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Biomedical subjects

A Stewart

Publications and source records attributed to A Stewart.

At least 235 records · Page 13Linked to original sources
PubMed1991

Seroepidemiology of hepatitis B infection in children in Vanuatu. Implications for vaccination strategy.

Four hundred and eighty-two unvaccinated children from three different age groups (12-18 months, 30-42 months, 54-115 months) in a hepatitis B virus (HBV) endemic area were tested for markers of HBV infection. HBV seromarkers were detected in 52.3% of children and 26.9% were hepatitis B surface antigen (HBsAg) positive. Evidence of infection was related to age, with HBV seromarker rates highest (67.5%) in school children aged 56-115 months. The HBsAg positive rate was highest (30.1%) in children 30-42 months of age. However, even children in the youngest age group (12-18 months) had high seromarker (26.8%) and HBsAg positive (17.0%) rates. A high proportion of HBsAg positive children (83.8%) were also hepatitis Be antigen (HBeAg) positive. Mothers of children in the youngest age group (12-18 months) were also tested, and 24.5% were HBsAg positive. Factors associated with higher rates of infection in children included maternal HBeAg positivity (for children in the youngest age group), increasing age, and residence on the islands of Emao or Nguna. Higher rates of HBsAg positivity were associated with these factors and with being male. Crossinfection between children is probably the most important source of infection, based on the evidence of the high rate of HBeAg positivity in children and the rising infection rate with age. A possible vehicle of spread is through skin infections and skin sores which are highly prevalent in children in Vanuatu. Since this study indicates that both perinatal and early child-to-child transmission are occurring, the most practical strategy to prevent the majority of infections is to vaccinate all children, commencing at birth and completing the course early in the first year of life.

Child↗
PubMed1991

The Johannesburg cardiac rehabilitation programme.

Cardiac rehabilitation has become a generally accepted mode of treatment for patients suffering from coronary artery disease. The Johannesburg cardiac rehabilitation programme was started in 1982 and has rapidly grown to become one of the largest programmes in southern Africa. This paper describes the 387 patients admitted to the unit between June 1986 and July 1988 and evaluates the effects of a combined exercise training and lifestyle modification programme. The mean age on admission was 55 years for males and 58 years for females. Most patients were from social classes I and II. Myocardial infarction, coronary artery bypass graft and a combination of both were the most common reasons for admission (35.4%, 23% and 21.2% respectively). On admission 72.9% of patients were smokers, 26.3% had hypertension and 34.3% had hypercholesterolaemia. A 50% drop-out rate within 12 months of starting the programme was noted. An increase in peak oxygen uptake, weight and skinfold thickness reduction, and improvement in the lipogram were seen after 6 months in patients who complied well with the programme. Cardiac rehabilitation is a secondary preventive strategy that can complement traditional medical and surgical therapies.

Adult↗
PubMed1991

Activation of alpha-myosin heavy chain gene expression by cAMP in cultured fetal rat heart myocytes.

The effect of cAMP on cardiac myosin heavy chain (MHC) gene expression in primary cultures of 18-day-old fetal rat heart myocytes was investigated. When myocytes were treated with either 10 microM forskolin or 1 mM 8-bromo-cAMP for 48 h, the relative amount of the V1 to -V3 myosin isoform ratio increased 3-fold. The abundance of alpha-MHC mRNA was also increased 3-to-4-fold in forskolin treated vs control cells. However, no appreciable change was observed in the level of beta-MHC mRNA. In addition, a 70% increase in the transcription rate of the cardiac MHC gene was observed by nuclear run-on assay following treatment of cells with 10 microM forskolin for 12 h. These results demonstrate the preferential induction of alpha-MHC mRNA by cAMP which is, in part, mediated by transcriptional activation of the gene.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1991

A technique for control of the condylar head during open reduction of the fractured mandibular condyle.

Open reduction of fractures of the neck of the mandibular condyle may be technically difficult. Control of the proximal fragment may be achieved by insertion of a Moule pin into the condylar neck. This facilitates retrieval of the condylar head and alignment of the bone fragments which are essential components of the technique. Accurate anatomical reduction and stabilisation of the fracture simplifies the technique of miniature plate fixation.

Adult↗
PubMed1991

Hypertension, cigarette smoking, and the decline in stroke incidence in eastern Finland.

Finland has high rates of both cardiovascular disease and cardiovascular disease risk factors. We studied random samples of the population 30-59 years of age for risk factors in two provinces of eastern Finland in 1972 and 1977. We then followed both cohorts until 1985 through linkage with national hospital discharge and death certificate registers. The prevalence of hypertension and smoking in both provinces declined between 1972 and 1977, as did the stroke incidence in the 8-year period of follow-up of each cohort. We observed no differences in stroke incidence between the two provinces. The relative risk of stroke in the later period (1977-1985) was 0.71 and 0.58 for men and women, respectively, when compared with the earlier period (1972-1980). Overall, 28% of all stroke events could be attributed to hypertension, 17% to smoking, and 43% to these two factors jointly. The decrease in the prevalence of hypertension and smoking accounted for about 29% of the decline.

Adult↗
PubMed1991

What about adopters?

Alison Stewart and Wendy Ring consider the adjustments people who adopt have to make when becoming parents. They outline a scheme to offer parentcraft to adopters and consider the implications for health visiting of this minority group.

Adaptation, Psychological↗
PubMed1991

Working partners.

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Gender Identity↗
PubMed1990

Coronary heart disease among Pacific Island people in New Zealand.

Coronary heart disease is the leading cause of death in New Zealand. Death rates are higher among the Maori than the European population but rates have been declining in both groups over recent years. The occurrence of coronary heart disease among the Pacific Island population in New Zealand is unknown. Data from the National Health Statistics Centre (NHSC) and the Auckland coronary or stroke (ARCOS) study were used to describe the occurrence of coronary heart diseases among Pacific Island people. Age standardised mortality rates show that coronary heart disease is an important cause of death among Pacific Island men. Death rates have declined between 1973-77 and 1978-82 but this trend did not continue among men in the 1983-86 period. Age standardised mortality rates from coronary heart disease from the ARCOS data are 175/100,000 and 52/100,000 for Pacific Island men and women compared with 325/100,000 and 141/100,000 for Maori men and women. Age standardised rates for European men and women are 154/100,000 and 36/100,000 respectively.

Adult↗
PubMed1990

Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case-control study.

OBJECTIVE: To determine the relation between sleeping position and quantity of bedding and the risk of sudden unexpected infant death. DESIGN: A study of all infants dying suddenly and unexpectedly and of two controls matched for age and date with each index case. The parents of control infants were interviewed within 72 hours of the index infant's death. Information was collected on bedding, sleeping position, heating, and recent signs of illness for index and control infants. SETTING: A defined geographical area comprising most of the county of Avon and part of Somerset. SUBJECTS: 72 Infants who had died suddenly and unexpectedly (of whom 67 had died from the sudden infant death syndrome) and 144 control infants. RESULTS: Compared with the control infants the infants who had died from the sudden infant death syndrome were more likely to have been sleeping prone (relative risk 8.8; 95% confidence interval 7.0 to 11.0; p less than 0.001), to have been more heavily wrapped (relative risk 1.14 per tog above 8 tog; 1.03 to 1.28; p less than 0.05), and to have had the heating on all night (relative risk 2.7; 1.4 to 5.2; p less than 0.01). These differences were less pronounced in the younger infants (less than 70 days) than the older ones. The risk of sudden unexpected death among infants older than 70 days, nursed prone, and with clothing and bedding of total thermal resistance greater than 10 tog was increased by factors of 15.1 (2.6 to 89.6) and 25.2 (3.7 to 169.0) respectively compared with the risk in infants of the same age nursed supine or on their side and under less than 6 tog of bedding. CONCLUSIONS: Overheating and the prone position are independently associated with an increased risk of sudden unexpected infant death, particularly in infants aged more than 70 days. Educating parents about appropriate thermal care and sleeping position of infants may help to reduce the incidence of the sudden infant death syndrome.

Age Factors↗
PubMed1990

A crying baby.

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Adult↗