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Biomedical subjects

R G Newcombe

Publications and source records attributed to R G Newcombe.

At least 19 recordsLinked to original sources

Association between postpartum thyroid dysfunction and thyroid antibodies and depression.

OBJECTIVE: To define the relation between mood and autoimmune thyroid dysfunction during the eight months after delivery. DESIGN: Double blind comparison of the psychiatric status of women positive and negative for thyroid antibodies. Clinical examination and blood sampling for free triiodothyronine and thyroxine, thyroid stimulating hormone, and thyroid antibody concentrations at four weekly intervals. Psychiatric assessment at six, eight, 12, 20, and 28 weeks post partum. SETTING: Outpatient department of district hospital. PATIENTS: 145 antibody positive women and 229 antibody negative women delivering between August 1987 and December 1989. MAIN OUTCOME MEASURES: Thyroid status. Number of cases of mental ill health by the general health questionnaire, research diagnostic criteria, Hamilton 17 item depression scale, hospital anxiety and depression scale, and Edinburgh postnatal depression scale. RESULTS: Six weeks after delivery the general health questionnaire showed 62 (43%) antibody positive women and 65 (28%) antibody negative women had mental ill health (chi 2 = 8.18, p less than 0.005). Follow up of 110 antibody positive and 132 antibody negative women showed significantly greater depression by research diagnostic criteria in antibody positive women (47%) than antibody negative women (32%) regardless of thyroid dysfunction. Antibody positive women showed higher mean scores for depression on the Hamilton (6.01 v 3.89, p = 0.0002), Edinburgh (7.45 v 5.92, p = 0.031), and hospital depression scales (4.95 v 3.79, p = 0.003). CONCLUSION: Depressive symptoms are associated with positive thyroid antibody status in the postpartum period.

Autoantibodies

Measurements of uterine volume: a comparison between measurements by ultrasonography and by water displacement.

The uterine volume was measured in 30 patients 24 hours before hysterectomy by ultrasonography using the prolate ellipsoid formula. At hysterectomy the volumes of the same uteri were measured again by water displacement. A comparison is made between the two methods of measurements. Although the correlation between the methods is high (r = 0.964) and the mean percentage bias very small (+2.0%), the agreement between the methods for 95% of subjects is between -33.6, 8% and +37.6%. This is a potentially large disagreement relative to the typical size of the uterus, indicating that ultrasonic uterine volume measurement by the prolate ellipsoid method is not adequately precise for clinical management of the individual patient.

Female

Smoking habits in psoriasis: a case control study.

We have examined smoking habits in 108 patients with psoriasis, including some with palmoplantar distribution, and compared the results with matched controls from the community. There was a significant association between psoriasis, current smoking status (OR = 2.7, 95% CI 1.44-5.42, P less than 0.01) and smoking habits prior to the onset of disease (OR = 3.75, 95% CI 1.68-9.47, P less than 0.001). There was also a marked dose-response relationship; the relative risk of psoriasis in those currently smoking more than 20 cigarettes/day was significantly elevated (OR = 5.3, 95% CI 2.1-13.0, P less than 0.001). Separate analysis of patients without palmoplantar distribution of psoriasis showed a significant association with smoking prior to onset of psoriasis (OR = 3.6, 95% CI 1.5-9.8, P less than 0.001). Smoking may play a role in the aetiology of this common skin disorder.

Adolescent

Comparison of six files to prepare simulated root canals. 1.

A total of 300 simulated root canals of various angles and positions of curvature in clear resin blocks were prepared by hand using either K-files, K-Flex files, Flexofiles, Flex-R files, Hedstrom files or Unifiles. Each file type was used to prepare 50 canals employing a linear filing motion and an anticurvature stepback technique. Part 1 of this two-part report describes the efficacy of the files in terms of preparation time, instrument failure, loss of canal length and weight loss from the blocks. Two-way analysis of variance confirmed that there was significant variation for each parameter between instruments, between canal types, and with interaction between instruments and canal types. Overall, preparation with Hedstrom files was significantly quicker than with any other file, whilst preparation with K-files and K-Flex files took significantly longer. Fracture and deformation of instruments occurred substantially less often with Flex-R and Hedstrom files, but significantly more often with Unifiles. Loss of working distance occurred with all file types, but was significantly greater in canals prepared with K-files. Unifiles and Hedstrom files were responsible for significantly more weight loss than the other files, whilst K-files produced significantly less weight loss. Canals with rough undulating walls were created most often by Hedstrom files and Unifiles. Overall, under the conditions of this study, Flexofiles, Flex-R files and Hedstrom files appeared to be substantially more effective than K-files, K-Flex files and Unifiles.

Analysis of Variance

Comparison of six files to prepare simulated root canals. 2.

A total of 300 simulated root canals of various angles and positions of curvature in clear resin blocks were prepared by hand using either K-files, K-Flex files, Flexofiles, Flex-R files, Hedstrom files or Unifiles. Each file type was used to prepare 50 canals employing a linear filing motion and an anticurvature stepback technique. Part 2 of this two-part report describes the efficacy of the files in terms of the prevalence of canal aberrations, the amount and direction of canal transportation and the overall postoperative canal shape. Hourglass shaped canals were found in 4.5% of curved canals, the majority of these being created by K-files and K-Flex files. Perforations were seen in 6.3% of curved canals, the majority being produced by Flex-R files and K-files. Excessive removal of material from along the inner aspect of the canal curve occurred in 10.4% of canals, by far the majority being created by Hedstrom files. Transportation of canals was a consistent finding with all instruments. Two-way analysis of variance revealed how significant differences in the absolute magnitude of transportation occurred between instruments, between canal types and by an interaction between instrument and canal type. In general, transportation was towards the outer aspect of the canal curve at the end-point of preparation and the zip and elbow, but towards the inner aspect at the beginning of the curve. Further towards the orifice, transportation reverted to the outer aspect of the canal curve.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance

Crossover trials comparing several treatments.

Designs exist for crossover studies in which the possibility of distortion by carryover effects is minimised. A novel design including 5 treatments and 15 subjects with this property is presented, along with existing designs. These designs incorporating balance for carryover effects should be used in preference to cyclical permutation designs. Statistical analysis of the resulting data is readily performed.

Analysis of Variance

Oral carriage of yeasts, coliforms and staphylococci in patients with advanced malignant disease.

Many patients with advanced cancer have oral problems, some of which may have a microbiologic basis. The oral flora in such patients has not, however, been characterized. This study has assessed the prevalence of yeasts, coliforms and coagulase positive staphylococci in the oral flora of 197 patients with advanced cancer. Both imprint cultures (n = 197) and oral rinses (n = 161) were collected. Yeasts were isolated from the mouths of 83% of the patients, coliforms from 49.1% and coagulase-positive staphylococci from 28%. All these percentages are considerably in excess of reported levels for healthy individuals. The results indicate a loss of colonization resistance of the oral mucosa in terminal cancer, with potential implications for the development of mouth care regimes for such patients.

Adult

Incidence of ulcerative colitis in Cardiff over 20 years: 1968-87.

The annual incidence of ulcerative colitis in the city of Cardiff was examined over a 20 year period. In the decade 1968-77, the mean annual incidence was 6.4 per 10(5) of the population compared with 6.3 for the period 1978-87. There was no difference in the distribution or extent of the disease between decades or between sexes. This contrasts with the increased incidence of Crohn's disease during the same period. The study included a survey of family practitioners which identified a further 19 patients (11% of the total).

Adolescent

Age at onset and life table risks in genetic counselling for Huntington's disease.

Age related genetic risk data for carrying the gene for Huntington's disease in relatives at risk, based on a previously documented life table approach, are presented in a form allowing ready access for use in genetic counselling. Figures are given for first degree relatives and for second degree relatives showing varying age combinations of consultand and intervening parent at risk. Data are also given for the risk of developing Huntington's disease over varying finite periods in relation to age. The availability of this information in tabular form should help those involved in genetic counselling for this disorder in providing accurate risk estimates to relatives; the data are also of importance for combination with genotype information in predictive testing.

Adult

Old versus new ECT.

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Confidence Intervals

The effect of a number of commercial mouthrinses compared with toothpaste on plaque regrowth.

Mouthwashes are frequently used as adjuncts to oral hygiene. However, for some products there is little supportive evidence that rinses provide greater benefits than plain water or additional benefits to the plaque inhibitory action provided by toothpaste. This study was a single blind, randomized, cross-over design in which 6 rinses were compared for inhibitory action against plaque regrowth. The formulations were a cetylpyridinium chloride rinse, a prebrushing detergent rinse, a peroxyborate rinse a toothpaste slurry rinse, a chlorhexidine rinse, and a saline rinse. From a zero baseline, plaque regrowth at day 5 was significantly reduced by chlorhexidine compared to peroxyborate; and, in turn, significantly reduced by peroxyborate compared to the other rinses. There were no significant differences between saline or a toothpaste slurry and the cetylpyridinium chloride or prebrushing rinse products. The findings would appear pertinent to the value of the respective rinses as adjuncts to oral hygiene.

Adult

Assessment of locomotor function in young boys with Duchenne muscular dystrophy.

Thirty-three young boys (mean age 3.42 years) with Duchenne muscular dystrophy (DMD) and 21 normal control boys (mean age 3.51 years) were studied prospectively to determine whether it is possible to objectively assess locomotor function in young boys with DMD so that they can be included in treatment trials. An initial reproducibility study using a hand-held myometer demonstrated that this method was not useful. The Hammersmith Motor Ability Score demonstrated an increase in developmental abilities with age which was markedly different from normal. The locomotor quotient of the Griffiths' Scales demonstrated a deterioration of quotient scores and is a useful method of assessment that could be used in treatment trials involving young boys with DMD. Sample size planning for treatment trials is discussed.

Child

Tables for estimation of individual risks of fetal neural tube and ventral wall defects, incorporating prior probability, maternal serum alpha-fetoprotein levels, and ultrasonographic examination results.

Tables are provided for estimation of the risk of open spina bifida in patients who have elevated maternal serum alpha-fetoprotein levels but normal results on detailed anatomy ultrasonographic scan. Risks are provided for various prior population risks, for various levels of elevated maternal serum alpha-fetoprotein, and for various assumptions about the sensitivity of ultrasonographic examination. The formula used is based on sequential multiplication of odds with the use of Bayes' theorem, but an arbitrary reduction (to the power of 0.5) in the degree to which ultrasonographic information modifies the odds has been made to allow for the nonindependence of ultrasonography and maternal serum alpha-fetoprotein tests. The wide range of resulting risks shows that the decision to offer amniocentesis after a negative scan should be individualized.

Abdominal Muscles

Evaluation of drug information for cardiology patients.

1. Cardiologists and pharmacists at the University Hospital of Wales collaborated to write 20 individual leaflets incorporating guidelines for a range of drugs used in the treatment of cardiology patients. The Plain English Campaign advised on the intelligibility and presentation of the information. 2. One hundred and twenty-five patients from the Regional Cardiology Unit, University Hospital of Wales were randomly allocated to receive usual verbal counselling about their drug treatment with or without an individualised drug information wallet. Two weeks after discharge from hospital patients completed a postal questionnaire to determine their satisfaction with the information about their drug treatment and their understanding of it. Forty-nine questionnaires were returned from the leaflet group and 52 from the control group. 3. The provision of written guidelines resulted in significant improvements in patients' satisfaction with their drug treatment (chi 2 = 33.3, P less than 0.001) and their understanding of it (P less than 0.001, Mann-Whitney test). Overall, patients who received leaflets were more likely to be aware of the potential side effects of their drugs but less likely to be apprehensive about them. Succinct guidelines concerning drug therapy can be assimilated by cardiology patients and provide them with a permanent record for future reference.

Adult

Dose-response relationship between objective measures of histamine-induced weals and dose of terfenadine.

Terfenadine is a safe non-sedative H1-receptor antagonist. This study aimed to quantify the relative reduction in weal and flare area, thickness and erythema at 4, 8, 12 and 24 h following a single but variable oral dose of terfenadine compared with pre-treatment measurements, in order to compare the dose-effect relationship and time course of the different dosages. In a double-blind randomized cross-over study, 12 healthy volunteers were given 60, 120 or 240 mg of terfenadine or placebo. Twenty micrograms of histamine acid phosphate was then injected intradermally at 4, 8, 12 and 24 h. The weal and flare areas were measured by planimetry, the thickness of the weal by an A-scan pulsed ultrasound device and the redness of both the weal and flare by an erythema-meter. A definite dose-response relationship was demonstrated between the weal and flare areas and the three active treatments. For the weal area, there was a significant difference between 60 mg and 240 mg of terfenadine at 4 h (p less than 0.01), at 8 and 12 h (p less than 0.05). For the flare area there was a similar significant difference at 4 h (p less than 0.01) and at 8 h (p less than 0.05). A dose-response relationship was demonstrated between weal erythema and 120 mg or 240 mg and 60 mg of terfenadine (p less than 0.05). There was a correlation between the plasma levels of the major metabolite and the initial dose of terfenadine, demonstrating their expected proportionality. This metabolite was also demonstrated in tissue fluid.

Adult