PubMed Health⌕ Search

Biomedical subjects

Pippa Oakeshott

Publications and source records attributed to Pippa Oakeshott.

32 records · Page 2Linked to original sources
PubMed2003

Long-term outcome in open spina bifida.

BACKGROUND: Doctors need reliable data on outcome in order to help parents faced with difficult decisions about termination of an affected pregnancy or treatment after birth. AIM: To determine survival, health and lifestyle at the mean age of 30 years in a complete cohort of adults born with open spina bifida. DESIGN OF STUDY: Prospective cohort study. PARTICIPANTS: Well-documented cohort of 117 consecutive cases of open spina bifida whose backs were closed non-selectively at birth between 1963 and 1971. METHOD: Survivors (age range = 26 to 33 years) were surveyed by postal questionnaire and telephone interview. The main outcome measures were the health, independence and lifestyle of the survivors in terms of living in the community, driving a car and working in open employment. RESULTS: Ascertainment was 100%. Sixty (51%) had died, mainly the most disabled. Of the 57 survivors, 84% had a cerebrospinal fluid (CSF) shunt, 70% had an IQ of 80 or more, 37% lived independently in the community, 39% drove a car, 30% could walk more than 50 metres and 26% were in open employment. However one-third (19) still needed daily care, three were on respiratory support, two were blind, two had diabetes mellitus, and one was on dialysis. Mortality, disability and achievement reflected the neurological deficit that had been recorded in infancy in terms of sensory level. Attainment and independence were reduced in those who had needed revision of CSF shunt. CONCLUSION: The survivors in this unselected cohort showed a wide range of outcome from apparent normality to very severe disability. This reflected both the extent of their original neurological deficit and events in the history of their CSF shunt.

Cerebrospinal Fluid Shunts↗
PubMed2002

Association between bacterial vaginosis or chlamydial infection and miscarriage before 16 weeks' gestation: prospective community based cohort study.

OBJECTIVES: To assess whether bacterial vaginosis or chlamydial infection before 10 weeks' gestation is associated with miscarriage before 16 weeks. DESIGN: Prospective cohort study. SETTING: 32 general practices and five family planning clinics in south London. PARTICIPANTS: 1216 pregnant women, mean age 31, presenting before 10 weeks' gestation. MAIN OUTCOME MEASURE: Prevalence of miscarriage before 16 weeks' gestation. RESULTS: 121 of 1214 women (10.0%, 95% confidence interval 8.3% to 11.7%) miscarried before 16 weeks. 174 of 1201 women (14.5%, 12.5% to 16.5%) had bacterial vaginosis. Compared with women who were negative for bacterial vaginosis those who were positive had a relative risk of miscarriage before 16 weeks' gestation of 1.2 (0.7 to 1.9). Bacterial vaginosis was, however, associated with miscarriage in the second trimester at 13-15 weeks (3.5, 1.2 to 10.3). Only 29 women (2.4%, 1.5% to 3.3%) had chlamydial infection, of whom one miscarried (0.32, 0.04 to 2.30). CONCLUSION: Bacterial vaginosis is not strongly predictive of early miscarriage but may be a predictor after 13 weeks' gestation. The prevalence of Chlamydia was too low to assess the risk, but it is unlikely to be a major risk factor in pregnant women.

Abortion, Spontaneous↗
PubMed2002

Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice: cross sectional population based study.

OBJECTIVE: To compare the 10 year risk of coronary heart disease (CHD), stroke, and combined cardiovascular disease (CVD) estimated from the Framingham equations. DESIGN: Population based cross sectional survey. SETTING: Nine general practices in south London. POPULATION: 1386 men and women, age 40-59 years, with no history of CVD (475 white people, 447 south Asian people, and 464 people of African origin), and a subgroup of 1069 without known diabetes, left ventricular hypertrophy, peripheral vascular disease, renal impairment, or target organ damage. MAIN OUTCOME MEASURES: 10 year risk estimates. RESULTS: People of African origin had the lowest 10 year risk estimate of CHD adjusted for age and sex (7.0%, 95% confidence interval 6.5 to 7.5) compared with white people (8.8%, 8.2 to 9.5) and south Asians (9.2%, 8.6 to 9.9) and the highest estimated risk of stroke (1.7% (1.5 to 1.9), 1.4% (1.3 to 1.6), 1.6% (1.5 to 1.8), respectively). The estimate risk of combined CVD, however, was highest in south Asians (12.5%, 11.6 to 13.4) compared with white people (11.9%, 11.0 to 12.7) and people of African origin (10.5%, 9.7 to 11.2). In the subgroup of 1069, the probability that a risk of CHD >/=15% would identify risk of combined CVD >/=20% was 91% in white people and 81% in both south Asians and people of African origin. The use of thresholds for risk of CHD of 12% in south Asians and 10% in people of African origin would increase the probability of identifying those at risk to 100% and 97%, respectively. CONCLUSION: Primary care doctors should use a lower threshold of CHD risk when treating mild uncomplicated hypertension in people of African or south Asian origin.

Adult↗
PubMed2002

Genital herpes.

Explore the source record for details and available documents.

Contact Tracing↗
PubMed2002

Pilot study of testicular cancer awareness and testicular self-examination in men attending two South London general practices.

BACKGROUND: Testicular cancer (TC) awareness and testicular self-examination (TSE) have never been evaluated adequately in UK general practice. TC has a 96% cure rate if detected early. OBJECTIVES: Our aim was to estimate awareness of TC and practice of TSE in a general practice population. METHOD: A cross-sectional questionnaire survey was carried out in 250 consecutive male attenders aged 18-50 years in two general practices, one inner city, and one suburban. After obtaining informed consent, male patients in the waiting room were asked to complete a brief confidential questionnaire about TC and TSE. RESULTS: The response rate was 81%. Mean age was 32 years (range 18-50). Seventy-five per cent of responders described themselves as white, 12% Asian, 6% black and 7% other ethnic groups. Ninety-one per cent were aware of TC but only 26% knew both the age group most affected (25-34 years) and that TC can be curable if detected early. Although 49% of responders had carried out TSE in the past year, only 22% were practising according to recommendations: feeling for lumps at least monthly. TSE was associated with age >35 years, white ethnicity, knowing someone with TC, having attended a Men's Health Clinic and having heard of the 'Everyman' TC awareness campaign. CONCLUSION: Although awareness of TC in this GP population was reasonable, less than half were practising TSE. Further public health campaigns may be needed.

Adolescent↗
PubMed2002

Contraceptive use among South Asian women attending general practices in southwest London.

A cross-sectional survey of contraceptive practices was conducted among 180 South Asian women aged 16 to 50 years, attending inner-city general practices. Overall prevalence of contraceptive use was 63% and ranged from 70% in South Asian teenagers, to only 50% in women over 30 who had completed their family. Thirteen per cent of women had had a termination of pregnancy Although contraceptive use in this group is increasing, it has not yet reached national levels.

Adolescent↗
PubMed2002

Radiography for low back pain: a randomised controlled trial and observational study in primary care.

BACKGROUND: Lumbar spine radiography has limited use in diagnosing the cause of acute low back pain. Consensus-based guidelines recommend that lumbar spine x-rays are not used routinely. However there have been no studies of the effect of referral for radiography at first presentation with low back pain in primary care. AIM: To compare short and long-term physical, social, and psychiatric outcomes for patients with low back pain who are referred or not referred for lumbar spine x-ray at first presentation in general practice. DESIGN OF STUDY: A randomised unblinded controlled trial with an observational arm to enable comparisons to be made with patients not recruited to the trial. SETTING: Ninety-four general practices in south London and the South Thames region. METHOD: Patients consulting their general practitioner (GP) with low back pain at first presentation were recruited to a randomised controlled trial (RCT) or to an observational group. Patients in the trial were randomly allocated to immediate referral for x-ray or to no referral. All patients were asked to complete questionnaires initially, and then at six weeks and one year after recruitment. RESULTS: Six hundred and fifty-nine patients were recruited over 26 months: 153 to the randomised trial and 506 to the observational arm. In the RCT referral for x-ray had no effect on physical functioning, pain or disability, but was associated with a small improvement in psychological wellbeing at six weeks and one year. These findings were supported by the observational study in which there were no differences between the groups in physical outcomes after adjusting for length of episode at presentation; however, those referred for x-ray had lower depression scores. CONCLUSIONS: Referral for lumbar spine radiography for first presentation of low back pain in primary care is not associated with improved physical functioning, pain or disability. The possibility of minor psychological improvement should be balanced against the high radiation dose involved.

Adult↗
PubMed2002

Detection of Chlamydia trachomatis infection in early pregnancy using self-administered vaginal swabs and first pass urines: a cross-sectional community-based survey.

A cross-sectional survey of 1216 newly pregnant women (mean age = 31 years) from 32 general practices and five family planning clinics was conducted to find the prevalence of chlamydial infection and to evaluate self-administered vaginal swabs and first-pass urines for detection of Chlamydia trachomatis by ligase chain reaction assay. Overall prevalence of infection was 2.4% (95% CI = 1.5 to 3.3) but in women aged less than 25 years it was 8.6% (95% CI = 4.1 to 12.9) and in pregnant teenagers it was 14.3% (95% CI = 3.7 to 24.9). In 1161 women with both swab and urine results, 25 women were positive on both specimens three on swab alone, and one on urine alone. When asked which they preferred to provide, 47% said urine, 59 swab and 48% preferred both equally. This is the first study to show that non-invasive screening in early pregnancy is feasible in the community. Although swabs detected 10% more infections, nearly half the women preferred providing urine specimens.

Adolescent↗