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Biomedical subjects

S E Reid

Publications and source records attributed to S E Reid.

At least 19 recordsLinked to original sources
PubMed2006

Meta-analysis of randomised controlled trials comparing latanoprost with brimonidine in the treatment of open-angle glaucoma, ocular hypertension or normal-tension glaucoma.

AIM: To compare the efficacy and tolerability of latanoprost versus brimonidine in the treatment of open-angle glaucoma, ocular hypertension or normal-tension glaucoma. METHOD: Systematic review of randomised controlled trials comparing latanoprost and brimondine, identified by searches including Medline, Embase and Cochrane Controlled Trials Register. Two reviewers independently assessed trials for eligibility and quality and extracted data. Data were synthesised (random effects model) and expressed as the absolute mean intraocular pressure (IOP) reduction difference from baseline to end point for efficacy and relative risk for adverse events. Subgroup analysis and regression were used to explore heterogeneity according to patient characteristics, trial design and quality. RESULTS: 15 publications reporting on 14 trials (1784 participants) were included for meta-analysis. IOP reduction favoured latanoprost (weighted mean difference (WMD) = 1.10 mm Hg (95% confidence interval (CI) 0.57 to 1.63)). Significant heterogeneity was present (chi(2)(13) = 38.29, p = 0.001, I(2) = 66.0%). Subgroup analysis showed greater WMD for studies where data were analysed from end points >6 months duration, cross-over design, open-angle glaucoma or ocular hypertension and monotherapy. Multiple regression showed no significant association of WMD with trial duration (t(9) = 1.92, p = 0.09), trial design (t(9) = 1.79, p = 0.11), trial quality (t(9) = -0.46, p = 0.66), or monotherapy or adjunctive therapy (t(9) = -2.14, p = 0.06). Fatigue was less commonly associated with latanoprost (RR = 0.27, 95% CI 0.08 to 0.88). Publication bias was not evident on visual inspection of a funnel plot. CONCLUSION: Latanoprost is more effective than brimonidine as monotherapy in lowering IOP. Brimonidine is associated with a higher rate of fatigue.

Administration, Topical↗
PubMed2004

Antiretroviral therapy in sub-Saharan Africa: adherence lessons from tuberculosis and leprosy.

Declining drug costs and increases in international donor interest are leading to greater availability of antiretroviral treatment programmes for persons living with the human immunodeficiency virus in parts of sub-Saharan Africa. Ensuring adequate adherence to antiretroviral drug therapy is one of the principal challenges facing successful implementation in Africa, where 70% of the world's infected persons live. Tuberculosis and leprosy are two diseases of global importance whose control programmes can provide important lessons for developing antiretroviral drug adherence strategies. This paper examines various approaches used in tuberculosis and leprosy control which could help enhance adherence to antiretroviral therapy in resource-limited settings.

Africa South of the Sahara↗
PubMed1998

Analysing potential harm in Australian general practice: an incident-monitoring study.

OBJECTIVE: To collect data on incidents of potential or actual harm to general practice patients and to evaluate the possible causes of these incidents. DESIGN: An observational study of incidents of potential harm based on a modified critical incidents technique. A non-random sample of general practitioners (GPs) anonymously submitted incident reports contemporaneously. SETTING AND PARTICIPANTS: Australian general practices between October 1993 and June 1995. During the study period, 324 GPs participated at some time. MAIN OUTCOME MEASURES: GP-reported free-text descriptions of incidents and structured responses for preventability, potential for harm, immediate consequences, predicted long-term outcomes, type of incident, contributing factors, mitigating factors, and additional resource use. RESULTS: 805 incidents were reported--76% were preventable; 27% had potential for severe harm. No long term harm was predicted for 66% of incidents. Incidents could relate to pharmacological management (51 per 100 incidents), nonpharmacological management (42 per 100 incidents), diagnosis (34 per 100 incidents) or equipment (5 per 100 incidents). The most common contributory factors were poor communication between patients and healthcare professionals and actions of others (23 per 100 incidents each) and errors in judgement (22 per 100 incidents). CONCLUSION: Human error and preventable system problems were identified. The incident monitoring technique provided useful data which could be applied to incident prevention strategies.

Adolescent↗
PubMed1998

Influence of load orientation on the posteroanterior stiffness of the lumbar spine.

OBJECTIVE: To compare the posteroanterior (PA) stiffness of the lumbar spine when the load is applied in a vertical direction with the stiffness when the load is applied perpendicular to the spinal curve. DESIGN: The PA stiffness of the lumbar spine was assessed at L1, L3 and L5 on 24 normal subjects using a mechanical spinal mobilization apparatus. The PA stiffness was measured when the load was applied in a vertical direction and when the load was applied perpendicular to the spinal curve at the level being tested. SETTING: A university biomechanics laboratory. DESIGN: A repeated-measures design with pseudorandomization of the order of testing. MAIN OUTCOME MEASURES: Stiffness variable derived from force-displacement curve. RESULTS: The difference in PA stiffness between the two loading conditions was small at all three levels tested. The stiffness of L5 was significantly lower when the load was applied in the vertical direction compared with the application of the load in the perpendicular direction (p = .0001). Altering the angle of inclination of PA load had no statistically significant effect on PA stiffness at L1 and L3. The mean PA stiffness of the lumbar spine increased in a caudal direction (L1 = 10.4 N/mm, L3 = 11.4 N/mm, L5 = 11.6 N/mm). CONCLUSION: The orientation of the PA load had only a small effect on the measured PA stiffness and would be unlikely to be detected during manual examination of the spine. However, changes in the orientation of the PA load may be important when considered in relation to the symptom response.

Adult↗
PubMed1997

Pap smears in general practice: a secondary analysis of the Australian Morbidity and Treatment Survey 1990 to 1991.

We investigated the characteristics of Australian general practice that predict performance of Pap smears by secondary analysis of the Australian Morbidity and Treatment Survey 1990 to 1991. Chi-squared analysis identified potential associations between Pap smear rate and patient, doctor and practice variables. Significant associations were examined using logistic regression and generalised estimating equations. Participants were 495 general practitioners who collected information on 113,468 doctor-patient encounters, of which 43,211 encounters involved females aged 18 to 70 years. Pap smear encounter (2449) were identified and classified as patient-requested (62 per cent), diagnostic (5 per cent) or opportunistic (33 per cent). The large difference in the unadjusted Pap smear rates per 100 female encounters for female general practitioners (11.7) and male general practitioners (4.2) required separate analysis by sex of the general practitioner. For male general practitioners, a Pap smear was less likely: as patient age increased; for new patients; for general practitioners with less general practice experience; for general practitioners with no postgraduate qualifications; with metropolitan practice location; and if the practice had more than 25 per cent of patients with English as a second language. For female general practitioners, a Pap smear was less likely: for older known patients; as the age of the general practitioners increased; and for management of fewer problems per 100 encounters. A Pap smear was less likely to be opportunistic: as patient age increased; for general practitioners who were Australian graduates; and for general practitioners with no postgraduate qualifications. Consideration of patient, doctor, and general practice characteristics may facilitate the design of interventions to improve cervical cancer screening.

Adolescent↗
PubMed1996

Pre-, peri-, and postoperative chemotherapy for breast cancer: is one better than the other?

The purpose of the present study was to determine the relative efficacy of pre-, peri-, and postoperative chemotherapy in the prevention of breast cancer relapse and prolongation of host survival. The studies were performed using an experimental mouse breast cancer model. TA3Ha mouse mammary adenocarcinoma was transplanted into the mammary fat pad of syngeneic mice to obtain tumors in their natural organ. The tumors were surgically excised with a "curative" intent. A single treatment with 10 mg/kg doxorubicin was given intravenously pre-, peri-, or postoperatively. Among 74 mice whose tumors were resected but no doxorubicin was given, local recurrence, axillary metastasis, and lung metastasis were seen in 43%, 37%, and 16% of the mice, respectively. Seventeen (23%) mice had no evidence of disease. Doxorubicin given 4 days preoperatively reduced the rate of growth of primary tumor. Local recurrence was reduced in these mice by 30% and metastasis to the axillary lymph nodes and lung was completely prevented. Disease-free survival was increased to 70% (P < 0.01). Similar beneficial effects were obtained when chemotherapy was administered 2 days prior to surgery. The peri-operative chemotherapy group showed 8% (2/26) local recurrence, 4% axillary metastasis, and 0% lung metastasis. Proportion of mice without any evidence of disease increased to 92% (P < 0.00001). Chemotherapy given 4 days postoperatively resulted in 63% (10/16) local recurrence, 38% axillary metastasis, and 6.3% lung metastasis. Only 38% of the mice were disease-free. Thus in the model studied, perioperative chemotherapy offers the best chance for reduced recurrence and for improved disease-free survival.

Adenocarcinoma↗
PubMed1996

The potential role of integrin receptor subunits in the formation of local recurrence and distant metastasis by mouse breast cancer cells.

BACKGROUND: The mechanisms by which surgical injury fosters tumor growth are examined. METHODS: TA3Ha mouse breast tumor line and its subline (TA3AD) differing in their metastatic abilities as tested by two models were used. In model a, TA3Ha/TA3AD tumors were grown in the mammary fat pads of mice and then surgically removed with a curative intent. In model b, TA3Ha/TA3AD cells were injected intravenously into mice subjected to liver or spleen wedge resection. Frequency of tumor formation at various sites was assessed. Expression of integrin, immunoglobulin, and proteoglycan cell adhesion receptors on TA3Ha and TA3AD cells was examined by flow cytometry. The roles of these receptors in metastasis were examined by blocking them by selected ligands and/or antibodies. RESULTS: Frequencies of local recurrence and axillary metastasis after surgical resection, were 43% (32/74), and 37% (27/74) with TA3Ha tumors and 4% (1/29) at both sites with TA3AD tumors. Tumors at surgically injured spleen and the liver were seen in 75% (141/189) and 45% (107/240) of the mice with TA3Ha cells and in 8% (3/38) and 10% (4/42) of the mice with TA3AD cells. alpha 5 and CD44 receptors were expressed by TA3Ha cells but not by TA3AD cells. Other receptors examined were similarly expressed by both cell lines. Blocking of alpha 5 receptor by fibronectin reduced tumor implantation in a dose-dependent manner. CONCLUSIONS: The data suggest a correlation among the ability to implant at surgically injured sites, to form local recurrence, and to express the fibronectin receptor subunit.

Animals↗
PubMed1996

Role of cytokines and growth factors in promoting the local recurrence of breast cancer.

The pathogenesis of local recurrence in breast cancer is not well understood. Breast-conserving surgery is particularly prone to local recurrence as it leaves behind breast tissue that may harbour occult cancer, and lends itself to enhanced intraoperative shedding of cancer cells due to narrower resection margins and transection of lymphatic channels. A review of clinical breast cancer studies as well as experimental research strongly suggests that these persisting cancerous cells are unlikely to develop into clinically evident disease if their environment remains unstimulated. However, an inordinately high local recurrence rate occurs at the surgical scar, and such recurrence must be triggered by the release of growth factors and cytokines into the healing wound. These factors can stimulate any available cancer cells which express the proper growth factor receptors. Perioperative strategies to neutralize this tumour cell-growth factor interaction should maximize local control.

Breast Neoplasms↗
PubMed1996

Endocrine and paracrine hormones in the promotion, progression and recurrence of breast cancer.

Both normal and neoplastic breast tissues are stimulated by endocrine and paracrine hormones. Epidemiological studies have demonstrated the significant role that hormones, growth factors and cytokines have in the promotion, progression and recurrence of breast cancer. Significant variations in the hormonal environment occur based on age, the cyclical changes occurring during the menstrual cycle and (mammographically determined) variations in breast composition. These variations have a significant influence on rates of local recurrence of breast cancer and survival. This review analyses data relevant to these issues and suggests means by which operative results may be improved.

Adult↗
PubMed1995

Influence of smoking on the development of lung metastases from breast cancer.

BACKGROUND: This study examined the association between cigarette smoking status and the development of lung metastases in a group of 835 women diagnosed with primary malignant unilateral breast cancer. METHOD: Female patients with breast cancer diagnosed between 1982 and 1991 at Roswell Park Cancer Institute (RPCI) in Buffalo, New York, who provided information on their cigarette smoking history at the time of their diagnosis were included. The subsequent disease status of patients was monitored by the RPCI Tumor Registry. The Cox regression model was used to estimate the relationship between smoking status and the development of lung metastases, adjusting for the patient's age, stage of disease at diagnosis, and body weight. RESULTS: Of those patients who developed lung metastases, 8.7% were nonsmokers, 14.1% were former smokers, and 14.3% were current smokers. Tests showed that nonsmokers had significantly fewer lung metastases than either of the two smoking groups (P < 0.01). The estimated relative rates of lung metastases developing adjusting for age, stage, and body weight in women who smoked less than 10,000, between 10,001 and 20,000, and more than 20,000 packs over their lifetimes compared with nonsmokers were 1.06 (95% CI, 0.51-2.20), 3.10 (95% CI, 1.5-6.3), and 3.73 (95% CI, 1.6-8.9) respectively. The Cox regression model showed that every 1000 packs of cigarettes consumed over a lifetime increased a woman's risk of developing lung metastases by about 3% to 7% (P < 0.001). CONCLUSION: This study found a significant association between cigarette smoking history and risk of lung metastases developing in women diagnosed with primary invasive unilateral breast cancer. The risk of lung metastases developing increased as the number of cigarettes smoked in a lifetime increased.

Adolescent↗
PubMed1995

Health status, life satisfaction and health practices: a study of Pacific Asian and Native Hawaiian elderly cohorts.

This article describes the sociodemographic characteristics, self-ratings of health status, life satisfaction and health practices of Pacific Asian and Native Hawaiian elderly groups. The data were gathered from two separate, non-equivalent elderly cohorts enrolled in an elderly self-care education program in Hawaii during the period 1989-1992. The findings generally reflected favorable self-ratings of health status, high life satisfaction levels, and positive health practices for both of these minority elderly groups. The exceptions regarding several health practices relate to snacking between meals, overweight problems and insufficient sleep for a sizable proportion of both groups. Slight to moderate differences between the two groups were also evident in 1) eating habits; 2) snacking; 3) types of physical activities; 4) weight control; 5) sleep patterns; 6) alcohol use; and 7) smoking. Despite the article's exploratory nature and limitation in the generalizability of its findings, the data offer a beginning database for Asian and Pacific Island elderly which is sorely lacking.

Aged↗
PubMed1991

Elderly self care education: a low technology primary health care option for developing countries.

This article presents a number of perspectives on the curriculum building processes as well as the methodology and content of a self care training curriculum and information packet that were prepared and field for the development of a model self care education program for older persons. Course content and topical areas are outlined, and various training agenda and educational materials are described. Although this program was undertaken as part of the national goal to develop a health promotion and disease prevention strategy for older people in the United States, a number of insights, principles and implications drawn from the curriculum development activities and field testing experiences are applicable to other countries, especially developing nations where the problems and needs of the aged are becoming increasingly apparent in the face of ever shrinking resources.

Aged↗
PubMed1990

An alternative approach to nonpalpable breast biopsies.

Traditionally, when a negative specimen radiograph is obtained during biopsy of a nonpalpable breast lesion, immediate re-excision is performed in an attempt to successfully remove the lesion. Based on a retrospective study of the biopsy results of 792 nonpalpable breast lesions, the authors suggest delaying the re-excision, despite a negative specimen x-ray, until postoperative mammography confirms the persistence of the lesion. Utilization of this approach was associated with a comparably low incidence of missed lesions (3%) and had the added advantages of preserving breast tissue and decreasing operative time.

Biopsy↗
PubMed1990

An evaluation of the efficacy of Doppler flow velocity waveform analysis as a screening test in pregnancy.

In a prospective double-blind study of 535 medium-risk pregnancies, growth data obtained by ultrasonography and Doppler flow velocity waveform systolic to diastolic ratios were recorded at 18, 24, 28, and 34 weeks' gestation. A significant association was observed between uteroplacental systolic to diastolic ratios at 24 weeks' gestation and subsequent fetal hypoxia with a sensitivity of 24.0% and a specificity of 93.9%. However, 70% of abnormal results were not followed by fetal hypoxia. Umbilical artery systolic to diastolic ratios at 24, 28, and 34 weeks' gestation were found to be predictive of intrauterine growth retardation. This predictive capability was enhanced in those growth-retarded fetuses in which hypoxia developed, but was weak when umbilical artery systolic to diastolic ratios were evaluated as primary screening tests for fetal hypoxia. The results confirm a role for Doppler systolic to diastolic ratios in the evaluation of high-risk pregnancies but do not support a role for their use as primary screening tests in low-risk obstetric populations.

Adult↗
PubMed1990

Effects of maternal cigarette smoking on ultrasonic measurements of fetal growth and on Doppler flow velocity waveforms.

Serial ultrasound biometry and Doppler flow velocity waveform analysis were used to measure the effects of maternal smoking in a prospective study of 535 pregnancies. Smoking was associated with significant reductions in maternal weight gain, birthweights and placental weights. Decreased fetal biparietal diameter measurements were observed in pregnancies of smoking women; this effect was maximal at 24 weeks' gestation, was restricted to male fetuses and was not associated with altered head circumferences after birth. Umbilical artery and uteroplacental systolic/diastolic ratios were similar in pregnancies of smoking and non-smoking women, indicating that the effects of smoking on placental vascular resistance are periodic rather than continuous. The findings of this study confirm the need for studies of fetal growth to include prenatal measurements obtained by high resolution ultrasound imaging, rather than relying on findings obtainable by examination of the infant after birth.

Adult↗