Biomedical subjects

F D Reid

Publications and source records attributed to F D Reid.

6 recordsLinked to original sources

PubMed1999

Explaining variation in hospital admission rates between general practices: cross sectional study.

OBJECTIVES: To quantify the extent of the variation in hospital admission rates between general practices, and to investigate whether this variation can be explained by factors relating to the patient, the hospital, and the general practice. DESIGN: Cross sectional analysis of routine data. SETTING: Merton, Sutton, and Wandsworth Health Authority, which includes areas of inner and outer London. SUBJECTS: 209 136 hospital admissions in 1995-6 in patients registered with 120 general practices in the study area. MAIN OUTCOME MEASURES: Hospital admission rates for general practices for overall, emergency, and elective admissions. RESULTS: Crude admission rates for general practices displayed a twofold difference between the 10th and the 90th centile for all, emergency, and elective admissions. This difference was only minimally reduced by standardising for age and sex. Sociodemographic patient factors derived from census data accounted for 42% of the variation in overall admission rates; 45% in emergency admission rates; and 25% in elective admission rates. There was a strong positive correlation between factors related to deprivation and emergency, but not elective, admission rates, raising questions about equity of provision of health care. The percentage of each practice's admissions to different local hospitals added significantly to the explanation of variation, while the general practice characteristics considered added very little. CONCLUSIONS: Hospital admission rates varied greatly between general practices; this was largely explained by differences in patient populations. The lack of significant factors related to general practice is of little help for the direct management of admission rates, although the effect of sociological rather than organisational practice variables should be explored further. Admission rates should routinely be standardised for differences in patient populations and hospitals used.

Cross-Sectional Studies↗

PubMed1998

The clinical relevance of chemosensitivity testing in ovarian cancer.

The aim of this study was to assess the role of in vitro chemosensitivity testing in ovarian cancer using the MTT assay. Cells were separated from solid biopsy or ascitic fluid samples from 73 patients with ovarian adenocarcinoma, FIGO stage III to IV, on presentation. A 48 h drug exposure was followed by the MTT assay to determine sensitivity. Patients were treated by conventional regimens containing platinum. There was a marked variation in sensitivity to the platinum drugs between individual patients. Clinical data were available for 37 patients. Eleven out of seventeen (65%) patients in the sensitive group had a complete response to therapy, compared with 3 out of 20 (15%) in the resistant group (p = 0.005). The overall survival rates were 36% for the sensitive group compared with 18% for the resistant group (p = 0.37). This study suggests that chemosensitivity testing in ovarian cancer may be effective in improving initial clinical response.

Adenocarcinoma↗

PubMed1996

Cholecystectomy as a risk factor for colorectal cancer: a meta-analysis.

BACKGROUND: It has been suggested that there is an increased risk of colorectal cancer after cholecystectomy due to increased levels of secondary bile acids. Some studies suggest the risk is higher for women and for the development of right-sided tumours. METHODS: A review of the literature yielded 95 relevant studies, of which 35 were suitable for a meta-analysis involving age- and sex-matched controls. RESULTS: The pooled odds ratio for a positive association between cholecystectomy and colorectal cancer was 1.11 (95% confidence interval (CI), 1.02 to 1.21). For women the odds ratio was 1.14 (95 % CI, 10.01 to 1.28) and for right-sided cancer 1.86 (95% CI, 1.31 to 2.65). CONCLUSIONS: It is possible that this small observed association may be due to a publication bias for positive results or bias within the included studies. If it is indeed a real effect, the risk to an individual is very small.

Adolescent↗

PubMed1995

The relationship between cholecystectomy, unoperated gallstone disease, and colorectal cancer. A necropsy study.

BACKGROUND: There may be an increased risk of colorectal cancer after cholecystectomy, but the literature is not consistent. It is also possible that any risk might be associated with gallstones rather than cholecystectomy. METHODS: In a prospective necropsy study of 8563 cases, all 219 cases of a previous cholecystectomy were pair-matched to subjects with gallstones and to subjects with a normal gallbladder. In a second study all 192 cases of colorectal cancer were pair-matched to cancer-free subjects. RESULTS: The odds ratio (OR) for developing colorectal cancer after cholecystectomy compared with a normal gallbladder was 1.0 (95% confidence interval, 0.30-3.34) and with unoperated gallstones was 0.88 (0.27-2.76). CONCLUSIONS: This study fails to support an association between cholecystectomy or gallstones and colorectal cancer. For those cases of colorectal cancer versus controls, the OR for previous cholecystectomy was 0.70 (0.23-2.04) and for gallstone disease was 0.93 (0.58-1.48).

Cholecystectomy↗

PubMed1995

Prospective study of the quality of life in patients assessed for liver transplantation: outcome in transplanted and not transplanted groups.

The quality of life in adult patients with chronic liver disease who were considered for transplantation was assessed prospectively over a 2 year period, for both those who did and did not subsequently receive transplants. The main outcome measures were the Nottingham Health Profile and survival. Of the 109 patients who completed an entry profile, 27 were transplanted, 71 not transplanted during the study period, and 11 rejected for transplant. Quality of life and severity of liver disease at entry was worse for the transplant group, whose survival at 15 months from entry was 81% compared with 78% for those not transplanted. Among transplant survivors there were marked improvements in quality of life, whilst amongst those not receiving transplants there was little change. In conclusion, liver transplantation was effective in improving quality of life in patients with chronic liver disease, but comparison between transplant and non-transplant patients is difficult because of differences between the groups.

Activities of Daily Living↗

PubMed1976

A method of measuring pressures against tissues supporting functioning complete dentures.

A metod for measuring pressures exerted by denture bases against the supporting tissues during mastication which yields valid quantitative results was developed. Use of a specially designed diaphragm pressure transducer overcomes the disadvantages of a cantilever-beam arrangement which gave inaccurate results in earlier studies. On going research using this method was described. Several suggestions for additional applications of this method for prosthodontic research were presented.

Dental Stress Analysis↗