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Biomedical subjects

D W Piper

Publications and source records attributed to D W Piper.

At least 19 recordsLinked to original sources

A note on sex-specific mortality and social class in Sydney, 1979 to 1983.

Simple indicators such as education, income, occupation, and employment status are often used to adjust for social class in studies of morbidity or mortality. The effect of social class on such outcomes can be different for men and women. In population-based studies, residential area may be the only means of assessing social class. This study investigated sex differences in the association between mortality between 1979 and 1983 and several area indices of social class--percentage with a degree, percentage professional, percentage blue collar, percentage unemployed, percentage with annual income greater than $40,000, and the composite indicator constructed by the Australian Bureau of Statistics. Thirty-seven Sydney statistical local areas were ranked for men and women separately according to the indicators and standardised mortality ratios. Correlations between the indicators and mortality were all negative and stronger for men than for women. The composite indicator and percentage unemployed correlated most strongly with mortality. There was a moderate correlation between the remaining indicators and mortality for men, but only a weak correlation for women. The results suggest that the use of simple area indicators may be inadequate to classify the social class of women, and that the unemployment rate in those over 35 years of age may be a reasonable alternative to the composite indicator for the purpose of social class adjustment in mortality studies.

Female

Cimetidine and gastric ulcer healing: a double-blind controlled trial.

The effect of cimetidine in the daily dose of 1200 mg on the healing rate of chronic gastric ulcer was assessed in a randomized double-blind trial in 48 patients. Cimetidine was found to accelerate the healing of chronic gastric ulcers in the ambulant patients, but it conferred no additional benefit on the patients in hospital. No significant side effects were observed.

Chronic Disease

A comparison of various parameters of social grade: a study of a Sydney population.

A comparison has been made between different methods of classifying a Sydney population of 118 persons into social grades. A positive correlation was found between address and occupation, education and occupation, occupation and father's occupation, address and education, address and father's occupation, and education and father's occupation, all correlations being significant at or below the P=0.004 level of statistical significance.

Australia

Which antacid?

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Antacids

Effect of ulcer healing on the prognosis of chronic gastric uler. Four-year follow-up.

Eighty three patients were followed-up for four years after an admission to hospital with a chronic gastric ulcer proven by radiology (index ulcer). The index ulcer healed completely in 50 patients, but was unhealed at the time of discharge in the other 33. Significantly fewer patients whose index ulcer was healed compared with those whose ulcer was unhealed at discharge had had a recurrence by one (p < 0.05), two, three and four years' (p < 0.01) follow-up. Moreover, the rate of recurrence was significantly greater for those patients with unhealed, compared with those with a healed index ulcer (p < 0.05) and by the end of the four-year period 61% of patients with unhealed, compared with 26% of those with healed index ulcers had had a recurrence. Patients over the age of 60 years with unhealed index ulcers had a significantly poorer prognosis than those of similar age whose index ulcer was healed at discharge (p < 0.025). The sex of the ulcer patient did not significantly influence ulcer recurrence. Large ulcers (> 57 mm(2)) were less often healed on initial discharge and were more frequently associated with recurrence at one (p < 0.05), two (p < 0.025), three and four years (p < 0.01) than smaller ulcers ([unk]57 mm(2)). Heavy intake of analgesics adversely influenced the course of patients whose ulcer was unhealed (p < 0.05), but did not alter the recurrence rate in those whose ulcer was healed. Ulcer recurrence was not influenced by smoking habits or by alcohol consumption.

Age Factors

Gastric mucosal proteins in patients with chronic peptic ulcer.

As ulcerogenesis could be explained by a defect in the mucosal proteins, a study of soluble proteins extracted from human gastric mucosa was made. The proteins were fractionated by gel electrophoresis. 7--8 major bands and several minor bands were present on polyacrylamide tube gels and 30 bands were visible on isoelectric focusing gels. No reproducible differences were found between body and antral mucosa or between the mucosa of gastric ulcer, duodenal ulcer and gastric carcinoma patients.

Chronic Disease

Chronic gastric ulcer and stress. A comparison of an ulcer population with a control population regarding stressful events over a lifetime.

Stress was measured by the frequency of 31 major life events with consequent change and distress scores in 50 patients with chronic gastric ulcer and 50 control subjects, matched for age, sex and place of residence. The gastric ulcer population did not differ from the control population regarding the number of events experienced and the associated change and distress scores. However, when analysed according to social grade, the ulcer patients in the lower status suburbs experienced more events and more change than their controls, but the stress scores were similar. In the higher status suburbs, no difference was present between the patients and controls. Change and distress scores rose progressively with age, but there was no significant difference in the number of events experienced between the three age groups. Both men patients and their controls experienced significantly more events and higher change scores than women patients and their controls.

Adult

The carcinogenic effect of cigarette smoke. The effect of cigarette smoke on human gastric mucosal cells in organ culture.

The carcinogenic effect of cigarette smoke on certain organs is well established epidemiologically, but the evidence in relation to gastric carcinoma is inconclusive. The present study reports the effect of cigarette smoke condensate (CSC) on gastric mucosa grown in organ culture and its effect is compared with that of the known gastric carcinogen, N-methyl-N1-nitro-N-nitrosoguanidine (NG). Viability of the cells was assessed by the uptake of labelled glucose and glycine. It was found that, as gauged by lactate and beta-glucuronidase production into the ambient fluid, CSC produced a response typical of malignancy that did not differ from that with NG.

Carcinogens

Treatment of chronic gastric ulcer a study of the treatment recived by 135 gastric ulcer patients in a western community.

A study was made of the treatment received by 135 gastric ulcer patients within one month and within six months of diagnosis. The treatment was divided into three types. Effective measures included surgery and those measures that have been shown favourably to influence the initial healing rate of chronic gastric ulcer (i.e. hospital admission and carbenoxolone sodium). Ineffective measures included those that have been shown convincingly not to accelerate ulcer healing--diet, antacids, sedatives and no treatmen at all. Anticholinergic drugs were included in the third group where the evidence is conflicting. The patient's therapeutic status was assessed one month and six months after diagnosis. Within six months of diagnosis only 32% of patients received treatment that clinical trials have shown favourably to influence the course of gastric ulcer and approximately half received treatment that has never been shown favourably to influence the course of gastric ulcer. The social class of the patients and whether they were seen by a consultant physicians or family doctor made no difference to the form of therapy received.

Australia

Lactate dehydrogenase isoenzyme pattern in uninvolved mucosa of patients with colorectal carcinoma.

Colorectal mucosa from patients with colorectal carcinoma was compared with rectal mucosa from a control group. It was found that the LDH isoenzyme pattern of uninvolved mucosa proximal and distal to the carcinoma differed from that of normal tissue and resembled that of carcinoma tissue except in the case of the uninvolved mucosa proximal to the carcinoma of the sigmoid colon, which did not differ from normal mucosa.

Colonic Neoplasms

beta-Glucoronidase and the gastric epithelial cell. A study using organ culture.

In an attempt to determine the significance of increased beta-glucuronidase content of gastric juice of patients with gastric carcinoma, gastric mucosal cells were exposed, in organ culture technique, to a known gastric carcinogen and indices of carcinogenic activity were studied in the ambient fluid and in the mucosal cells. Isotopic methods were used to determine cell viability. Indices of carcinogenic activity in the ambient fluid were beta-glucuronidase and lactate production and changes in the LDH isoenzyme pattern of the homogenates of the exposed cells were also studied. Incubation with the carcinogen resulted in increased production of beta-glucuronidase and lactate, suggesting the increased beta-glucuronidase activity in the gastric juice of patients with gastric cancer indicates malignancy.

Carcinogens

Aspirin esterase of gastric mucosal origin.

The enzyme, aspirin esterase, which converts acetylsalicyclic acid to the less toxic salicyclic acid, was found to be present in gastric mucosal specimens obtained from surgically resected tissue. The enzyme was found to be stable to storage and active at two pH optima. Alcohol in the reaction mixture produced a net effect of slowing the rate of aspirin hydrolysis; this was attributable to a marked inhibitory effect on aspirin esterase activity which was not completely counteracted by the increased rate of spontaneous breakdown of aspirin by alcohol. Age, sex, or gastric disease state of the patient from whom the tissue was obtained, did not significantly alter the level of enzyme activity measured, nor were different levels obtained from body or antral mucosa. In patients with gastric ulcer, those with a previous history of regular aspirin consumption did not show significantly different levels from those without such a history. It is concluded that aspirin esterase activity of gastric mucosa is not alone a significant factor in any role acetylsalicyclic acid may play in the etiology and natural history of chronic peptic ulcer.

Age Factors