, and so assess whether short pulses of intermittent prophylactic treatment might serve as an alternative means of managing mild asthma, is reported. The 20-50-yr-old participants, who were recruited from an epidemiological study of the general population, had never knowingly received any regular treatment for asthma. Fluticasone propionate at the maximum recommended dose level (2,000 microg daily) and placebo were administered via metered-dose inhalers, and airway responsiveness was quantified conventionally by the provocative dose of methacholine causing a 20% fall in forced expiratory volume in one second (FEV1) (PD20) at 2-week intervals during the treatment phase and at various intervals subsequently. Compared with placebo fluticasone propionate was associated with a highly significant decrease in airway responsiveness (1.9 doublings of the geometric mean PD20), which was maximal at the end of the 6-week treatment period. No persisting benefit was detectable at the next measurement 2 weeks later, or thereafter. Multiple linear regression analysis showed that the magnitude of the fluticasone propionate effect was significantly greater in males than in females (3.2 versus 1.2 doublings respectively of the geometric mean PD20), but was uninfluenced by current smoking, age or FEV1. In conclusion, in the absence of any possibility of tachyphylaxis, inhaled fluticasone propionate at this dose causes a steadily increasing improvement in airway responsiveness over a 6-week period, which is modified by sex but lost almost immediately on treatment cessation. Short pulses of intermittent prophylactic treatment would not, therefore, be useful as a means of managing mild asthma.

Administration, Inhalation↗
PubMed1997

Psoriatic arthritis and minocycline induced autoantibodies.

A case of psoriatic arthritis where diagnosis was originally complicated by the presence of minocycline-induced auto-antibodies and hepatic dysfunction. The range of auto-antibodies associated with minocycline includes ds DNA and SCL 70.

Acne Vulgaris↗