Biomedical subjects

James A Kaye

Publications and source records attributed to James A Kaye.

22 records · Page 2Linked to original sources

PubMed2003

Epidemiology and possible causes of autism.

OBJECTIVES: To review the recent literature on possible causes of the increase in frequency of diagnosed autism reported from three countries, and to compare the medical diagnoses and drug therapy from a new series of autistic boys and their mothers with that of comparable nonautistic boys and their mothers. DESIGN: Case-control evaluation. PARTICIPANTS: Members of over 250 general practices in the United Kingdom. MEASUREMENTS AND MAIN RESULTS: Frequency of exposure to drugs and presence of preexisting clinical illnesses in autistic children and their mothers were compared with nonautistic children and their mothers over time. According to published studies, the incidence of boys diagnosed with autism rose dramatically in the 1990s. Numerous published studies have concluded that the measles-mumps-rubella vaccine is not responsible for the large rise in diagnosed autism. In our study, boys diagnosed with autism had medical and drug histories, such as vaccines, before diagnosis, that were closely similar to those of nonautistic boys, except that developmental and sensory disorders were far more common in autistic boys. No material differences during pregnancy were found between the mothers of autistic boys and those of nonautistic boys in relation to illness or drug therapy. In the early 1990s, boys with diagnosed developmental disorders were infrequently diagnosed with autism. In the later 1990s, such boys more often were diagnosed with autism. CONCLUSION: A major cause of the recent large increase in the number of boys diagnosed with autism probably is due to changing diagnostic practices.

Autistic Disorder↗

PubMed2003

Validity of the general practice research database.

The United Kingdom General Practice Research Database (GPRD) is an office-based, computer-generated, medical resource designed from its inception to be used for epidemiologic research. A distinct version of the GPRD is maintained by the Boston Collaborative Drug Surveillance Program and has been the source of more than 130 scientific articles primarily addressing drug safety issues. We reviewed evidence related to the validity of the GPRD. Specifically, with our extensive experience with this automated database, we evaluated the quality and completeness of the data that it contains.

Databases, Factual↗

PubMed2002

Relation of childhood gastrointestinal disorders to autism: nested case-control study using data from the UK General Practice Research Database.

OBJECTIVES: To assess whether children with autism are more likely to have a history of gastrointestinal disorders than children without autism. DESIGN: Nested case-control study. SETTING: UK General Practice Research Database. SUBJECTS: Children born after 1 January 1988 and registered with the General Practice Research Database within 6 months of birth. OUTCOME MEASURES: Chronic inflammation of the gastrointestinal tract, coeliac disease, food intolerance, and recurrent gastrointestinal symptoms recorded by the general practitioner. RESULTS: 9 of 96 (9%) children with a diagnosis of autism (cases) and 41 of 449 (9%) children without autism (matched controls) had a history of gastrointestinal disorders before the index date (the date of first recorded diagnosis of autism in the cases and the same date for controls). The estimated odds ratio for a history of gastrointestinal disorders among children with autism compared with children without autism was 1.0 (95% confidence interval 0.5 to 2.2). CONCLUSIONS: No evidence was found that children with autism were more likely than children without autism to have had defined gastrointestinal disorders at any time before their diagnosis of autism.

Autistic Disorder↗

PubMed2002

Clinical risk factors for venous thromboembolus in users of the combined oral contraceptive pill.

AIMS: To estimate the risk of venous thromboembolism among women prescribed the oral contraceptive pill who have acute clinical conditions such as lower limb fractures, compared with women with idiopathic venous thromboembolism. METHODS: A nested case-control analysis using the General Practice Research Database, January 1993 to December 1999 was carried out. The participants were women aged 15-39 years, prescribed third generation oral contraceptives (gestodene and desogestrel) or oral contraceptives containing levonorgestrel. The main outcome measures were odds ratios as a measure of the relative risk estimate for venous thromboembolism in women with clinical conditions that predispose to VTE. RESULTS: The adjusted relative risk estimate for venous thromboembolism among patients with the acute clinical conditions, compared with those without such illness, and adjusted for oral contraceptive use, was 17 (95% CI 6.5, 46). CONCLUSIONS: This paper documents the strong independent association between certain acute clinical conditions and venous thromboembolism in women prescribed oral contraceptives. Failure to accurately identify and exclude such patients from a study of the effect of oral contraceptives on the risk of venous thromboembolism would result in an underestimate of the risk of venous thromboembolism associated with oral contraceptives.

Adolescent↗