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Biomedical subjects

D Preston

Publications and source records attributed to D Preston.

At least 37 records · Page 2Linked to original sources
PubMed1993

Deliberate self-harm and public holidays: is there a link?

It has previously been reported [Davenport & Birtle, 1990] that there is a positive association between nonfatal deliberate self-harm in adolescents and emotionally charged festivals, such as St Valentine's Day and Christmas Day. We studied all cases of nonfatal deliberate self-harm presenting to three Central London hospitals on St Valentine's Day and Christmas Day and on two control dates, between 1983 and 1989. No association was found between cases of deliberate self-harm and St Valentine's Day, but a negative association was found with Christmas Day.

Adolescent↗
PubMed1991

Frequent chest X-ray fluoroscopy and breast cancer incidence among tuberculosis patients in Massachusetts.

The incidence of breast cancer was determined in 4940 women treated for tuberculosis between 1925 and 1954 in Massachusetts. Among 2573 women examined by X-ray fluoroscopy an average of 88 times during lung collapse therapy and followed for an average of 30 years, 147 breast cancers occurred in contrast to 113.6 expected [observed/expected (O/E) = 1.29; 95% confidence interval (CI) = 1.1-1.5]. No excess of breast cancer was seen among 2367 women treated by other means: 87 observed versus 100.9 expected. Increased rates for breast cancer were not apparent until about 10 to 15 years after the initial fluoroscopy examination. Excess risk then remained high throughout all intervals of follow-up, up to 50 years after first exposure. Age at exposure strongly influenced the risk of radiation-induced breast cancer with young women being at highest risk and those over age 40 being at lowest risk [relative risk (RR) = 1.06]. Mean radiation dose to the breast was estimated to be 79 cGy, and there was strong evidence for a linear relationship between dose and breast cancer risk. Allowing for a 10-year minimum latent period, the relative risk at 1 Gy was estimated as 1.61 and the absolute excess as 10.7 per 10(4) woman-years per gray. When compared to other studies, our data suggest that the breast is one of the most sensitive tissues to the carcinogenic force of radiation, that fractionated exposures are similar to single exposures of the same total dose in their ability to induce breast cancer, that risk remains high for many years after exposure, and that young women are especially vulnerable to radiation injury.

Breast Neoplasms↗
PubMed1991

Radiation-induced skin carcinomas of the head and neck.

Radiation exposures to the scalp during childhood for tinea capitis were associated with a fourfold increase in skin cancer, primarily basal cell carcinomas, and a threefold increase in benign skin tumors. Malignant melanoma, however, was not significantly elevated. Overall, 80 neoplasms were identified from an extensive search of the pathology logs of all major hospitals in Israel and computer linkage with the national cancer registry. Radiation dose to the scalp was computed for over 10,000 persons irradiated for ringworm (mean 7 Gy), and incidence rates were contrasted with those observed in 16,000 matched comparison subjects. The relative risk of radiogenic skin cancer did not differ significantly between men or women or by time since exposure; however, risk was greatest following exposures in early childhood. After adjusting for sex, ethnic origin, and attained age, the estimated excess relative risk was 0.7 per Gy and the average excess risk over the current follow-up was 0.31/10(4) PY-Gy. The risk per Gy of radiation-induced skin cancer was intermediate between the high risk found among whites and no risk found among blacks in a similar study conducted in New York City (Shore et al., Radiat. Res. 100, 192-204, 1984). This finding suggests the role that subsequent exposure to uv radiation likely plays in the expression of a potential radiation-induced skin malignancy.

Adolescent↗
PubMed1990

Weight-training injuries in adolescents.

We studied the incidence of injury caused by weight training in junior and senior high school football players. Three hundred fifty-four subjects completed a retrospective injury questionnaire; histories were confirmed for high school athletes. Cumulative incidence and incidence rates were determined for injuries causing more than 7 days of missed participation. The cumulative incidences of injuries were as follows: all athletes, 7.6% (27/354); junior high school athletes, 7.1% (7/98); high school freshman/junior varsity athletes, 9.4% (15/159); and high school varsity athletes, 5.2% (5/97). The total incidence rate was 0.082 injuries per person-year, with 0.11 injuries per person-year in junior high school athletes, 0.091 injuries per person-year in high school freshman/junior varsity players, and 0.051 injuries per person-year in high school varsity players. Differences in the incidence measures among groups were not statistically significant. The most common injury type was a strain (74.1%), and the most common site was the back (59.3%). Certain exercise apparently caused more back injuries in older athletes.

Adolescent↗
PubMed1990

Chronic progressive and relapsing neuromyopathy with massive dilatations of endoplasmic reticulum in muscle fibers.

Large intracytoplasmic inclusions arising from the endoplasmic reticulum and nuclear envelope were found in the muscle fibers of a 32-year-old individual with a life-long, chronic and progressive sensory-motor neuropathy. The morphological features of the inclusions were similar to that occasionally reported in the striated muscles in several unrelated conditions as well as to "hyaline" or "colloid" inclusions commonly seen in motor neurons of the brain stem and spinal cord. The chemical nature of the inclusions is not known. Their occurrence in the muscle fibers is probably secondary to chronic denervation.

Adult↗
PubMed1990

Long-term serum creatinine values after radical nephrectomy.

Both pre- and postnephrectomy levels of serum creatinine were measured in 52 consecutive patients who underwent radical nephrectomy for localized renal cell carcinoma between 1971 and 1976. At the time of follow-up, 17 patients were alive and 35 had died, 14 of renal cell carcinoma and 21 of other causes. Follow-up lasted a minimum of 115.5 months (mean 151.1 months, median 141.1, range 115.5-211.3 months) for 16 of the 17 patients who were alive. In this group only 2 patients had elevations in the serum creatinine level above 1.6 mg/dL-1.9 mg/dL and 2.4 mg/dL, respectively. The patient whose value was 2.4 mg/dL was a diabetic who required insulin. No serious renal failure, renal disease, or tumors in the contralateral kidney occurred among the total group of 52 patients. These data indicate that renal function remains adequate in patients who have a normal contralateral kidney and are treated by radical nephrectomy.

Carcinoma, Renal Cell↗
PubMed1990

Indicators of mental hospital bed use.

This study explored the use of survivorship curves as a type of indicator of lengths of hospital stay. Using data from the psychiatric services of a single Region, an attempt was made to determine the existence of a performance indicator with the advantages of fixed cohort analysis. By comparison with the proposed Department of Health indicators, this approach offers advantages in that it is less distorted by the presence in a District of large numbers of long-stay beds. However, although the findings show that patients are discharged more slowly from Districts with a large mental hospital and that a greater proportion of patients are still resident one year after admission, it is important to stress that measures of bed use of this type alone are not an indication of the quality of psychiatric services provided.

Data Collection↗
PubMed1989

Disease prevention models of voluntary confidential screening for human immunodeficiency virus (HIV).

Epidemic models are developed to evaluate the potential benefits of voluntary confidential testing (VCT) for HIV. The number of tests required to prevent one case (called the economic ratio ER), and the number of cases prevented by the screening programme are calculated. Methods differ from commonly used epidemic models because susceptibles and infecteds are subdivided according to testing status, to permit modelling of the efficacy of knowledge of HIV status in retarding epidemic spread. The methods also allow for subdivision into several homogeneous subpopulations whose members may be attracted in varying degrees to members of other subpopulations. Thus the common assumption of free mixing across subpopulations is relaxed. The following conclusions which refer to a population of 100,000 persons over a period of 5 to 15 years, are robust to wide variations in assumed parameter values and other aspects of modelling: 1. VCT prevents hundreds or thousands of infections in isolated high risk populations and ER values are typically less than 100 making VCT very attractive economically. 2. VCT prevents only a few infections in isolated low risk populations with initial prevalence 0.1 per cent or less, and the ER values are well above 2000. However, in 'low risk' populations with 1 per cent initial prevalence, tens or hundreds of infections may be prevented, and ER values fall below 2000 for plausible spread rates, indicating that VCT may be economically feasible in such settings. 3. In a mixed population of gays, bisexuals and heterosexuals, a VCT programme that aims primarily at the gay/bisexual subpopulations prevents more disease in the gay/bisexual populations, prevents more disease in the heterosexual populations, and requires fewer tests per case prevented than a VCT programme that tests all subpopulations equally.

AIDS Serodiagnosis↗
PubMed1989

Thyroid neoplasia following low-dose radiation in childhood.

The thyroid gland is highly sensitive to the carcinogenic effects of ionizing radiation. Previously, we reported a significant increase of thyroid cancer and adenomas among 10,834 persons in Israel who received radiotherapy to the scalp for ringworm. These findings have now been extended with further follow-up and revised dosimetry. Overall, 98 thyroid tumors were identified among the exposed and 57 among 10,834 nonexposed matched population and 5392 sibling comparison subjects. An estimated thyroid dose of 9 cGy was linked to a fourfold (95% Cl = 2.3-7.9) increase of malignant tumors and a twofold (95% Cl = 1.3-3.0) increase of benign tumors. The dose-response relationship was consistent with linearity. Age was an important modifier of risk with those exposed under 5 years being significantly more prone to develop thyroid tumors than older children. The pattern of radiation risk over time could be described on the basis of a constant multiplication of the background rate, and an absolute risk model was not compatible with the observed data. Overall, the excess relative risk per cGy for thyroid cancer development after childhood exposure is estimated as 0.3, and the absolute excess risk as 13 per 10(6) PY-cGy. For benign tumors the estimated excess relative risk was 0.1 per cGy and the absolute risk was 15 per 10(6) PY-cGy.

Adolescent↗
PubMed1985

A community-based program for juvenile firesetters.

In 1981 the Dallas Fire Department began a new program for juvenile firesetters. Based on an interview graphing technique that helps the juvenile firesetter to correlate triggering events with feelings leading to aggressive firesetting behavior, the program is staffed by fire department personnel who are trained by psychiatric faculty of the University of Texas Southwestern Medical School at Dallas. Comparisons with the city's previous program demonstrate the new program's effectiveness in preventing the recurrence of firesetting behavior as well as its cost-efficiency. Similar programs have been successfully adopted in Houston and Fort Worth.

Adolescent↗
PubMed1981

Lithium carbonate in patients with small cell lung cancer receiving combination chemotherapy.

Lithium administration has been shown to attenuate the leukopenia associated with systemic chemotherapy. The results of a randomized trial of lithium in 45 patients with small cell lung cancer who received combination chemotherapy and radiation therapy are reported. Patients randomized to receive lithium were started on 300 mg three times daily for 18 days of every 21 day chemotherapy cycle. Patients who received lithium experienced significantly less mid-cycle leukocyte and neutrophil count depression and spent fewer days with leukopenia and neutropenia than control patients regardless of age or extent of disease. Patients who received lithium spent fewer days hospitalized and fewer days with fever in the presence of severe neutropenia than control patients. The cumulative risk of fever with signs of infection was greater in control patients regardless of age, disease extent or the presence of marrow involvement. Patients who were given lithium received significantly more chemotherapy than control patients. Patient survival was greatest in those with limited disease, in complete responders and in those who received more than 75 percent of their induction chemotherapy although it did not differ between the two study groups. The majority of patients required either reduction or discontinuation of lithium. Those who received lithium continuously demonstrated a higher objective response rate and longer survival than either patients in whom the lithium had to be discontinued or those randomized to the control group. Infection was an important cause of death in the control group and cardiovascular event occurred frequently in the lithium group, but the major cause of death in this patient population remains progressive malignant disease.

Carcinoma, Small Cell↗
PubMed1980

The use of lithium carbonate to reduce infection and leukopenia during systemic chemotherapy.

To investigate whether lithium ameliorates the infectious complications that accompany systemic chemotherapy, we studied 45 patients with small-cell bronchogenic carcinoma receiving combination chemotherapy and radiation therapy. Twenty received lithium carbonate, and 25 received no additional therapy. Control subjects experienced more days with neutropenia than the lithium-treated group (2.17 days per 100 patient-days vs. 0.29), more severe febrile episodes (seven patients vs. one patient), more days hospitalized with fever and neutropenia (1.92 per 100 patient-days vs. 0.18), and more infection-related deaths (five vs. none). Infection-free survival was significantly longer in the lithium-treated group than in controls (P less than 0.05). Delay in subsequent chemotherapy was longer (P less than 0.01) and the number of dose reductions greater (P less than 0.01) in the control group. For both leukocytes and neutrophils, the first cycle nadir, mean of all treatment nadirs, and the lowest nadir observed during treatment were significantly higher in the lithium group. Mean mid-cycle monocyte counts were greater in the lithium group (P less than 0.05) and correlated with concurrent serum lithium levels (rs = 0.74, P less than 0.05). We believe that lithium carbonate shows promise as a means of lowering the risk of infection among patients receiving cytotoxic therapy.

Antineoplastic Agents↗
PubMed1980

Hypochloremic alkalosis in infants associated with soy protein formula.

Thirteen infants, 2 to 10 months of age, developed hypochloremic alkalosis (serum chloride 59 to 92 mEq/l) while taking Neo-Mull-Soy (Syntex), a soy-based formula low in chloride (measured to be 0 to 2 mEq/l) but with considerable potassium citrate. Range of symptoms included lethargy, anorexia, mild spitting up, diarrhea, hematuria, and growth failure. Urine chloride excretion was less than 3 mEq/l. Plasma renin activity or aldosterone, measured in six infants, was elevated. All responded promptly to supplemental salt. One infant receiving Neo-Mull-Soy redeveloped alkalosis when supplemental salt was discontinued. Two of nine apparently normal infants receiving Neo-Mull-Soy also had hypochloremia (85, 86 mEq/l). Three of four receiving Prosobee (Mead Johnson; Cl content 7 mEq/l) had urine chloride concentration less than 20 mEq/l. The chloride content of some infant formulas is insufficient to offset salt losses following mild stress.

Alkalosis↗