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K Cooney

Publications and source records attributed to K Cooney.

9 recordsLinked to original sources

Potential selection bias in a community-based study of PSA levels in African-American men.

The first phase of the Flint Men's Health Study (FMHS) in Michigan was a community-based epidemiologic study of prostate cancer and benign prostatic hyperplasia (BPH) in African-Americans aged 40 to 79 years. An objective of the FMHS was to determine age-specified prostate specific antigen (PSA) reference ranges in a random population sample of African-American men without clinically evident prostate cancer. The FMHS study protocol included an initial in-home epidemiologic interview followed by PSA testing and a urologic examination of eligible subjects. Since the participation rate in the PSA phase of the study was under 60%, it was important to determine whether selectivity in participation biased the FMHS results for age-specific PSA distributions. Logistic regression analyses were used to investigate selectivity in the sample of subjects who participated in the PSA testing and urologic examination. Younger men, with current urologic symptoms, and with a family history of prostate cancer were more likely to participate in the PSA testing and urologic examination. Linear regression analysis indicated that greater participation by African-American men without clinically evident prostate cancer but with obstructive or irritative lower urinary tract symptoms or a family history of prostate cancer did not bias the estimated age-specific reference ranges for total PSA concentrations and free-to-total PSA ratios.

Adult↗

Intracranial germ cell tumors.

Intracranial germ cell tumors are a heterogeneous group of lesions which occur in children and adults. Within the classification of intracranial germ cell tumors, there are a variety of different tumor types which carry different prognoses. The diagnosis of an intracranial germ cell tumor usually requires histological information, but a subgroup of tumors will secrete specific tumor markers, including alpha-fetoprotein and beta-human chorionic gonadotropin, which may obviate the need for surgical intervention. The management of intracranial germ cell tumors in both children and adults remains unsettled. Germinomas have a good prognosis, as over 90% of patients can be effectively treated with radiation therapy. The dose and volume of radiation therapy needed for disease control is not well established, and controversy exists concerning the need for whole brain or craniospinal radiation therapy for localized tumors. Germinomas are also chemosensitive and recent reports suggest that the dose and volume of radiation therapy required for disease control can be lessened with the addition of adjuvant chemotherapy. The outcome for patients with nongerminomatous germ cell tumors is less favorable. Radiation therapy alone will result in disease control in 40%-60% of patients. The addition of chemotherapy to radiation therapy may improve the rate of survival.

Adult↗

Infant growth charts.

Detection and monitoring childhood growth disorders requires the correct use of growth charts. A check on the accuracy of every point plotted on Gairdner-Pearson growth charts of premature infants in a hospital paediatric department was carried out. Errors beyond set limits were recorded. Of 611 points plotted on the growth charts of 50 premature infants who were at least 1 year of age at the time of the study, there were 173 (28.5%) points plotted in error. Altogether 94.7% of the errors occurred when plotting the age along the horizontal (X) axis of the growth chart, irrespective of whether weight, length, or head circumference was being measured. There was no evidence that the errors caused appreciable changes in clinical management. Potential sources of error identified were failure to adjust for prematurity correctly, inaccuracy in calculating age, and the use of the logarithmic scale. These errors could be serious and it is important that there should be greater vigilance in using growth charts. The use of age calculators or improved chart design is recommended. Assessment of the use of other growth charts in different settings is also suggested.

Anthropometry↗

Temporary residents.

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