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P C Lambert

Publications and source records attributed to P C Lambert.

25 records · Page 2Linked to original sources
PubMed1996

Hypertension in pregnancy: which method of blood pressure measurement is most predictive of outcome?

OBJECTIVE: To determine the clinical effectiveness of blood pressure (BP) measurement using conventional sphygmomanometry in the antenatal clinic and obstetric day unit compared with automated BP monitoring at home. METHODS: The study population consisted of 109 nulliparous white women with BPs of at least 140 or 90 mmHg at the antenatal clinic after 20 weeks' gestation, who underwent obstetric day unit and 24-hour automated BP monitoring on the same day. Automated measurement was obtained every half hour for 24 hours using a commercially available device that had been previously validated in pregnancy. RESULTS: At the traditional BP cutoff point (140/90 mmHg), the relative risk for subsequent development of adverse obstetric outcome was greatest for automated BP measurement: The relationships between outcome and automated diastolic BP were all statistically significant: proteinuria (P = .034), preterm delivery (P < .001), birth weight below the tenth percentile (P = .001), admission to the special care neonatal unit (P = .001), and cesarean delivery (P = .007). CONCLUSION: Automated BP measurement appears to improve the identification of patients who are at high risk of poor obstetric outcome. Automated BP measurement is worthy of further evaluation as an antenatal screening and diagnostic test.

Adolescent↗
PubMed1996

Night cough in a population-based sample of children: characteristics, relation to symptoms and associations with measures of asthma severity.

Nocturnal cough in asthma is a common but poorly understood phenomenon. The aims of this study were to determine the relationship between recorded night cough, reported night cough and current wheeze in a population-based sample of children previously identified as wheezy, and to examine the relationship of nocturnal cough to current symptoms, markers of asthma severity and environmental exposure. Children were reassessed in the early school years by measuring current symptoms, ventilatory function, bronchial reactivity, peak flow variability, respiratory symptom diaries and home monitoring of overnight cough, transcutaneous arterial oxygen saturation, room temperature and humidity. Night studies were performed on 59 asymptomatic children and 41 children with current wheeze. Cough occurred more frequently in current wheezers compared to asymptomatic children (16 out of 41 (39%) vs 11 out of 59 (19%)), and more cough episodes were recorded (median 3.5 vs 2.0). Night cough was not associated with bronchial reactivity, peak flow variability, degree of morning dip, mean overnight arterial oxygen saturation, ventilatory function, maternal smoking or treatment of asthma. However, it was associated with lower overnight air temperature. Although night cough is more common in current wheezers, there is poor agreement between recorded and reported night cough. Objective tests of asthma severity are of little use in predicting its presence in this age group. The sleeping environment deserves further study.

Asthma↗
PubMed1995

The natural history of respiratory symptoms in preschool children.

We studied the natural history of preschool respiratory symptoms in a population-based sample of children followed during the early school years. Current symptoms, ventilatory function, bronchial responsiveness to methacholine (BR), atopic status, and peak expiratory flow variability (PEFV) were assessed. Among those initially asymptomatic (210 subjects), 83.3% remained symptom-free, 6.7% started to wheeze, and 10% developed recurrent cough. Nearly half (46.9%) of the initial wheezing group (145 subjects) became symptom-free, 37.9% continued to wheeze, and 15.2% reported recurrent cough. Over half (56.0%) of the cough group (127 subjects) became symptom-free, 7.2% developed wheeze, and 36.8% reported continuing cough. Preschool wheezers showed the greatest BR (geometric mean 1.91 mg/ml) and the highest atopic prevalence (AP) (43.6%) when compared with the preschool asymptomatic group (BR: 3.39 mg/ml; AP: 23.8%) and the cough group (BR: 2.62 mg/ml; AP: 26.7%) (p = 0.0001 and p = 0.006 respectively). Children whose wheeze had persisted from the preschool period exhibited the poorest ventilatory function, the highest BR, a high AP, and high PEFV. The study shows that fewer than half of preschool wheezy children continued to wheeze in the early school years but those with persistent wheeze display many of the clinical characteristics consistent with a diagnosis of asthma.

Age Factors↗
PubMed1980

My life.

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

A Bayesian approach to a general regression model for ROC curves.

A fully Bayesian approach to a general nonlinear ordinal regression model for ROC-curve analysis is presented. Samples from the marginal posterior distributions of the model parameters are obtained by a Markov-chain Monte Carlo (MCMC) technique--Gibbs sampling. These samples facilitate the calculation of point estimates and credible regions as well as inferences for the associated areas under the ROC curves. The analysis of an example using freely available software shows that the use of noninformative vague prior distributions for all model parameters yields posterior summary statistics very similar to the conventional maximum-likelihood estimates. Clinically important advantages of this Bayesian approach are: the possible inclusion of prior knowledge and beliefs into the ROC analysis (via the prior distributions), the possible calculation of the posterior predictive distribution of a future patient outcome, and the potential to address questions such as: "What is the probability that a certain diagnostic test is better in one setting than in another?"

Bayes Theorem↗