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Biomedical subjects

J Lynch

Publications and source records attributed to J Lynch.

At least 19 recordsLinked to original sources
PubMed2006

Effects of socioeconomic change from birth to early adulthood on height and overweight.

BACKGROUND: In this work we explored the association of height and overweight with change in socioeconomic position between birth and 19 years of age. METHODS: A birth cohort has been followed-up in Pelotas, Brazil, since 1982. All 5914 hospital births were enrolled in the study just after delivery. In 2001, 27% of the cohort subjects were sought, and 1031 (69% of the survivors) were interviewed. Weight and height were obtained for women; men had been examined 6 months earlier. Information on family income in 1982 and 2001 was used to classify the sample into tertiles, the lowest classified as 'poor' and the other two as 'non-poor'. Four trajectories resulted: always poor, never poor, poor at birth/non-poor at 19, and non-poor at birth/poor at 19-which were compared in terms of mean height and prevalence of overweight. RESULTS: Height showed a similar behaviour for men and women, with the never poor presenting the highest mean, followed by those who were non-poor at birth and later became poor. Those who were poor at birth, regardless of later status, were shortest. Overweight was approximately twice as common among men who were never poor in relation to the others. Among women, those who were always poor presented the highest prevalence of overweight. In this case, social determination seems to be complex and may involve aspects of lifestyle and behaviour acting differently for each gender. CONCLUSION: Socioeconomic trajectories affected both height and overweight, the effect on the latter being different for each gender.

Birth Weight↗
PubMed2006

The relation between socioeconomic and demographic factors and tumour stage in women diagnosed with breast cancer in Denmark, 1983-1999.

The authors investigated the association between socioeconomic position and stage of breast cancer at the time of diagnosis in a nationwide Danish study. All 28 765 women with a primary invasive breast cancer diagnosed between 1983 and 1999 were identified in a nationwide clinical database and information on socioeconomic variables was obtained from Statistics Denmark. The risk of being diagnosed with a high-risk breast cancer, that is size >20 mm, lymph-node positive, ductal histology/high histologic grade and hormone receptor negative, was analysed by multivariate logistic regression. The adjusted odds ratio (OR) for high-risk breast cancer was reduced with longer education with a 12% reduced risk (95% confidence interval (CI), 0.80,0.96) in women with higher education and increased with reduced disposable income (low income group: OR, 1.22; 95% CI, 1.10,1.34). There was an urban-rural gradient, with higher risk among rural women (OR 1.10; 95 % CI, 1.02, 1.18) and lower risk among women in the capital suburbs (OR, 0.85; 95% CI, 0.78, 0.93) and capital area (OR, 0.93; 95% CI, 0.84-1.02). These factors were significant only for postmenopausal women, although similar patterns were observed among the premenopausal women, suggesting a subgroup of aggressive premenopausal breast cancers less influenced by socioeconomic factors.

Adult↗
PubMed2006

Quantitative measures of air-gun pulses recorded on sperm whales (Physeter macrocephalus) using acoustic tags during controlled exposure experiments.

The widespread use of powerful, low-frequency air-gun pulses for seismic seabed exploration has raised concern about their potential negative effects on marine wildlife. Here, we quantify the sound exposure levels recorded on acoustic tags attached to eight sperm whales at ranges between 1.4 and 12.6 km from controlled air-gun array sources operated in the Gulf of Mexico. Due to multipath propagation, the animals were exposed to multiple sound pulses during each firing of the array with received levels of analyzed pulses falling between 131-167 dB re. 1 microPa (pp) [111-147 dB re. 1 microPa (rms) and 100-135 dB re. 1 microPa2 s] after compensation for hearing sensitivity using the M-weighting. Received levels varied widely with range and depth of the exposed animal precluding reliable estimation of exposure zones based on simple geometric spreading laws. When whales were close to the surface, the first arrivals of air-gun pulses contained most energy between 0.3 and 3 kHz, a frequency range well beyond the normal frequencies of interest in seismic exploration. Therefore air-gun arrays can generate significant sound energy at frequencies many octaves higher than the frequencies of interest for seismic exploration, which increases concern of the potential impact on odontocetes with poor low frequency hearing.

Acoustic Stimulation↗
PubMed2005

[Anaesthetic-related complications of caesarean section].

In spite of an increase in the number of caesarean sections, the incidence of anaesthetic-related complications remains low. This is due primarily to the increasing use of regional anaesthesia (spinal and or epidural anaesthesia) as general anaesthesia is associated with a 17-fold increase in complications, in particular failed endotracheal intubation, aspiration of gastric contents and hypoxia. It is most important that all obstetric patients deemed at risk for general anaesthesia (e. g. morbidly obese, hypertension, placenta praevia) should be identified as such by the obstetricians and referred to the anaesthetic department at an early stage. Furthermore there should be common procedural guidelines to define the degree of urgency of caesarean section as most anaesthetic complications occur during "emergency" cases under general anaesthesia. Many of these so-called emergency cases are not real emergencies and could be equally well performed under regional anaesthesia. A continuing audit of maternal deaths in Germany should be established along similar lines to the Confidential Enquiries into Maternal Deaths in the United Kingdom. Most importantly, the increasing use of regional anaesthesia should be propagated as its use in Germany still lies well behind other countries such as Switzerland, the USA and the United Kingdom.

Anesthesia, Conduction↗
PubMed2004

Determinants of quality of life in first-episode psychosis.

OBJECTIVE: To assess patient and/or illness characteristics associated with aspects of quality of life (QOL) in first-episode psychosis (FEP). METHOD: Patient characteristics, symptom ratings and Wisconsin QOL scale (client version) were assessed. Data were analysed with correlation coefficients and a hierarchical regression analysis. RESULTS: Patients presented with varying levels of QOL on different domains. The level of 'general satisfaction' was related to age of onset and social premorbid adjustment; 'weighted index of QOL' to social premorbid adjustment and inversely to educational premorbid adjustment; 'social relations' inversely to duration of untreated psychosis (DUP), length of prodrome and negative symptoms; 'psychological well-being' inversely to depression and educational premorbid adjustment; 'activities of daily living' to social premorbid adjustment and inversely to negative symptoms; and 'outlook on symptoms' to level of depression. CONCLUSION: Domains of self-rated QOL in FEP patients are differentially associated with malleable and non-malleable aspects of patient and illness characteristics.

Adult↗
PubMed2004

Neighbourhood social participation and women's use of anxiolytic-hypnotic drugs: a multilevel analysis.

STUDY OBJECTIVES: To identify and quantify a hypothesised collective effect of the neighbourhood on individual use of anxiolytic-hypnotic drugs (AHD). To analyse the general impact of neighbourhood social participation on use of AHD, adjusting for individual characteristics. DESIGN: Cross sectional analysis performed by multilevel logistic regression with women at the first level and neighbourhoods at the second level. SETTING: Malmö (250 000 inhabitants), Sweden. PARTICIPANTS: 15 456 women aged 45 to 73, residing in 95 neighbourhoods in Malmö, who took part in the Malmö diet and cancer study (1991-1996). MAIN RESULTS: The prevalence of AHD use was 5.5% in the study sample. Overall, 1.7% of the total individual differences in the propensity for using AHD were explained by the neighbourhood level. This percentage, however, differed between different individuals. Low level of social participation in the neighbourhood was associated with higher probability of AHD use (OR = 3.10 (95% CI 1.51 to 6.41)), independently of individual age, low social participation, low educational level, and living alone. This association was reduced (OR = 2.01 (95% CI 0.97 to 4.14)) after the additional accounting for individual disability pension, low self rated health, stress, and medication for somatic disorders. CONCLUSIONS: The neighbourhood level of social participation seems to affect individual use of AHD, possibly through individual characteristics. However, neighbourhood boundaries play a minor part in understanding individual AHD use in the city of Malmö.

Aged↗
PubMed2003

Comparison of fixed-flexion positioning with fluoroscopic semi-flexed positioning for quantifying radiographic joint-space width in the knee: test-retest reproducibility.

OBJECTIVE: To compare fixed-flexion radiography of the knee with fluoroscopic semi-flexed radiography in terms of the reproducibility of measurements of minimum joint-space width (JSW) in the medial femorotibial joint. METHODS: Posteroanterior radiographs of the right knees of 18 normal volunteers were acquired with the patients standing on an upright fluoroscopy table, the feet externally rotated 10 degrees and the toes touching the vertical table. Knees were positioned and radiographed with two different techniques: (1) semi-flexed positioning under fluoroscopic guidance using a horizontal X-ray beam; and (2) fixed-flexion positioning, with the knees and thighs touching the vertical table, using 10 degrees caudal beam angulation without fluoroscopy. Foot maps were drawn in each case. Subjects were repositioned and radiographed twice using each technique. The posteroanterior beam angle that optimally projected the medial tibia plateau with the patient in the fixed-flexion position was also determined for each subject in a separate examination using fluoroscopy. Ten patients with osteoarthritis were also examined with the fixed-flexion technique using a conventional radiographic unit. Minimum medial joint-space width (JSW) in the medial femorotibial joint was measured manually with a graduated lens and also with a semi-automated computer algorithm. RESULTS: Reproducibility errors (root-mean-square SD) for manual and automated JSW measurement were 0.2 mm and 0.1 mm, respectively, for fluoroscopic semi-flexed positioning in volunteers; 0.3 mm and 0.1 mm, respectively, for fixed-flexion positioning in volunteers; and 0.2 mm and 0.1 mm, respectively, for fixed-flexion positioning in osteoarthritic patients. The optimal beam angle for visualizing the joint space was 9.0 degrees +/-3.6 degrees. CONCLUSION: Fixed-flexion, non-fluoroscopic radiography of the knee can provide reproducible JSW measurement using widely available X-ray equipment. This technique is more feasible for multicenter clinical studies and routine clinical use than are methods that rely on fluoroscopic alignment of the tibial plateau.

Adult↗
PubMed2003

Survey of abuse and violence by patients and relatives towards intensive care staff.

A postal survey of senior nurses in intensive care units in England and Wales was conducted. The aim was to ascertain the frequency of abusive and violent behaviour by patients and relatives towards intensive care staff, discover the perceived causes, effects and documentation of such behaviour and define the current and proposed security arrangements for intensive care units. Response rate was 94%. During the study period, verbal abuse of nurses by patients and by relatives occurred in 87% and 74% of intensive care units, respectively. The relevant figures for doctors were 65% and 59%, respectively. Nurses experienced physical abuse by patients and by relatives in at least 77% and 17% of intensive care units, respectively (doctors 38% and 8%). Illness was the main perceived cause of offences by patients whereas 'distress' (45%), alcohol (24%), sociopathic behaviour (27%) were the main putative causes amongst relatives. Whilst 43% of intensive care units have no security system at the door, staff awareness, training and communication skills may be the principle tools in reducing the frequency and consequences of violent and abusive behaviour. This survey probably underestimates the problem.

Aggression↗
PubMed2003

The parieto-collicular pathway: anatomical location and contribution to saccade generation.

The monkey lateral intraparietal area (LIP), involved in reflexive shifts of visual attention, has two main oculomotor outputs: towards frontal oculomotor areas and towards the superior colliculus. Recent studies suggest that these two outputs do not carry similar information. Direct LIP-collicular neurons would convey visual signals providing the oculomotor system with on-line visuo-spatial information. Parietal visuo-spatial information regarding internal stimuli would access the brainstem oculomotor circuitry through a parieto-frontal network. Consequently, an interruption of parieto-tectal neurons should affect reflexive saccades towards unpredictable targets and have little or no effect on saccades towards predictable or memorised stimuli. In order to test this hypothesis in humans, we have determined in rhesus monkeys the location of LIP-tectal fibres in the region of the internal capsule, and found that these neurons travel in the most posterior region of the posterior limb of the internal capsule. We have then tested, in seven patients with a small lesion involving this region, several oculomotor paradigms designed to determine the influence of spatial predictability on saccade accuracy and the ability to withhold reflexive saccades. In all patients, saccade accuracy was affected in unpredictable conditions but was normal when target location could be predicted or memorised. Reflexive saccade inhibition was affected only in the three patients in whom the capsular lesion had the most anterior extent. These results therefore support in humans the hypothesis that parieto-tectal neurons (i) transmit an on-line signal that is used by the oculomotor system for reflexive saccade triggering, (ii) are not crucial for the computation of internally guided saccades and (iii) are not crucial for reflexive saccade inhibition.

Adult↗
PubMed2003

Labour market income inequality and mortality in North American metropolitan areas.

OBJECTIVE: To investigate relations between labour market income inequality and mortality in North American metropolitan areas. METHODS: An ecological cross sectional study of relations between income inequality and working age (25-64 years) mortality in 53 Canadian (1991) and 282 US (1990) metropolitan areas using four measures of income inequality. Two labour market income concepts were used: labour market income for households with non-trivial attachment to the labour market and labour market income for all households, including those with zero and negative incomes. Relations were assessed with weighted and unweighted bivariate and multiple regression analyses. RESULTS: US metropolitan areas were more unequal than their Canadian counterparts, across inequality measures and income concepts. The association between labour market income inequality and working age mortality was robust in the US to both the inequality measure and income concept, but the association was inconsistent in Canada. Three of four inequality measures were significantly related to mortality in Canada when households with zero and negative incomes were included. In North American models, increases in earnings inequality were associated with hypothetical increases in working age mortality rates of between 23 and 33 deaths per 100 000, even after adjustment for median metropolitan incomes. CONCLUSIONS: This analysis of labour market inequality provides more evidence regarding the robust nature of the relation between income inequality and mortality in the US. It also provides a more refined understanding of the nature of the relation in Canada, pointing to the role of unemployment in generating Canadian metropolitan level health inequalities.

Adult↗
PubMed2003

Socioeconomic health inequalities among a nationally representative sample of Danish adolescents: the role of different types of social relations.

STUDY OBJECTIVE: To investigate the role of different types of social relations in adolescent health inequalities. DESIGN: Cross sectional study. Measures included family social class, indices of social relations to parents, friends, teachers, and school. SETTING: Random sample of 55 schools in Denmark. PARTICIPANTS: Nationally representative sample of 5205 students from grades 5, 7, and 9. MAIN OUTCOME MEASURES: Self reported physical and psychological symptoms. RESULTS: Adolescents from families of lower socioeconomic position reported more physical and psychological symptoms. This ranged from 40% increased odds for multiple physical symptoms among less advantaged girls, to 90% increased odds of multiple psychological symptoms for less advantaged boys. Relationships with friends or teachers showed small social class differences, while strong and consistent social class differences were found in the ways adolescents reported their own and their parents relations to school. For example, girls from families of lower socioeconomic position were more than four times as likely to report their parents unwilling to attend school meetings (odds ratio=4.54, 95% confidence intervals: 2.68 to 7.69). Poorer relations with parents, peers, teachers, and school were all associated with worse health. Patterns of parent-child relations with the school were the greatest contributors to socioeconomic differences in physical and psychological symptoms. CONCLUSIONS: The school is one of the first important social institutions directly experienced by children and socioeconomic differences in how adolescents and their parents relate to the school may be part of the cascade of early life influences that can lead to later social and health disadvantage.

Adolescent↗
PubMed2003

Use of a quality index in threshold contrast detail detection measurements in television fluoroscopy.

The use of a single index to assist in quality control procedures of X-ray television fluoroscopy systems was investigated. A single quality index was devised incorporating a measure of threshold contrast detail detectability (TCDD) performance and taking into account image intensifier input kerma rate, field size, differences in radiation beam quality, and pulsed fluoroscopy. This was applied to a number of clinical systems to investigate changes in image quality index quantified over time. Accepted measurement protocols were used to obtain these measurements. The results show system performance for different systems and can establish the decline in performance parameters over time or assess non-optimal image quality with clinical systems in field measurements. The systems studied were assessed with a variety of performance parameters including TCDD results, low contrast sensitivity, limiting resolution, and image intensifier input kerma rate under clinical modes of operation. The TCDD quality index, and dose normalized quality index, were found to be useful image quality assessment parameters for serial testing of systems, which augment the use of graphical methods for the display of TCDD curves.

Fluoroscopy↗
PubMed2002

Use of frozen bagged seed inoculum for secondary metabolite and bioconversion processes at the pilot scale.

Frozen bagged seed inoculum was prepared, thawed and tested for seven cultures. Thawing techniques were developed and other key influences on thawing rate were quantified; seed bag thawing without a water bath rarely required more than 4 to 5 h and was as short as 0.5 to 1 h for lower fill volume bags. Testing included growth of bagged seed as a function of bag fill volume (0.5, 1.0, 2.0, and 3.5 L), comparison of culture age at time of bagging, growth of bagged versus laboratory-prepared seed, productivity of production cultures derived from bagged versus laboratory-prepared seed, growth of bagged seed as a function of volume percent glycerol added at time of bagging, and growth of bagged seed as a function of frozen storage time and temperature. For each culture tested, conditions were developed such that seed tanks inoculated with bagged seed showed only minimal delay in attaining the target oxygen uptake rate (OUR) relative to seed tanks inoculated with laboratory-prepared inoculum. Although the bag fill volume did influence culture growth in some cases, bag fill volumes required were reasonable (typically 2.0 to 3.5 L) compared with laboratory seed inoculum volumes of 2.0 L. In the most remarkable example, frozen bagged seed was prepared from a second-stage seed-tank cultivation of Glarca lozoyensis, then thawed and inoculated into first-stage seed medium. It grew to the desired OUR in a similar timeframe as laboratory-prepared inoculum inoculated into first-stage seed medium. Thus, the frozen bagged seed replaced an existing laboratory inoculum preparation period of 7 days without an appreciable delay in either of the two subsequent seed-tank growth stages. Furthermore, productivities were found to be comparable for bagged-seed-derived and laboratory-seed-derived production cultivations for four different fermentation processes.

Bioreactors↗
PubMed2002

Mitotic counts provide additional prognostic information in grade II mammary carcinoma.

The ability to predict how long a patient diagnosed with breast cancer is likely to survive is still imprecise, despite numerous studies which have identified potential prognostic markers. The "established" markers such as nodal status, tumour size, and histological grade have been used for many years and certainly provide some degree of accuracy upon which treatment can be based. However, women with similar prognostic features can vary significantly in their outcome and very few of the newly identified markers provide information that is sufficiently useful to warrant the time and expense spent on their evaluation. In a cohort of 145 women, an assessment has been made of whether knowledge of the proliferative activity of grade II infiltrating ductal breast carcinomas can improve the accuracy of predicting clinical outcome for individual patients. Use of the mitotic count (MC), which was assessed as part of the grading system, enabled patients to be stratified into "good" and "bad" prognostic groups. The measurement of S-phase fraction using flow cytometry gave a similar result, but has the disadvantage that the technique requires specialized equipment. The evaluation of Ki-67 expression using immunohistochemistry was of no additional prognostic value in this defined group. It is proposed that MC, used once to establish grade, could be used again amongst the grade II tumours to improve the accuracy of prognosis and thus influence treatment strategies with minimal additional effort or expense.

Adult↗
PubMed2002

Soluble adhesion molecules (E-selectin, ICAM-1 and VCAM-1) in breast carcinoma.

Adhesion molecules are important in cell-cell and cell-basement membrane interactions. They are intimately involved in inflammatory reactions and a role in tumour progression has been postulated. E-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) play a role in cell adhesion to the vascular endothelium, and may have a role in tumour cell dissemination. Soluble forms of these molecules have been described and this study was established to examine these adhesion molecules in patients with breast carcinoma. Serum was obtained from 92 patients with breast carcinoma and 31 age-matched patients with benign breast disease. All samples were obtained prior to surgery. Soluble levels of E-selectin, ICAM-1, and VCAM-1 were significantly elevated in patients with Stage 4 disease compared with controls. (E-selectin 88.6 (47.9) versus 51.4 (18.4) ng/ml; P<0.001: ICAM-1 447 (249) versus 244 (79) ng/ml; P<0.001: VCAM-1 779 (159) versus 552 (135) ng/ml; P<0.001 results expressed on mean (SEM) SD placed above this.). The prognostic value of the adhesion molecules was examined. In patients with Stage 2 disease, elevated VCAM-1 was predictive of decreased survival, even when corrected for T and N status. Adhesion molecules are elevated in patients with advanced disease and elevation in VCAM-1 has prognostic significance in patients with breast carcinoma.

Biomarkers, Tumor↗