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Biomedical subjects

A Gardner

Publications and source records attributed to A Gardner.

At least 91 records · Page 5Linked to original sources

Prevention of unexpected infant death. Evaluation of the first seven years of the Sheffield Intervention Programme.

In the years 1973-79, 39452 infants born to parents resident in Sheffield were scored at birth for risk of unexpected infant death. Before 1973 post-perinatal mortality in Sheffield was on average 11.5% above the rate for England and Wales. Since 1973 it has only once exceeded the rate for England and Wales. "Possibly preventable" deaths have fallen from 5.2 to 1.9 per 1000. 12% of this decline is associated with a rise in the average age of the mother and a fall in the number of pregnancies, 9% with a reduction in precipitate deliveries, 24% with an increase in breastfeeding, 18% with extra care given by health visitors to high-risk infants, and 36% with other factors. The reduction in mortality attributed directly to the effect of increased visiting of high-risk infants is numerically similar to the number of lives saved by treating cancers of children. This suggests that home visiting by health visitors is highly cost-effective.

Clinical Trials as Topic↗

Fragile X chromosome: clinical and cytogenetic studies on cases from seven families.

Results of detailed clinical and cytogenetic studies on 13 mentally retarded males and two heterozygous females (one normal and one retarded) are reported. Reference is made to technical modifications to enhance the incidence of expression of the fragile X. The addition of excess methionine to the fibroblast cultures (final concentration of 115 mg/l medium TC 199) was found to be particularly valuable, increasing the incidence of expression up to four-fold, and enabling the demonstration of the fragile X in fibroblasts when it could not be demonstrated in blood cultures in at least one case. Studies on replication patterns of the X chromosomes in the two heterozygous females showed that the fragile X chromosome was genetically active in a significantly greater proportion of cells (74%) in the mentally retarded female, whereas the normal X was active in a similar proportion (72%) in the carrier with normal intelligence.

Adult↗

Are all born equal? Incidence of febrile convulsions by seasons of birth.

To test whether the seasons of birth had an effect on subsequent experience of illness, details were obtained of all Sheffield children born between 1973 and 1977 who were admitted to hospital before their second birthday with a first febrile convulsion. Analysis by date of birth in consecutive 28-day cohorts showed that the incidence of febrile convulsions ranged from 2.5 per thousand live births to 30.2 per thousand in different "month" cohorts. Statistically significant variations were noted in the incidence rates in relation to season and year of birth. The implication is that even large scale epidemiological studies which have been confined to children born in a particular week or month may not be representative of the whole child population.

England↗

Somatomedins in aging and dementia disorders of the Alzheimer type.

Serum levels of somatomedins were determined in apparently healthy aged individuals and dementia patients primarily with clinically suspected Alzheimer type disorder. Serum somatomedin values, determined by radioreceptorassay and radioimmunoassay, fell with advancing age in normal subjects. A significant elevation in serum somatomedins was observed in dementia patients. CSF somatomedin levels were also increased in the only two patients with suspected Alzheimer type disease examined. Since somatomedins are believed to act as anabolic hormones, it was suggested that the elevated levels represent a compensatory mechanism to overcome receptor insensitivity in patients with dementia disorders of the Alzheimer type.

Aged↗

Glutamine synthetase subunit mixing and regulation in Bacillus subtilis partial diploids.

A specialized transducing phage, SP beta c2 dglnA2, of Bacillus subtilis was used to construct partial diploids with various glutamine auxotrophs. The overproduction of manganese-stimulated glutamine synthetase no longer occurred in the diploids. The kinetics of heat inactivation of the enzyme extracted from two diploids suggests that there was subunit mixing.

Bacillus subtilis↗

The prevention of hepatitis B with vaccine. Report of the centers for disease control multi-center efficacy trial among homosexual men.

A randomized, double-blind, vaccine/placebo trial of the Merck 20-micrograms hepatitis B virus (HBV) vaccine was done among 1402 homosexual men attending venereal disease clinics in five American cities. Vaccination was followed by only minimal side effects. Two doses of vaccine induced antibody in 80% of vaccine recipients. A booster dose 6 months after the first dose induced antibody in 85% of recipients and markedly increased the proportion of recipients who produced high antibody titers. The incidence of HBV events was markedly less in the vaccine recipients compared to that in the placebo recipients (p = 0.0004). Between month 3 and 15 after the first dose, 56 more significant HBV events (hepatitis, or hepatitis B surface antigen positive, or both) occurred in the placebo group while only 11 occurred in the vaccine group. Ten of the 11 HBV events in the vaccine recipients occurred in hypo- or nonresponders to the vaccine. This vaccine appears to be safe, immunogenic, and efficacious in preventing infection with hepatitis B virus.

Adult↗

The effect of estrogen priming on induction of labor with prostaglandins.

A double-blind, randomized study was designed to determine whether estrogen "priming" of the unripe cervix followed by prostaglandin induction of labor would have a synergistic effect on cervical ripening and improve the success rate of induction. One hundred near-term patients with Bishop scores less than or equal to 4 received an intramuscular injection of either 10 mg of estradiol valerate or a placebo 48 hours prior to induction of labor with oral prostaglandin E2. The serial changes in Bishop scores were very similar in both groups. The success rate of induction in the study group (69.8%) was not statistically different from that in the control group (61.9%). The duration of labor was 9.9 +/- 4.1 hours in the study group versus 9.1 +/- 3.7 hours in the control group (not significant). This study showed that 10 mg of estradiol valerate had no detectable effect on the unripe cervix near term and did not show a synergistic effect with prostaglandins during induction of labor.

Adult↗

Identification of some infants at immediate risk of dying unexpectedly and justifying intensive study.

Children who die unexpectedly in infancy often have symptoms of illness before death. Survey data are used to evaluate risks associated with symptoms. There is a 1 in 50 chance of unexpected infant death occurring in the next 9 days when two or more symptoms occur in infants defined to be at high risk by a discriminant score. The score is based on data collected on all infants at birth and by health visitors at 1 month. This system would identify 50% of cot deaths and provides a basis for prospective physiological studies.

Child Reactive Disorders↗