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Biomedical subjects

A J Hall

Publications and source records attributed to A J Hall.

At least 163 records · Page 9Linked to original sources
PubMed1991

Response to hepatitis B vaccine in relation to the hepatitis B status of family members.

The influence of the hepatitis B status of family members on the response to hepatitis B vaccine of an infant has been examined in 395 families. The presence of one or more HBsAg-positive family members did not appear to have any effect on the vaccine response. This is an encouraging finding as children born into carrier families are at an increased risk of becoming carriers themselves. That the vaccine response of such children is as good as for those born into non-carrier families means that they are likely to be protected against the carrier state by the vaccine.

Family↗
PubMed1991

Accuracy of answers obtained using a one-year recall period compared to a series of fortnightly recalls.

In a study to examine factors influencing transmission of hepatitis B virus, a comparison has been made between answers obtained about events occurring over a one-year period and the summation of the results from fortnightly questionnaires administered over the same period. Complete data were available for 532 children and the results showed that for an estimate of rates within the population, the results from both methods were similar. At the individual level, however, the differences between the one-year recall and fortnightly questions were large. Thus it appears that for population estimates longer recall periods may be satisfactory, but in any study requiring accurate data at the individual level shorter recall periods are required.

Child, Preschool↗
PubMed1991

Morbidity survey of post mortem room staff.

A retrospective study of post mortem staff who had taken leave due to sickness was carried out over a 12 month period throughout England and Wales. Eight hundred and nineteen post mortem room personnel (representing a 57% response) replied to individual postal questionnaires regarding their sick leave of two days or more, for the period June 1985 to June 1986. Complete responses were available for 751. Post mortem room technical staff reported more mean days sickness per person (7.8) than either pathologists (1.6) or a control group of coroners' officers (3.9). The annual inception rate (frequency by spells) was also higher among technicians than the other two groups. Technical staff had more infectious disease (0.73 mean days of absence compared with pathologist (0.10) or coroners' officers (0.12] and more frequent absences due to cuts and lacerations.

Absenteeism↗
PubMed1991

Low frequency maintenance ganciclovir for cytomegalovirus retinitis.

45 patients on maintenance ganciclovir for treated cytomegalovirus (CMV) retinitis were reviewed retrospectively. Treatment was given at 30 mg/kg/week in 3 divided doses: Monday, Wednesday, Friday. The median time to clinical relapse was 5.4 months. This is similar to that reported with higher frequency maintenance regimens. The high degree of immunodeficiency (median CD4 count 16 cells/microliters) and poor prognosis (median survival 8.2 months) associated with CMV retinitis were confirmed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

High grade astrocytomas in children: Hartford Hospital experience.

Anaplastic astrocytomas (AA) and glioblastoma multiforme (GBM), although common primary tumors of the brain in adults, are relatively infrequent in children. Eleven patients with these lesions were treated at our hospital over a period of 20 years. This retrospective study of high-grade gliomas examines numerous factors that could help in the future management of these tumors.

Adolescent↗
PubMed1990

Risk factors for transmission of hepatitis B virus to Gambian children.

Risk factors for hepatitis B virus transmission were examined in 973 Gambian children aged 6 months to 5 years. 33% had evidence of infection with hepatitis B virus and a third of these were carriers. A significant association was found between infection and tropical ulcer scars, and between e antigenaemia and the presence of bedbugs in each child's bed. There was no association between infection and traditional scarring, circumcision, or injections. Skin disease and arthropods are the two most likely modes of transmission of hepatitis B virus between children in West Africa.

Acute Disease↗
PubMed1990

Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria.

OBJECTIVE: To examine whether the observed excess of childhood leukaemia and lymphoma near the Sellafield nuclear plant is associated with established risk factors or with factors related to the plant. DESIGN: A case-control study. SETTING: West Cumbria health district. SUBJECTS: 52 Cases of leukaemia, 22 of non-Hodgkin's lymphoma, and 23 of Hodgkin's disease occurring in people born in the area and diagnosed there in 1950-85 under the age of 25 and 1001 controls matched for sex and date of birth taken from the same birth registers as the cases. MAIN OUTCOME MEASURES: Antenatal abdominal x ray examinations, viral infections, habit factors, proximity to and employment characteristics of parents at Sellafield. RESULTS: Expected associations with prenatal exposure to x rays were found, but little information was available on viral illnesses. Relative risks for leukaemia and non-Hodgkin's lymphoma were higher in children born near Sellafield and in children of fathers employed at the plant, particularly those with high radiation dose recordings before their child's conception. For example, the relative risks compared with area controls were 0.17 (95% confidence interval 0.05 to 0.53) for being born further than 5 km from Sellafield 2.44 (1.04 to 5.71) for children of fathers employed at Sellafield at their conception, and 6.42 (1.57 to 26.3) for children of fathers receiving a total preconceptual ionising radiation dose of 100 mSv or more. Other factors, including exposure to x rays, maternal age, employment elsewhere, eating seafood, and playing on the beach did not explain these relationships. Focusing on Seascale, where the excess incidence has predominantly been reported, showed for the four out of five cases of leukaemia and one case of non-Hodgkin's lymphoma whose fathers were employed at Sellafield and for whom dose information was obtained that the fathers of each case had higher radiation doses before their child's conception than all their matched control fathers; the father of the other Seascale case (non-Hodgkin's lymphoma) was not employed at the plant. These results seem to explain statistically the geographical association. For Hodgkin's disease neither geographical nor employment associations with Sellafield were found. CONCLUSIONS: The raised incidence of leukaemia, particularly, and non-Hodgkin's lymphoma among children near Sellafield was associated with paternal employment and recorded external dose of whole body penetrating radiation during work at the plant before conception. The association can explain statistically the observed geographical excess. This result suggests an effect of ionising radiation on fathers that may be leukaemogenic in their offspring, though other, less likely, explanations are possible. There are important potential implications for radiobiology and for protection of radiation workers and their children.

Case-Control Studies↗
PubMed1990

Methods and basic data of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria.

OBJECTIVE: To examine whether the observed excess of childhood leukaemia and lymphoma near the Sellafield nuclear plant is associated with established risk factors or with factors related to the plant. DESIGN: A case-control study. SETTING: West Cumbria health district. SUBJECTS: 52 Cases of leukaemia, 22 of non-Hodgkin's lymphoma, and 23 of Hodgkin's disease occurring in people born in the area and diagnosed there in 1950-85 under the age of 25 and 1001 controls matched for sex and date of birth taken from the same birth registers as the cases. MAIN OUTCOME MEASURES: Antenatal abdominal x ray examinations, viral infections, habit factors, proximity to and employment characteristics of parents at Sellafield. RESULTS: Ascertainment of cases through multiple sources was as complete as possible, and the diagnosis was established for nearly all cases from hospital records and by independent pathological review when suitable material (60% (58) of cases) was available. Identification and tracing of the parents of cases and controls enabled questionnaires to be forwarded to 730 (66%), and 467 (64%) of the questionnaires were returned completed. Obstetric records were located for 481 (44%) of the relevant births, more frequently in recent years. Linkage of study subjects to the Sellafield workforce file enabled dates of employment and records on external doses of whole body ionising radiation to be obtained. Concordance of information from duplicate sources (when available) was reasonably high with no indications of bias. CONCLUSION: Overall the collected data were sufficiently reliable for detailed analysis and careful interpretation.

Case-Control Studies↗
PubMed1990

The first 2 years of the Gambian National Cancer Registry.

We describe the creation, and the first 2 years experience, of the Gambian National Cancer Registry. The major problems involved in the creation of such a registry in a developing country are discussed. The data accumulated show a low overall rate of cancer incidence compared to more developed parts of the world and indicate that the prevalent cancers, hepatoma, carcinoma of the cervix and lymphoma, are likely to be due to infectious agents. It is hoped that immunisation of children under one year against hepatitis B will drastically reduce the incidence of hepatocellular carcinoma.

Adolescent↗
PubMed1990

Aflatoxin-albumin adducts in human sera from different regions of the world.

An immunoassay now permits the determination of human exposure to aflatoxin at an individual level and consequently allows a better assessment of the role of aflatoxin, and its interaction with hepatitis B virus infection, in the aetiology of liver cancer. Measurements of aflatoxin bound to serum albumin in children and adults from various African countries show that between 12 and 100% contain aflatoxin-albumin adducts, with levels up to 350 pg AFB1-lysine equivalent/mg albumin. In Thailand, lower levels and prevalence of this adduct were observed, while no positive sera were detected from France or Poland. Data are presented showing that exposure to this carcinogen can occur throughout life and the relevance of these observations to the understanding of the multifactorial aetiology of liver cancer in these countries is discussed.

Adult↗
PubMed1990

The pattern of childhood hepatitis B infection in two Gambian villages.

Serologic markers of hepatitis B virus (HBV) infection were measured in children from Manduar and Keneba, two adjacent villages in The Gambia, in 1980 and in 1984. The rate of HBV infection over the 4 years differed markedly: in Manduar 71% of children who were less than 5 years of age in 1980 became infected, whereas in Keneba only 37% became infected. Male children were more frequent carriers of either HBs or e antigen than were female children. Marked clustering of hepatitis B surface antigen (HBsAg) antigenemia within sibling relationships was shown in both villages. The chance of the youngest child in a household being a carrier of HBsAg was strongly related to the number of antigen-positive siblings. Four years later, 53% of children who were initially positive for HBsAg and 33% who were positive for hepatitis B e antigen still carried these antigens. Jaundice was not observed.

Adolescent↗
PubMed1990

The social origins of Perthes' disease of the hip.

Four hundred and ninety-two children with Perthes' disease of the hip were identified from the records of the Family Fund which gives financial help to families of disabled children. Their social circumstances were compared with those of other children referred to the Fund. The relative risk of Perthes' disease increased with lower social class, living in a council house, parental unemployment and a larger sibship size. These findings support other evidence that the disease is caused by dietary deficiencies acting in the prenatal or early postnatal period. The Family Fund may be a useful source of information for paediatric epidemiology in Britain.

Adolescent↗
PubMed1989

Limb volume measurements in peripheral arterial disease.

A simple method for measuring limb volumes of patients with peripheral arterial disease undergoing limb blood flow measurement is described. The device uses the change in surface level of water in a cylindrical reservoir to generate a voltage which is amplified and converted to a volume. The plethysmograph is stable and accurate over a wide range of limb volumes. For patients with leg ulcers or gangrene, where water immersion is not possible, a geometrical model has been developed which allows the volume to be calculated from a series of six external measurements. Comparison with measured volumes in 46 patients has shown this model to be accurate with a mean error of 3.3%. It provides a convenient alternative to direct measurement in these patients.

Blood Volume↗
PubMed1989

Low blood manganese levels in Liverpool children with Perthes' disease.

The aetiology of Perthes' disease of the hip, avascular necrosis of the head of the femur, is unknown. Children with the disease have a generalised abnormality of growth. A similar disproportionate growth is found in chicks given a diet deficient in manganese. In Liverpool, which has the highest incidence of Perthes' disease reported anywhere in the world, children with the disease were shown to have lower blood manganese levels than controls. This is evidence that manganese deficiency around the time of birth may be a cause of Perthes' disease, but the results require confirmation.

Age Factors↗
PubMed1989

Bacteriological sampling of postmortem rooms.

Thirty hospital and coroners' postmortem rooms in the West Midlands were visited over two years. The design, environmental facilities, and hygienic practices were investigated and air exchange rates were measured. Microbiological samples were taken from the environment and from gloves, hands, and protective clothing of staff. Glove punctures were also recorded and a plastic isolator evaluated. Bacterial counts in the air were low and related more to the number of people in the room than to the air exchange rate. There was little evidence of the production of aerosol containing bacteria, although splashing occurred while intestines were being washed out. Surfaces often remained contaminated with Gram negative bacilli after cleaning but numbers were considerably reduced on drying. Decontamination of instruments was satisfactory. A wide range of disinfectants and concentrations was used, but none showed evidence of contamination. Gloves were heavily contaminated after use, and occasionally the hands of the wearer after removal of the gloves. Washing the hands effectively removed residual transient organisms, irrespective of the agent used. The incidence of glove punctures was higher among technicians (38%) than pathologists (12%). The plastic isolator reduced smells and limited environmental contamination but visibility and acceptability were poor. The results of the study suggest that there is little evidence of risk of infection to staff, providing basic hygienic precautions are taken, but consideration should be given to the prevention of glove punctures.

Air Microbiology↗