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Biomedical subjects

A D Harries

Publications and source records attributed to A D Harries.

At least 145 records · Page 8Linked to original sources
PubMed1991

Early anti-HBs antibody response to accelerated and to conventional hepatitis B vaccination regimens in healthy persons.

A significantly higher prevalence of a protective concentration of anti-HBs was achieved at 1 and 2 months among 132 healthy medical students who received an accelerated vaccination schedule with a recombinant hepatitis B vaccine (Engerix-B) than among 120 medical students who received a conventional regimen. With the accelerated schedule, however, 60% students at 1 month and 27% at 2 months were still unprotected (anti-HBs titre less than 10.0 IU/l). Additional passive immunisation should therefore continue to be offered if the accelerated schedule is adopted for post-exposure prophylaxis.

Adult↗
PubMed1991

Phlebotomy in inoculation risk patients: a questionnaire survey of knowledge and practices of hospital doctors in Liverpool.

To assess the knowledge of hospital doctors about patients at increased risk of infection with human immunodeficiency virus (HIV) or hepatitis B virus, and the precautions they took during phlebotomy in such patients, an anonymous postal questionnaire was sent to all 307 hospital doctors working at two District General Hospitals in Liverpool, UK. Two hundred and thirty-eight (77.5%) of the questionnaires were returned. More than 90% of respondents considered a history of male homosexuality, intravenous drug abuse, prostitution or a child of a prostitute to indicate an inoculation risk. There was uncertainty about a previous prison sentence in the 1980s, residence in a home for the mentally handicapped, previous residence in the tropics and hospital treatment in the tropics. Thirty-eight percent of doctors would never enquire about sexual preference, 54.1% about a previous prison sentence and 15.7% about intravenous drug abuse in their clinical history. Although 97.4% of doctors would sometimes or always wear gloves during phlebotomy of an inoculation risk patient, 25.5% always resheathed the needle after phlebotomy and 20.8% would never take the sharps box to the patient. More effort is required to identify accurately inoculation risk patients and greater care is needed in phlebotomy techniques.

Blood Specimen Collection↗
PubMed1991

The platelet count as a simple measure to distinguish inflammatory bowel disease from infective diarrhoea.

A total of 212 adult patients with infective diarrhoea and 27 with inflammatory bowel disease (IBD), admitted consecutively to an infectious disease unit, were studied in order to determine whether clinical features and laboratory measurements performed on admission identified cases of IBD. Long-standing diarrhoea, blood in the faeces, anaemia, leucocytosis, thrombocytosis, raised ESR and a reduced concentration of serum albumin were more common in patients with IBD (P less than 0.05). The most striking difference was in the platelet count with 59% patients with IBD and 1.6% patients with infective diarrhoea having platelet counts greater than 450 x 10(9)/l. A raised platelet count in a patient admitted to hospital with 'acute gastro-enteritis' suggests IBD.

Adult↗
PubMed1991

Stevens-Johnson syndrome during anti-tuberculosis chemotherapy in HIV-seropositive patients: report on six cases.

Hypersensitivity reactions may occur during antituberculous chemotherapy. Severe reactions are rare, and in the three years 1983-86 during which we have both worked in Africa managing large numbers of patients with tuberculosis we only saw one or two cases with severe and generalised cutaneous hypersensitivity. In the last 12 months, however, there have been a number of cases with severe Stevens-Johnson syndrome which developed during antituberculous chemotherapy and has invariably been associated with seropositivity to HIV (human immunodeficiency virus).

Antitubercular Agents↗
PubMed1990

Acute gastroenteritis: the need to remember alternative diagnoses.

Five hundred and ninety-four patients were consecutively admitted to an infectious disease unit over a 2-year period with a referral diagnosis of acute gastroenteritis or food poisoning. In 175 (29%) patients, gastrointestinal symptoms were associated with a condition other than gastrointestinal infection. Non-infective gastrointestinal disease was present in 90 patients, systemic infection in 50 and systemic disease in 35. Four illustrative case histories are presented to emphasize the need for a high index of suspicion if diseases such as malaria, septicaemia or appendicitis are not to be missed.

Acute Disease↗
PubMed1990

Intestinal helminthiasis in ex-patriates returning to Britain from the tropics. A controlled study.

A retrospective study was performed of clinical features in expatriates attending the Hospital for Tropical Diseases, London, with a sole diagnosis of ascariasis (100), trichuriasis (100), hookworm (75), and strongyloidiasis (36). Results were compared with a control group of 100 ex-patriates attending the same hospital in whom no diagnosis was made and in whom stool microscopy and peripheral blood eosinophil counts were normal. Almost one half of all patients with intestinal helminthiasis were asymptomatic. Of those with symptoms specific clinical features were no different from controls with the exception of a transient itch or rash in patients with strongyloidiasis. The presence of eosinophilia was not a reliable indicator of infection. This study suggests that it may be worth while performing stool microscopy in ex-patriates returning from the tropics even if they are asymptomatic.

Adult↗
PubMed1990

Medical admissions to Kamuzu Central Hospital, Lilongwe, Malawi in 1986: comparison with admissions to Queen Elizabeth Central Hospital, Blantyre in 1973.

A retrospective survey was carried out on adult medical admissions to Kamuzu Central Hospital, Lilongwe, Malawi during the period January to December 1986, and results compared with those obtained in Queen Elizabeth Central Hospital, Blantyre in 1973. There were 4700 admissions which was more than twice the number seen in Blantyre. However, the age distribution, the pattern of disease and the overall hospital mortality were similar. Infections (malaria, pneumonia, tuberculosis, gastroenteritis/dysentery and meningitis) were the most common cause of admission, and the major causes of death were still tuberculosis, pneumonia and meningitis. Smoking related diseases were uncommon, and there was no documented case of ischaemic heart disease. The reasons for the importance of periodic surveys, such as the present study, are discussed.

Hospitalization↗
PubMed1989

Plasma and urine electrolyte concentrations and vasopressin levels in patients admitted to hospital for falciparum malaria.

Vasopressin levels, together with plasma and urinary electrolytes, were measured in the acute and convalescent stages of 17 patients with malaria and 11 patients with other febrile illnesses. There was a significantly lower serum sodium in the acute stages of both groups (p less than 0.01 and p less than 0.02). There was no significant difference between the malaria and control groups. There were no significant changes in the vasopressin levels, although one patient with malaria showed evidence of inappropriate vasopressin secretion which returned to normal after treatment. This study suggests the mild hyponatraemia sometimes seen in the acute stages of malaria is not related to inappropriate secretion of vasopressin, although this condition may be of importance in more severe cases of hyponatraemia.

Adolescent↗
PubMed1989

Upper gastrointestinal bleeding in Malawian adults and value of splenomegaly in predicting source of haemorrhage.

Fibreoptic endoscopy was carried out on 100 Malawian adults consecutively admitted to the department of medicine, Kamuzu Central Hospital, Lilongwe, with acute upper gastrointestinal bleeding. The principal causes of haemorrhage were oesophageal varices (45%), duodenal ulcer (16%), gastritis/erosions (9%) and gastric ulcer (7%). 69% of 29 patients with oesophageal varices who were investigated had S. mansoni infection. A palpable spleen positively predicted oesophageal varices in 91% of cases, while no palpable spleen predicted a source of haemorrhage other than varices in 97% of cases. In Malawi oesophageal varices are the major cause of upper gastrointestinal bleeding in adults, and the presence or absence of splenomegaly is a useful clinical pointer respectively to the presence or absence of oesophageal varices.

Adult↗