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Biomedical subjects

E Oliver

Publications and source records attributed to E Oliver.

At least 19 recordsLinked to original sources
PubMed2001

Nested case-control analysis of high pesticide exposure events from the Agricultural Health Study.

BACKGROUND: A nested case-control analysis of high pesticide exposure events (HPEEs) was conducted using the Iowa farmers enrolled in the Agricultural Health Study (AHS). METHODS: In the 12 months of the study, 36 of the 5,970 farmer applicators randomly chosen from the AHS cohort (six per 1,000 farmer applicators per year) met our definition of an HPEE, by reporting "an incident with fertilizers, weed killers, or other pesticides that caused an unusually high personal exposure" resulting in physical symptoms or a visit to a health care provider or hospital. Eligibility criteria were met by 25 HPEE cases and 603 randomly selected controls. RESULTS: Significant risk factors for an HPEE included: poor financial condition of the farm which limited the purchase of rollover protective structures OR = 4.6 (1.5-16.6), and having a high score on a risk acceptance scale OR = 3.8 (1.4-11.2). Other non-significant factors were also identified. CONCLUSIONS: The limited statistical power of this study necessitates replication of these analyses with a larger sample. Nonetheless, the observed elevated odds ratios of an HPEE provide hypotheses for future studies that may lead to preventive action.

Accidents, Occupational↗
PubMed2001

Treatment pathways, resource use and costs in the management of small cell lung cancer.

BACKGROUND: Small cell lung cancer (SCLC) represents about 20% of primary lung tumours and the costs associated with the management of SCLC can be significant. The main objective of this study was to obtain information on current patterns of care and associated resource use and costs for patients with SCLC from initial diagnosis and treatment phase, throughout disease progression and terminal care. METHODS: A 4 year retrospective patient chart analysis (1994-7) was conducted on a consecutive series of 109 patients diagnosed with SCLC in two Newcastle hospitals. For this consecutive series of patients all details about care received including tests and procedures, treatment, and medication from diagnosis till death were recorded. Pathways of care and forms were designed to enable resource use to be captured for different disease phases. Unit costs were determined from a variety of sources including the Newcastle Hospitals NHS Trust Finance Department and the British National Formulary. RESULTS: The average total cost per patient calculated for the full cohort of 109 patients was pound 11,556. Initial treatment was the most resource use intensive constituting 48.2% of the total cost. The major cost element throughout all disease phases was hospitalisation. Twenty eight percent of the total costs of care occur after recurrence of the disease until death, of which 73% are generated by terminal care. CONCLUSION: The results of this retrospective medical chart analysis show that the costs of care of SCLC are considerable, although the variability between patients in terms of the type and quantity of resource use is very high. Analyses such as this provide a useful insight into resources used in actual clinical practice.

Aged↗
PubMed1999

Consensus statement on the diagnosis of multiple system atrophy.

We report the results of a consensus conference on the diagnosis of multiple system atrophy (MSA). We describe the clinical features of the disease, which include four domains: autonomic failure/urinary dysfunction, parkinsonism and cerebellar ataxia, and corticospinal dysfunction. We set criteria to define the relative importance of these features. The diagnosis of possible MSA requires one criterion plus two features from separate other domains. The diagnosis of probable MSA requires the criterion for autonomic failure/urinary dysfunction plus poorly levodopa responsive parkinsonism or cerebellar ataxia. The diagnosis of definite MSA requires pathological confirmation.

Autonomic Nervous System Diseases↗
PubMed1999

Diagnostic criteria for Parkinson disease.

The clinical diagnosis of Parkinson disease (PD) is based on the identification of some combination of the cardinal motor signs of bradykinesia, rigidity, tremor, and postural instability, but few attempts have been made to develop explicit diagnostic criteria. We propose a clinical diagnostic classification based on a comprehensive review of the literature regarding the sensitivity and specificity of the characteristic clinical features of PD. Three levels of diagnostic confidence are differentiated: Definite, Probable, and Possible. The diagnoses of Possible and Probable PD are based on clinical criteria alone. Neuropathologic confirmation is required for the diagnosis of Definite PD in patients with the clinical diagnosis of Possible or Probable PD. Criteria for histopathologic confirmation of PD are also presented.

Antiparkinson Agents↗
PubMed1999

[Consensus on the diagnosis of multi-system atrophy].

We report the results of a consensus conference on the diagnosis of multiple system atrophy. We describe the clinical features of the disease, which include four domains: autonomic failure/urinary dysfunction, parkinsonism and cerebellar ataxia, and corticospinal dysfunction. We set criteria to define the relative importance of these features. The diagnosis of possible multiple system atrophy requires one criterion plus two features from separate domains. The diagnosis of probable multiple system atrophy requires the criterion for autonomic failure/urinary dysfunction plus poor levodopa responsive parkinsonism or cerebellar ataxia. The diagnosis of definite multiple system atrophy requires pathological confirmation.

Diagnosis, Differential↗
PubMed1998

Consensus statement on the diagnosis of multiple system atrophy.

We report the results of a consensus conference on the diagnosis of multiple system atrophy (MSA). We describe the clinical features of the disease, which include four domains: autonomic failure/urinary dysfunction, parkinsonism and cerebellar ataxia, and corticospinal dysfunction. We set criteria to define the relative importance of these features. The diagnosis of possible MSA requires one criterion plus two features from separate other domains. The diagnosis of probable MSA requires the criterion for autonomic failure/urinary dysfunction plus poorly levodopa responsive parkinsonism or cerebellar ataxia. The diagnosis of definite MSA requires pathological confirmation.

Autonomic Nervous System Diseases↗
PubMed1998

Consensus statement on the diagnosis of multiple system atrophy. American Autonomic Society and American Academy of Neurology.

We report the results of a consensus conference on the diagnosis of multiple system atrophy (MSA). We describe the clinical features of the disease, which include four domains: autonomic failure/urinary dysfunction, parkinsonism and cerebellar ataxia, and corticospinal dysfunction. We set criteria to define the relative importance of these features. The diagnosis of possible MSA requires one criterion plus two features from separate domains. The diagnosis of probable MSA requires the criterion for autonomic failure/urinary dysfunction plus poor levodopa responsive parkinsonism or cerebellar ataxia. The diagnosis of definite MSA requires pathological confirmation.

Antiparkinson Agents↗
PubMed1998

Phycomysterols and other sterols from the fungus Phycomyces blakesleeanus.

In the search for novel bioactive products from filamentous fungi, sterols and triterpenoids found in Phycomyces blakesleeanus were analyzed using semipreparative HPLC, GC-MS, and NMR techniques. Structures proposed for the three new compounds identified, phycomysterol A (1), phycomysterol B (2), and neoergosterol (3), were confirmed by chemical synthesis. Phycomysterols possess a new natural 19-norergostane skeleton with an aromatic B ring. Phycomysterol A showed anti-HIV activity.

Animals↗
PubMed1993

Biospheric 129I concentrations in the pre-nuclear and nuclear age.

In order to detect characteristic regional differences or temporal changes of 129I concentrations in the biosphere, thyroids from humans, grazing livestock, and herbivorous wildlife species (reindeer and roedeer) were collected in various areas of the world which are not affected by reprocessing plants. For reasons of comparison, all samples were analyzed for their 129I:127I atom ratios. Human and bovine thyroids taken from the 10th region in Southern Chile (39 degrees-41 degrees South) indicated values of the 129I:127I atom ratio between 1.1 x 10(-9) and 2.0 x 10(-9) and between 1.2 x 10(-10) and 9 x 10(-9), respectively. They showed no significant increase in the concentration of biospheric 129I in comparison with that established in the pre-nuclear age. Atom ratios found in human thyroids collected in Lower Saxony (Federal Republic of Germany), which is a region not directly affected by reprocessing plants, exhibited 129I:127I values between 8 x 10(-9) and 6 x 10(-8) from February 1988 to September 1990. Thyroid glands of reindeer and roedeer as well as heather, moss, and lichen were taken from the Vilhelmina, Heby, and Gävle communes in Sweden and analyzed for 129I and 127I. All three communes were found to be seriously contaminated by fallout from the Chernobyl accident. Highest 129I:127I atom ratios between 3.5 x 10(-7) and 1 x 10(-6) were found in the Gävle commune (approximately 150 km northwest of Stockholm) where the highest 137Cs ground deposition (70-80 kBq m-2) was measured. Two soil samples taken from Krasnaya Gora and Mirny locations in Russia (approximately 200 km northeast of Chernobyl) exhibited ratios of about 1 x 10(-6). These locations showed a 137Cs ground deposition of 370 and 1,300 kBq m-2, respectively.

Animals↗
PubMed1988

Short-latency autogenic inhibition (IB inhibition) in human spasticity.

The inhibitory effect of IB interneurons on motoneurons was tested in both legs of six hemiplegic adults. On the normal side, an inhibition of 10 ms, (14.6%) was observed in all cases and was similar to that described previously. On the spastic side, the same technique results in a facilitation of same duration reaching a maximum of 15%. Hence the IB inhibitory effect is, at least functionally, absent in spasticity. Disappearance of IB inhibition is an additional mechanism to be considered in interpreting spasticity.

Adult↗
PubMed1986

Chordoma: role of radiation therapy.

The treatment of 21 patients with a diagnosis of chordoma seen over a 20-year period is described. The 13 men and eight women (ratio 1.6:1) ranged in age from 7 to 82 years (average, 50 years). Eleven chordomas arose from the clivus; the others originated in the sacral region (three patients), thoracic spine (one), cervical spine (three), and lumbar spine (three). Primary treatment consisted of surgery, reserving radiation therapy for recurrence in the majority of patients. Radiation doses, delivered with megavoltage equipment, ranged between 5,000 cGy delivered over 5 weeks and 6,600 cGy over 6 1/2 weeks. Irradiation produced significant tumor control, with remission of symptoms from 1 to 6 years. The combination of high-dose radiation therapy and complete or subtotal surgical resection offers the best chance for prolonged survival in this group of patients.

Adult↗
PubMed1977

Unsuspected exposure to asbestos and bronchogenic carcinoma.

Two hundred and fifty men admitted to a thoracic surgical centre and matched controls were questioned in detail about their occupations after leaving school and their smoking habits. Of 201 men with confirmed bronchial carcinoma 58 gave a history of occupational exposure to asbestos, whereas only 29 out of 201 men matched for age and residential area who were admitted with other diseases gave such a history. This difference was statistically highly significant. The usual association of bronchial carcinoma with heavy smoking was observed, but asbestos exposure increased the risk of carcinoma whatever the level of smoking. These results are consistent with the hypothesis that asbestos exposure and the level of smoking act independently in causing bronchial carcinoma. The patients with carcinoma who had been exposed to asbestos presented on average three years earlier than those who had not been exposed. Asbestos regulations have eliminated the risk of exposure to workers in scheduled industries, so asbestos-induced diseases will probably be increasingly found among the many workers who have had incidental exposure to asbestos. It is therefore important to take a full occupational history.

Adenocarcinoma↗