Inaccuracies in plasma thyrotropin concentrations with the Amersham "Amerlite" (monoclonal) assay.
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Biomedical subjects
Publications and source records attributed to M Greig.
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The aim of this case control study was to define the strength of the associations of smoking, alcohol, and heavy analgesic ingestion with chronic gastric ulcer (GU). Ninety-nine patients were interviewed about smoking, alcohol, and analgesic ingestion for the 6 months before exacerbation of their chronic GU. The 180 non-ulcer community control subjects were frequency-matched with the patients for the characteristics of age, sex, and social status. Smoking, alcohol, and heavy analgesic ingestion were studied when present as sole factors and in combinations. Their associations with GU were measured by the odds ratio (OR) and the adjusted odds ratio (AOR). Smoking in male patients (OR 15.4) and heavy analgesic ingestion in female patients (OR 23.4) were significant as sole factors. Smoking plus heavy analgesic ingestion was significant in female patients (OR 10.0), and the combination of all three factors was significant in male patients (OR 13.0) and in female patients (OR 6.3). Smoking had significantly increased AORs of 3.3 in male patients and 3.5 in female patients; alcohol had a significantly decreased AOR of 0.4 in female patients; and heavy analgesic ingestion was significantly increased in female patients (AOR 7.2). It is concluded that smoking in all patients and heavy analgesic ingestion in female patients are risk factors for chronic GU. Alcohol, however, does not appear to be a risk factor.
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A comparison has been made between different methods of classifying a Sydney population of 118 persons into social grades. A positive correlation was found between address and occupation, education and occupation, occupation and father's occupation, address and education, address and father's occupation, and education and father's occupation, all correlations being significant at or below the P=0.004 level of statistical significance.
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Eighty three patients were followed-up for four years after an admission to hospital with a chronic gastric ulcer proven by radiology (index ulcer). The index ulcer healed completely in 50 patients, but was unhealed at the time of discharge in the other 33. Significantly fewer patients whose index ulcer was healed compared with those whose ulcer was unhealed at discharge had had a recurrence by one (p < 0.05), two, three and four years' (p < 0.01) follow-up. Moreover, the rate of recurrence was significantly greater for those patients with unhealed, compared with those with a healed index ulcer (p < 0.05) and by the end of the four-year period 61% of patients with unhealed, compared with 26% of those with healed index ulcers had had a recurrence. Patients over the age of 60 years with unhealed index ulcers had a significantly poorer prognosis than those of similar age whose index ulcer was healed at discharge (p < 0.025). The sex of the ulcer patient did not significantly influence ulcer recurrence. Large ulcers (> 57 mm(2)) were less often healed on initial discharge and were more frequently associated with recurrence at one (p < 0.05), two (p < 0.025), three and four years (p < 0.01) than smaller ulcers ([unk]57 mm(2)). Heavy intake of analgesics adversely influenced the course of patients whose ulcer was unhealed (p < 0.05), but did not alter the recurrence rate in those whose ulcer was healed. Ulcer recurrence was not influenced by smoking habits or by alcohol consumption.
Stress was measured by the frequency of 31 major life events with consequent change and distress scores in 50 patients with chronic gastric ulcer and 50 control subjects, matched for age, sex and place of residence. The gastric ulcer population did not differ from the control population regarding the number of events experienced and the associated change and distress scores. However, when analysed according to social grade, the ulcer patients in the lower status suburbs experienced more events and more change than their controls, but the stress scores were similar. In the higher status suburbs, no difference was present between the patients and controls. Change and distress scores rose progressively with age, but there was no significant difference in the number of events experienced between the three age groups. Both men patients and their controls experienced significantly more events and higher change scores than women patients and their controls.
A study was made of the treatment received by 135 gastric ulcer patients within one month and within six months of diagnosis. The treatment was divided into three types. Effective measures included surgery and those measures that have been shown favourably to influence the initial healing rate of chronic gastric ulcer (i.e. hospital admission and carbenoxolone sodium). Ineffective measures included those that have been shown convincingly not to accelerate ulcer healing--diet, antacids, sedatives and no treatmen at all. Anticholinergic drugs were included in the third group where the evidence is conflicting. The patient's therapeutic status was assessed one month and six months after diagnosis. Within six months of diagnosis only 32% of patients received treatment that clinical trials have shown favourably to influence the course of gastric ulcer and approximately half received treatment that has never been shown favourably to influence the course of gastric ulcer. The social class of the patients and whether they were seen by a consultant physicians or family doctor made no difference to the form of therapy received.
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Forty-four patients with chronic gastric ulcer were compared with a control group matched for age, sex, and place of residence. The personality pattern was studied by the Eysenck Personality Inventory and personality assessed in terms of neuroticism and extroversion. The relevance of social class was also studied. The gastric ulcer population did not differ from the control group except among the male population, in which the gastric ulcer population was significantly more neurotic and less extroverted than their controls.
The factors that determine the recurrence rate of chronic gastric ulcer were studied in 105 patients. It was found that complete healing of the ulcer significantly reduced the recurrence rate and subsequent need for hospital admission because of ulcer symptoms when this group was compared with those who left hospital with their ulcers unhealed. Those admitted with large ulcers also had a higher recurrence rate. The age and sex of the patient, ingestion of analgesics and cigarette smoking did not influence recurrence. The initial healing rate of the ulcer also had no effect on the subsequent course of the patient.
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