PubMed Health⌕ Search

Biomedical subjects

D Strachan

Publications and source records attributed to D Strachan.

46 records · Page 3Linked to original sources
PubMed1993

Self-reported prevalence of asthma symptoms in children in Australia, England, Germany and New Zealand: an international comparison using the ISAAC protocol.

There is a need for a standardized approach to international and regional comparisons of the prevalence and severity of asthma, and for the monitoring of asthma morbidity over time. In 1991, standardized written and video questionnaires were developed and administered in surveys of schoolchildren, aged 12-15 yrs, in five regions in four countries: Adelaide, Australia (n = 1,428); Sydney, Australia (n = 1519); West Sussex, England (n = 2,097); Bochum, Germany (n = 1928); and Wellington, New Zealand (n = 1863). The self-reported prevalence of wheezing during the previous 12 months was similar in West Sussex (29% using the written questionnaire and 30% using the video questionnaire), Wellington (28 and 36%), Adelaide (29 and 37%), and Sydney (30 and 40%), but was lower in Bochum (20 and 27%). The one year prevalence of severe wheezing limiting speech was greater in Wellington (11%), Adelaide (10%) and Sydney (13%), than in West Sussex (7%) and Bochum (6%). The self-reported one year prevalences of frequent attacks, frequent nocturnal wheezing, and doctor diagnosed asthma, were also higher in the Australasian centres than in the European centres. We conclude, that an international comparison of asthma symptom prevalence in childhood, using simple standardized instruments, is feasible. Possible explanations for the differences in reported asthma severity between the Australasian and European centres include differences in exposure to risk factors and differences in the management of asthma.

Adolescent↗
PubMed1993

Are viral warts seen more commonly in children with eczema?

BACKGROUND AND DESIGN: We sought to test the hypothesis that warts are seen more commonly in individuals with eczema by analyzing skin examination data from a national birth cohort study of 9263 British children born between March 3 and 9, 1958. RESULTS: Warts were seen less frequently in those with visible eczema at ages 11 and 16 years (relative risk, 0.60; 95% confidence intervals, 0.37 to 0.95; P = .03). This inverse association persisted after adjustment for potential confounders and was consistent within each age and sex group for children with a history of eczema who did not have visible eczema at the time of examination and for children with asthma/wheezy bronchitis regardless of eczema status. Visible acne or psoriasis was not associated with a decreased prevalence of warts. CONCLUSIONS: These findings contradict previous suggestions of an increased risk of viral warts in atopic eczema and raise new questions regarding the role of cell-mediated immunity in atopic subjects.

Acne Vulgaris↗
PubMed1992

Childhood living conditions and Helicobacter pylori seropositivity in adult life.

Infection with Helicobacter pylori increases an individual's risk of peptic ulceration and gastric cancer. In the developed world, prevalence of infection rises with age and varies with social class. We used a cross-sectional study design to test the hypothesis that H pylori infection would be more closely associated with childhood living conditions than with current socioeconomic status. Prevalence of IgG antibodies against H pylori was determined with an enzyme-linked immunosorbent assay in 215 subjects (median age 46 years, range 18-82) attending a health-screening clinic in London. Seropositivity varied from 9% (age less than 30) to 67% (greater than or equal to 70). Subjects were asked about their living conditions at present and when they were aged 8 years. Absence of a fixed hot-water supply (p = 0.0005) and domestic crowding (p = 0.0005) in childhood were powerful independent risk factors for current infection with H pylori. Among current living conditions, only the number of children living in the household was independently associated with H pylori infection (p = 0.004). Most British adults infected with H pylori probably became infected by household contact in childhood.

Adult↗
PubMed1992

Surgical experience with juvenile nasopharyngeal angiofibroma.

A retrospective analysis was made of 24 cases of nasopharyngeal angiofibroma treated by the ENT Department of the Hospital de Clínicas de Porto Alegre between 1975 and 1989. All the patients were male with an average age of 16. All were treated by surgery alone, with an average peri-operative blood loss of 1,784 ml; pre-operative embolization made no significant difference to the blood loss. No other operative complications were encountered. Five patients (21%) had a recurrence, one of which was intracranial and required further surgery to effect a cure. The average length of follow-up was 19 months. We believe that surgical excision must be the treatment of choice for nasopharyngeal angiofibroma.

Adolescent↗
PubMed1991

Strategies of prevention revisited: effects of imprecise measurement of risk factors on the evaluation of "high-risk" and "population-based" approaches to prevention of cardiovascular disease.

Imprecise measurement of risk factors causes misclassification of individuals, limits sensitivity to detect those with high true levels, and dilutes associations between risk factors and disease. The implications of these effects for two particular examples were explored using data from a large prospective study relating plasma cholesterol to coronary heart disease (CHD) mortality and diastolic blood pressure (DBP) to fatal stroke. The absolute and relative effectiveness of three "high-risk" strategies of screening and treatment and a "population-based" shift in the risk factor distribution were compared, assuming different degrees of measurement error. The absolute benefits of each strategy were greater than suggested by unadjusted estimates from survey data. For cholesterol and CHD (a linear relationship in this cohort), uncorrected estimates tended to exaggerate the effectiveness of "high-risk" strategies relative to the "population-based" approach. For DBP and stroke (an exponential relationship), the relative effectiveness of screening and treatment was underestimated if no allowance was made for measurement error. These findings are strictly applicable only to the middle-aged men from whom they were derived, but the effects of misclassification and regression dilution need to be considered in any assessment of preventive strategies.

Adult↗
PubMed1989

Respiratory symptoms as predictors of 27 year mortality in a representative sample of British adults.

OBJECTIVE: To examine associations between reported respiratory symptoms (as elicited by questionnaire) and subsequent mortality. DESIGN: Prospective cohort study. SETTING: 92 General practices in Great Britain. PARTICIPANTS: A nationally representative sample of 1532 British men and women aged between 40 and 64. MAIN OUTCOME MEASURES: Mortality from all causes, cardiovascular disease, lung cancer, and chronic bronchitis. RESULTS: Subjects were interviewed in 1958 regarding various respiratory symptoms (including cough, phlegm, breathlessness, and wheeze) by using a questionnaire which formed the basis of the Medical Research Council's questionnaire on respiratory symptoms. By the end of 1985, 889 deaths had been reported, including 51 in men due to chronic bronchitis. After adjustment for differences in age and smoking habits death rates from chronic bronchitis in men who reported symptoms were greater than those in men who did not for each of the symptoms examined. The adjusted mortality ratios were 3.4 (95% confidence interval 1.8 to 6.5) for morning cough, 3.7 (2.0 to 6.9) for morning phlegm, 6.4 (3.0 to 13.8) for breathlessness when walking on the level, and 10.5 (4.4 to 24.6) for wheeze most days or nights. Mortality ratios were also significantly raised for four episodic symptoms not usually included in more recent respiratory symptom questionnaires--namely, occasional wheeze (mortality ratio 6.0; 95% confidence interval, 2.4 to 15.1), weather affects chest (5.7; 3.1 to 10.3), breathing different in summer (4.9; 2.8 to 8.6), and cold usually goes to chest (3.7; 2.0 to 6.8). The excess mortality associated with these symptoms remained significant after further adjustment for breathlessness or phlegm. Ratios for all cause mortality in men and women were also significantly raised for most respiratory symptoms, death rates being some 20-50% higher in people reporting symptoms after adjustment for age, sex, and smoking. Breathlessness was the only symptom significantly associated with excess mortality from cardiovascular disease (mortality ratio 1.4 (95% confidence interval 1.0 to 1.9) for breathlessness when walking on the level). Ratios were generally around unity and not significant for mortality due to lung cancer. CONCLUSIONS: The results suggest that episodic symptoms, which often do not appear in standard respiratory questionnaires, predict subsequent mortality from chronic obstructive airways disease. This supports the hypothesis that reversible airflow obstruction may be a precursor of progressive and irreversible decline in ventilatory function.

Adult↗
PubMed1979

Patients' reactions to a two-way mirror in general practice.

From a survey of 200 patients in two general practices it would appear that the patients' reaction to the use of a two-way mirror is on the whole not unfavourable. The results suggest, however, that in the very personal setting expected of general practice people suffering from psychiatric problems (especially depression) should be given every opportunity to decline consultation in front of the mirror and if any patient becomes upset, then the mirror should be 'turned off' immediately. Internal examinations should not take place when the mirror is in use.

Attitude↗