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Biomedical subjects

G Berry

Publications and source records attributed to G Berry.

At least 19 recordsLinked to original sources
PubMed1992

Prevalence of asthma in adults in Busselton, Western Australia.

OBJECTIVE: To estimate whether the prevalence of asthma in adults increased over a nine year interval. DESIGN: Serial cross sectional studies of the population with a protocol that included both subjective and objective measurements. SETTING: Busselton, Western Australia. SUBJECTS: A random sample of 553 subjects aged 18-55 years in 1981, and of 1028 subjects aged 18-55 years in 1990. MAIN OUTCOME MEASURES: Respiratory symptoms measured by self administered questionnaire, bronchial responsiveness measured by bronchial challenge with histamine, and allergy measured by skin prick tests. RESULTS: Symptoms with increased prevalence were those with significant association with allergy in this population. Recent wheeze increased from 17.5% to 28.8% (p < 0.001) and diagnosed asthma increased from 9.0% to 16.3% (p < 0.001). The increase was greatest in subjects less than 30 years old. The prevalence of shortness of breath coming on at rest and of hay fever also increased significantly, but the prevalence of shortness of breath on exertion, chronic cough, bronchial hyperresponsiveness, current asthma (defined as recent wheeze plus bronchial hyperresponsiveness), and allergy did not increase. The severity of bronchial responsiveness did not change significantly in any symptom group. CONCLUSIONS: Young adults showed a significant increase in reporting of symptoms related to allergy but not in the prevalence of current asthma. The increase in symptoms may be due to increased awareness of asthma in this community, to changed treatment patterns, or to increased exposures to allergens.

Adult↗
PubMed1992

Predictors of the course of tardive dyskinesia in patients receiving neuroleptics.

As many patients still require maintenance neuroleptic medication, it is important to determine what factors affect the course of tardive dyskinesia (TD) during ongoing neuroleptic treatment. In this study the data are from a series of annual examinations using the Abnormal Involuntary Movement Scale (AIMS) in a cohort of outpatients. Average neuroleptic exposure at the commencement of the examinations was 10 yr. The data on AIMS scores at successive visits are analysed using autoregressive modeling. Two hundred thirty-five patients contributed the 678 pairs of examinations. Separate analyses are reported for orofacial, limb-truncal, and total AIMS scores. Different predictor variables emerged as important for orofacial and limb-truncal dyskinesia. Age, sex, being on anticholinergic medication, and two variables describing duration of neuroleptic exposure contributed to the outcome score for total AIMS score after 1 yr.

Adult↗
PubMed1992

Relation of dose-response slope to respiratory symptoms and lung function in a population study of adults living in Busselton, Western Australia.

For describing bronchial responsiveness, it has been suggested that the dose-response slope (DRS), which is the linear slope of the dose-response curve, is a more useful measure of severity than the provoking dose that causes a 20% fall in FEV1 (PD20FEV1). To determine the distribution of DRS measurements and their relation to respiratory illness in adults, we have reanalyzed data collected in 1981 from a random sample of the population of Busselton, Western Australia. We measured bronchial responsiveness to histamine by the rapid method and atopy by skin prick tests to 15 common allergens. Satisfactory bronchial challenge data were recorded for 858 subjects. Subjects were classified as having asthma symptoms by self-reported history or as having chronic airflow limitation by abnormality of lung function. In normal subjects, DRS values were symmetrically distributed on a logarithmic scale so that a value that represented abnormal responsiveness could be calculated. The dose-response slope had a significant independent association with past and current asthma symptoms, smoking history, sex, atopy, and FEV1/FVC ratio but not with chronic airflow limitation. In subjects in whom a PD20FEV1 could not be measured, the DRS had a significant relation to asthma symptoms, smoking history, and FEV1/FVC. Thus, DRS values, which could be obtained for most subjects, contributed additional information to PD20FEV1 values and discriminated more accurately between groups classified according to respiratory history. These data confirm that DRS values should be used in preference to PD20FEV1 values for describing the severity of bronchial responsiveness in populations.

Adult↗
PubMed1992

Dispersal of adult females of Culex annulirostris in Griffith, New South Wales, Australia.

The dispersal of Culex annulirostris, a major arbovirus vector in Australia, was studied in Griffith, N.S.W. using a mark-release-recapture technique. From an empirical model of dispersal, fitted to data on recaptured adults, the average distance dispersed was 6.8 km (95% c.l. 4.1-40.9 km), and 50% of the population dispersed 4.8 km or more. Maximum recorded dispersal was 8.7 km, and 2 individuals traveled more than 5 km in 1 day. The relevance of the findings to control strategy is discussed.

Animals↗
PubMed1992

Dispersal of adult female Culex annulirostris in Griffith, New South Wales, Australia: a further study.

The dispersal of Culex annulirostris was studied during February 1986 in Griffith, N.S.W. using a mark-release-recapture technique. Parity was determined of recaptured females and a sample of the population at release. Parity rates of the 2 populations were comparable, and no significant differences were detected between the dispersal characteristics of the nulliparous and parous recaptured females. The maximum flight distance observed was 12 km, the limit of the trapping network. It was estimated that the mean distance traveled was 4.4 km and 36.6% (n = 377) of the population dispersed further than 5 km. The majority (81.2%, n = 377) of recaptures were taken within 2 days of release and the rate of dispersal of the population was estimated at 2.2 km/day.

Animals↗
PubMed1992

Diversity of T-cell antigen receptor variable genes used by mycosis fungoides cells.

The expression of T-cell antigen receptor beta-chain variable genes (V beta) was evaluated in 28 cases of mycosis fungoides. A novel polymerase chain reaction (PCR) technique was used to associate expression of particular V beta genes with monoclonal T-cell populations. In addition, the same biopsies used for PCR analysis were also examined for reactivity with a panel of seven monoclonal antibodies that specifically recognized V beta proteins from four different families. Only three cases clearly stained with the antibodies, a result consistent with a diverse set of V beta genes being used. This was confirmed by PCR analysis, which indicated that V beta genes from many different families were expressed by these tumors. Preferential use of the V beta 8 family, which had been previously use of the V beta 8 family, which had been previously reported for this disease, was not evident among the cases analyzed.

Antibodies, Monoclonal↗
PubMed1991

Trauma studies.

Explore the source record for details and available documents.

Ambulatory Care↗
PubMed1991

Relationship between lung asbestos fiber type and concentration and relative risk of mesothelioma. A case-control study.

Lung tissue from 221 definite and probable cases of malignant mesothelioma reported to the Australian Mesothelioma Surveillance Program from January 1980 through December 1985 and from an age-sex frequency matched control series of 359 postmortem cases were examined by light microscopic (LM) and analytical transmission electron microscopic (TEM) analysis and energy dispersive x-ray analysis (EDAX). Concentrations of total fibers (coated and uncoated) (LM), crocidolite, amosite, chrysotile, and unidentified amphibole (TEM) (fibers/g dry lung tissue) were measured. Fiber concentrations less than 10 microns in length and greater than or equal to 10 microns in length were separately quantified. By comparing cases (221) and controls (359 LM, 103 TEM), odds ratios for increasing fiber concentrations compared with less than 15,000 fibers/g (LM) and less than 200,000 fibers/g (TEM) (the respective detection limits) were calculated. Univariate analyses showed statistically significant dose-response relationships between odds ratio and fiber concentration for all fiber concentration measures. The relationship between log(odds ratio) and log(fiber concentration) was linear. Multiple logistic regression analysis showed that a model containing crocidolite greater than or equal to 10 microns, amosite less than 10 microns, and chrysotile less than 10 microns as explanatory variables best described the data. The odds ratios for a X10 increase in fiber concentration (fibers/micrograms) were as follows: crocidolite greater than or equal to 10 microns, 29.4 (95% confidence interval [CI], 3.6 to 241); chrysotile less than 10 microns, 15.7 (95% CI, 6.1 to 40); amosite less than 10 microns, 2.3 (95% CI, 1.0 to 5.3). An additive risk model gave similar results. In a subgroup of cases and controls with only chrysotile in the lungs, a significant trend in odds ratio with increasing fiber content was found.

Adult↗
PubMed1991

Primary non-Hodgkin lymphoma of the spleen.

Primary splenic lymphoma is a relatively infrequent cause of splenomegaly, its reported incidence being less than 1%. Nonetheless, various series have reported on its occurrence and its unfavorable prognosis, but these series have reported data on heterogenous populations, including many patients with nodal or hepatic disease. We report on a series of nine patients with primary splenic lymphoma. None of these patients had biopsy-proven evidence of extrasplenic disease and were categorized as involving spleen only (stage 1) or spleen and splenic hilum (stage 2). In this series, classified by the recent N.C.I. working formulation, four patients had intermediate or high-grade histology and five patients had low-grade histology. There was no correlation between histological subtype and prognosis, nor could other factors be delineated to explain their favorable prognosis. The median survival in this group of patients was 7.48 years, and no evidence of relapse has been documented. The data suggest that primary splenic lymphoma, treated by splenectomy alone or combination therapy, may be potentially curative. Further studies should address the question of aggressive accurate staging in hopes of obtaining homogenous patient populations so that appropriate treatment in primary splenic lymphoma can be better defined.

Adult↗
PubMed1991

The incidence of malignant mesothelioma in Australia 1982-1988.

From 1980 to 1985, the Australian Mesothelioma Surveillance Program, and since 1986, the Australian Mesothelioma Register, have been collecting data on all cases of malignant mesothelioma that could be ascertained in Australia. Incidence rates were calculated on 854 Program and 696 Register cases (total 1271) diagnosed in Australia between January 1, 1982 and December 31, 1988. Australia has one of the highest national rates of mesothelioma in the world (15.8 cases per million of population aged 20 years and older), and the rate is rising. The rate is far higher in males (28.3) than females (3.3). The Western Australian rate (28.9) is the highest among the states, as may be expected because of the crocidolite mine at Wittenoom; however, the largest numbers of cases occur in the more populous and industrial New South Wales. The high incidence rate, its expected continuing increase, and absence of a history of exposure to asbestos in approximately 28% of cases, demand consideration of potential environmental factors other than asbestos in the causation of this tumor, as well as continued surveillance.

Adult↗
PubMed1991

A comparison of two simple hazard ratio estimators based on the logrank test.

Two hazard ratio estimators based on the logrank test are investigated using a simulation study. The Pike estimator (ratio of relative death rates) was shown to be consistently less biased than the Peto (1-step) estimator. The latter has recently been advocated as the method of choice for point and interval estimation. Both estimators exhibited bias with increasing hazard ratios, although the bias was minimal for effects less than 3. The confidence intervals also did not achieve the nominal coverage with increasing hazard ratios, but again the Pike estimator was superior. The coverage could be improved by recalculation of the variance incorporating the point estimate. For a hazard ratio of less than 3 we recommend the use of the Pike estimator, otherwise it is necessary to use a more complex method of estimation.

Confidence Intervals↗
PubMed1991

CD4% is the best predictor of development of AIDS in a cohort of HIV-infected homosexual men.

To determine the relationships between individuals' baseline T-cell subsets, their rates of change with time, and AIDS-free survival time, data were collected at 6-monthly intervals from 379 HIV-seropositive homosexual Sydney men, of whom 31 developed AIDS during the 3-year observation period. Both CD4% and rate of change of CD4% in an individual had significant prognostic value in determining AIDS-free survival time. Compared with subjects whose CD4% remained stable, subjects whose CD4% dropped by 7% or more in a year had a relative hazard of 35.1 (95% confidence interval = 11.7-105.6, P less than 0.001) of developing AIDS. Increasing CD4% had a significant protective effect, reducing the risk of developing AIDS. CD4%, CD4 cell count and CD4: CD8 ratios showed steeper declines in subjects who were later diagnosed with AIDS than in those who remained AIDS-free. The rates of immunological change in AIDS-free seroconverters and seropositives were similar, despite indeterminate differences in durations of infections. In the multivariate Cox regression analysis, baseline CD4%, the rate of change of CD4%, and baseline lymphocyte count were associated with AIDS-free survival time. Baseline CD4% had greater prognostic value than baseline CD4 cell count. Baseline CD8%, baseline CD8 count, their rates of change and their mean square errors were not independently significant in this analysis. These findings are important for clinicians monitoring HIV infection in an individual and for entry criteria and monitoring procedures in clinical trials. They also have implications for resource-poor settings; prognosis based on CD4% can be made with a flow cytometer without a full blood count.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1991

The Dubbo study of the health of elderly: correlates of coronary heart disease at study entry.

A prospective study of the health of elderly Australians recently commenced in Dubbo, NSW, the study population comprising 1,237 males and 1,568 females 60 years and older. The prevalence rates of coronary heart disease (CHD) and its associated risk factors have been examined in the baseline data. The age-standardized rate of CHD was 23.8/100 in males and 18.1/100 in females. The prevalence rate increased with age until 79 years in males, thereafter declining. The rate increased steadily with age in females. In a multiple logistic model, the following possible predictors of CHD were included: age, cigarette smoking, use of alcohol, exercise, religiosity, years of education, hypertension, diabetes, family history of CHD, body mass index, lipid and lipoprotein variables. The presence of CHD in males was significantly predicted by age, hypertension (odds ratio, OR = 1.40), family history (OR = 2.05), and high density lipoprotein (HDL) cholesterol (OR = 0.78). The significant predictors in females were age, years of education (OR = 0.82), hypertension (OR = 1.45), family history (OR = 1.77), serum triglycerides (OR = 1.30), and HDL cholesterol (OR = 0.73). Hypertension was found to be a stronger predictor of CHD in the younger age group (60-69 years), while diabetes was a predictor of CHD in older males (70-79 years). Our findings require confirmation in the prospective study now in progress.

Age Factors↗
PubMed1991

Prediction of mesothelioma, lung cancer, and asbestosis in former Wittenoom asbestos workers.

Projections have been made of the number of mesotheliomas, lung cancers, and cases of asbestosis that might occur over the period 1987 to 2020 in former workers at the Wittenoom crocidolite asbestos mine in Western Australia. Predictions were based on the observed mortality to the end of 1986 and modelling of the mesothelioma rate. Elimination of crocidolite from the lungs was included in the model. Between the years 1987 and 2020 it is predicted that between 250 and 680 deaths will occur due to mesothelioma. This wide range is due to uncertainty on the functional form of the relation between mesothelioma rate and time, and insufficient data to estimate the elimination rate of crocidolite from the lungs. The most likely range is the lower half of this total range--that is, between 250 and 500. It is predicted that between 340 and 465 deaths will occur due to lung cancer. About 45% of these deaths would be attributable to exposure to asbestos. It is estimated that currently there are up to 200 cases of undiagnosed asbestosis. Of these about 50 will die of lung cancer or mesothelioma and are therefore also included in the figures above. Up to 60 former workers may develop the first signs of asbestosis in the future but any such cases are likely to progress to more serious disease at a much slower rate than the cases that have already been identified.

Adult↗
PubMed1991

Ulcerative tracheobronchitis after lung transplantation. A new form of invasive aspergillosis.

Invasive aspergillosis is frequently a fatal disease in the setting of immunosuppression, including organ transplant recipients. The fungus usually affects lung parenchyma and may disseminate from there. We have recently noted tracheobronchitis in six patients with heart-lung and lung transplants, three of whom had deep mucosal ulceration and histologic evidence of invasive aspergillosis. This apparently new form of invasive disease is initially limited to the anastomosis site and large airways. Ulceration, necrosis, cartilage invasion, and formation of a pseudomembrane are the pathologic features. In two patients subsequent disseminated aspergillosis occurred with a fatal outcome. In the two single-lung recipients, disease was limited to the transplanted side emphasizing the importance of abnormal local defense mechanisms in the airways of lung transplant recipients. Routine bronchoscopic examination of the airways is important in early detection of this complication. Oral therapy with the new, antifungal agent itraconazole was successful in five of the six patients, with fatal relapse in one. A classification of the various forms of saprophytic, allergic, and invasive forms of aspergillus tracheobronchitis, to include this new entity, is proposed.

Adult↗
PubMed1991

Relation of dose-response slope to respiratory symptoms in a population of Australian schoolchildren.

To describe bronchial responsiveness in populations, the dose-response slope (DRS), which is the linear slope of the dose-response curve, may be a more useful measure of severity than the provoking dose that causes a 20% fall in FEV1 (PD20 FEV1). To examine the distribution of DRS measurements and their relation to respiratory symptoms in children, we have analyzed data collected during a population study designed to measure the prevalence of bronchial hyper-responsiveness and respiratory symptoms. In this study, respiratory symptom history was measured by a self-administered questionnaire to parents and bronchial responsiveness was measured using the rapid inhalation method. Of 1,217 children studied, DRS values were obtained for 1,203 children who had technically satisfactory bronchial challenge data. In asymptomatic children, DRS values were distributed symmetrically on a logarithmic scale. The geometric mean DRS was reliable measure of the central position of the curve, and 1.96 standard deviations only slightly underestimated the 95% interval. In children with recent wheeze, the distribution was skewed toward larger DRS values. Mean DRS values were significantly different between groups determined according to symptom frequency. It appears that DRS values are more useful than PD20 FEV1 values in epidemiologic studies of respiratory illness in children because a value that relates well to symptom history can be calculated for the entire sample. The major advantages are that the measurement more clearly discriminates between symptom severity groups and that a value that represents abnormal responsiveness can be calculated.

Asthma↗