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Biomedical subjects

V Siskind

Publications and source records attributed to V Siskind.

At least 19 recordsLinked to original sources

Prediction of hospital discharge in immediate survivors of ventricular fibrillation or asystole.

Survival from ventricular fibrillation and asystole is influenced by variables measured during resuscitation that affect both immediate survival and discharge from hospital. These variables have been used to develop a formula to calculate an individuals chances of immediate survival and hospital discharge. It has allowed this heterogenous group to be subdivided into groups which can be compared both within and between institutions for the purposes of audit and evaluation of resuscitation protocols. This study evaluates the addition of clinical parameters to the prognostic index. One hundred twelve immediate survivors of ventricular fibrillation or asystole were examined immediately after resuscitation and clinical parameters measured and recorded. At the same time parameters previously described were recorded. The increase in the numbers of survivors improved the reliability (area under the receiver operator curve (ROC) improved from 0.79 to 0.83) of the index for predicting hospital discharge. Addition of the clinical variables of conscious state, respiratory state, blood pressure and pulse rate improved the prognostic index further to an ROC area of 0.86. This ensures that the predictive power of the new index is now highly reliable for predicting hospital discharge after successful resuscitation from ventricular fibrillation and asystole.

Aged

Socioeconomic status and mortality revisited: an extension of the Brisbane area analysis.

Using the methodology of an earlier study of socioeconomic mortality gradients, we partitioned Brisbane City into five strata of equal size on the basis of suburb scores derived from aggregate socioeconomic census data. Numbers of deaths by stratum, age, sex and cause were obtained from mortality files. For almost all causes, mortality gradients had not changed between 1976-1979 and 1980-1987. A new category, medically-preventable death under age 65, had lower rates in higher-ranking suburbs. Potential years of life lost (PYLL) per unit of population, age-standardised, were also computed by stratum and cause. External causes of death were the main contributors to PYLL among men, with a strong socioeconomic gradient, while neoplasms were most important among women, with little evidence of a social class effect. It is estimated that, in urban Australia, the annual number of additional deaths under age 65 due to socioeconomic circumstances is over 2000 for males and over 1000 for females. This study provides a baseline against which the programs of health advancement initiated in the mid-1980s may be evaluated, or conversely, the effects of societal changes assessed.

Adolescent

Prediction of survival from resuscitation: a prognostic index derived from multivariate logistic model analysis.

Despite advances in resuscitation, the ability to predict survival at cardiac arrests remains unsophisticated. We identified the factors determining outcome of all cardiopulmonary resuscitations performed at our institution over a 4-year period, and used a Cox multivariate regression model to design prognostic indices to assess the probability of successful resuscitation and hospital discharge. Cardiac arrests (710) were studied, and 193 (28%) were successfully resuscitated. The most influential variables, judged by the size and significance of their logistic regression coefficients, were rhythm, resuscitation delay, and age (for successful resuscitation), and rhythm, performance of intubation and defibrillation, defibrillation delay, and age (for survival until discharge). The combination of these in a prognostic index reliably predicted both outcome (area under the receiver operating curve of 0.78), and survival until discharge (area under the curve of 0.80).

Aged

Shared antenatal care in Brisbane.

The prevalence of antenatal care shared between general practitioner (GP) and public hospital services in Brisbane, and its acceptability to patients was assessed. Responses to questionnaires put to women in the immediate puerperium of the public wards of 2 major teaching hospitals are presented. Antenatal shared-care was undertaken in 54% of pregnancies. Indications of advantages for women to undergo antenatal shared-care were identified with convenience of appointment time, and decreased travel and waiting time. An important cooperation between GP and hospital obstetric services appears to have evolved in the area of antenatal care that provide benefits at least for patients' convenience.

Adult

A profile of Australian women practicing breast self-examination.

Breast self-examination (BSE) and medical breast examination practices were studied in a group of 1,103 women without diagnosed breast cancer, randomly sampled to conform in age and social status with breast cancer cases from the population of Brisbane, Australia between 1981 and 1985. Relationships between these practices and sociodemographic factors, breast cancer risk indicators, health related behaviors and source of knowledge about BSE were analyzed. Overall, 63% of women reported performing BSE. BSE was practiced frequently (monthly or more). BSE frequency was only weakly associated with breast cancer risk indicators. It was more strongly linked with age, the 20-44 year group being more likely to examine their breasts occasionally and the women 65 years and over being less likely to examine their breasts. Married women were the most likely to practice BSE frequently and widowed or single women most likely never to practice. Women who underwent cervical smear testing were more likely to perform BSE than those who did not have smear tests. Women who learned BSE from their doctors as opposed to other sources practiced BSE more frequently and were more likely to practice BSE exactly as taught.

Adult

Viral-like characteristics of particle aggregates in a lymphoblastic cell line.

A lymphoblastic cell line (K45) established from a child with acute lymphoblastic leukemia (ALL) is characterized by a profusion of intracytoplasmic particle aggregates (PA) similar in morphology to those occurring in fresh childhood ALL cells. The PA in K45 cells were examined for morphology and capacity for nucleic acid synthesis to test the hypothesis that they are identical to those in fresh ALL cells, and also to identify characteristics which might distinguish PA from cell organelles and which might determine if they are viral-like. In contrast to cell organelles, the PA in both K45 and ALL cells were found to be characterized by a localized thickening of the particle wall. Furthermore, autoradiography of K45 cells showed uptake by PA of 3H uridine rather than 3H thymidine indicating an RNA composition. The presence of PA in profusion was associated with, but preceded necrotic death of K45 cells. These combined features suggest that the PA in K45 and in ALL cells are identical, that they are distinct from cell organelles, are not formed as a consequence of the initiation of cell death and that, while their exact nature remains unknown, a viral origin cannot be excluded.

Autoradiography

Case-control evaluation of a school-age BCG vaccination programme in subtropical Australia.

In 1956 a programme was initiated to vaccinate all children aged 12-14 years who were attending schools in Queensland, Australia. In view of the declining incidence of tuberculosis in Australia as a whole, there was a need to evaluate the effectiveness of the programme and its procedures. We therefore carried out a case-control study of Queensland's population, excluding certain known high-risk groups. Cases were Queensland residents with notified tuberculosis and of the appropriate age; two controls per case were chosen from the electoral roll. Information on vaccination status was obtained mainly from questionnaires and school records, where available. The results show that at best BCG vaccination had a modest protective effect, approximately 30% when the patients were diagnosed, which was on average 15 years after they had been vaccinated in the school programme. In the north the climate of Queensland is tropical, while in the more heavily populated south it is subtropical. A substantial proportion of the school records reported weak positive reactions to preliminary tuberculin testing, believed to be due largely to atypical mycobacteria. A similar phenomenon has been observed in other tropical regions, and may help to explain the apparent absence of a strongly protective effect for BCG vaccination.

Adolescent

Prescription drug advertising: medical journal practices under different types of control.

Medication is one important aspect of health care delivery. The sources of information used to select appropriate medication include drug advertisements which appear in professional journals. There is a need to monitor the quality of these advertisements. The study reported in this paper includes a longitudinal (1961 to 1977) and cross-societal (Britain, United States and Australia) content analysis of drug advertisements. Such a comparison contributes to the debate concerning the type of regulation likely to be effective for this form of advertising.

Advertising

Myocardial infarction in Queensland provincial cities, 1975.

A survey was made of patients admitted to hospitals with a diagnosis of acute myocardial infarction in seven Queensland provincial cities between January 1, and December 31, 1975. Estimates of the incidence of, and mortality from, myocardial infarction are made, and details of the type of care offered, patient characteristics, and length of stay in hospital and intensive care units are presented.

Arachnid Vectors

Accidents in old age.

Elderly persons particularly are liable to falls which in women often cause major fractures and other injuries. In Australia, some two per cent of deaths of women aged 65 and over are attributed to non-traffic accidents, and the length of hospital care and subsequent disability following fractures are both important aspects of the total morbidity resulting from falls suffered by older persons.

Accidents

Antenatal exposure to doxylamine succinate and dicyclomine hydrochloride (Benedectin) in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score.

In a prospective cohort study of 20, 282 gravidas and their offspring, congenital malformation rates were similar in the children of over 1,000 women exposed and those not exposed to two components of Bendectin (doxylamine succinate and dicyclomine hydrochloride) during the first four lunar months of pregnancy. In a cohort reduced to 41,337 mother-child pairs for technical reasons, mean birth weight and perinatal mortality rates were similar according to exposure or nonexposure to either drug, as were intelligence quotient scores measured at four years of age in 28,358 of the children. Control of potential confounding factors with a variety of multivariate techniques did not materially alter these findings.

Abnormalities, Drug-Induced

Antenatal exposure to the phenothiazines in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score.

In a prospective cohort study of 50,282 gravidas and their offspring, over-all rates of congenital malformations were similar in 1,309 children of women exposed to phenothiazine drugs during the first four lunar months of pregnancy and in 48,973 children of women who were not exposed. There was a suspicion of association between phenothiazine exposure and cardiovascular malformations. In a cohort reduced to 41,337 mother-child pairs for technical reasons, perinatal mortality rates and mean birth weight were similar according to phenothiazine exposure or nonexposure, as were intelligence quotient scores measured at four years of age in 28,358 of the children. Control of potential confounding factors with a variety of multivariate techniques did not materially alter the findings.

Abnormalities, Drug-Induced

Aspirin and congenital malformations.

In a cohort of 50 282 gravidas and their offspring in the U.S.A., malformation rates were similar in the children of 35 418 women not exposed to aspirin, 9736 with intermediate exposure, and 5128 women heavily exposed during the first four lunar months of pregnancy. After controlling a wide range of potential confounding factors using multi-variate analysis, the observed and expected numbers for a variety of malformation categories were similar in all three comparison groups. The data suggest that aspirin is not teratogenic.

Abnormalities, Drug-Induced

Perinatal mortality and birth-weight in relation to aspirin taken during pregnancy.

In a cohort of 41 337 gravidas and their offspring in the U.S.A. there was no evidence that aspirin taken in pregnancy is a cause of stillbirth, neonatal death, or reduced birth-weight. The women were divided into those who were not exposed to aspirin (14 956), those with intermediate exposure (24 866), and those who were heavily exposed (1515). Stillbirth-rates were similar for all three groups. Differences in neonatal death-rates and mean birth-weights were slight and none were statistically significant. Trends were opposite among approximately equal numbers of White and Black children.

Aspirin

Anticonvulsants and parental epilepsy in the development of birth defects.

The results of two studies, one in Finland and one in the U.S.A., raise the possibility that fetal damage previously attributed to phenytoin and other anticonvulsant drugs, principally phenobarbitone, may be due to epilepsy itself. In the U.S.A., drug-exposure information was collected before delivery in a cohort of 50 282 mother/child pairs. The total malformation rate in 305 children born to epileptic mothers was 10.5%, as against 6.4% in the remainder (p less than 0.01); corresponding rates for major malformations were 6.6% and 2.7%. When the fathers had epilepsy, the malformation-rates in their children were intermediate. The rates did not vary significantly according to maternal anticonvulsants therapy. Mental and motor scores as 8 months of age, and intelligence quotient scores at 4 years were lower in children of epileptic mothers, but not in children of epileptic fathers. The scores showed only random variation according to maternal anticonvulsant therapy. In Finland, 2784 children with craniofacial anomalies were compared with an equal number of normal children; 8 and 2 mothers, respectively, received anticonvulsants, while pregnant, for epilepsy. In that study, the separate effects of the disease and its treatmet could not be evaluated. Both studies did not find evidence of fetal damage when phenobarbitone was taken for indications other than epilepsy.

Abnormalities, Drug-Induced