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Biomedical subjects

C K Fairley

Publications and source records attributed to C K Fairley.

At least 91 records · Page 5Linked to original sources
PubMed1997

A self-administered technique for the detection of sexually transmitted diseases in remote communities.

The control of sexually transmitted diseases (STDs) in remote rural communities would be enhanced by a sensitive self-administered method for the detection of asymptomatic infection. Results of conventional methods for the detection of STDs were compared with results of tampon-collected specimens analyzed by polymerase chain reaction (PCR) for 480 women. Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis were detected by routine methods in 4 (1%), 14 (3%), and 41 (9%) samples, respectively, while PCR detected these organisms from 52 (11%), 26 (5%), and 75 (16%) tampons, respectively. The detection of each organism was significantly greater by PCR in tampon-collected samples than by routine conventional methods (P < .01). Discrepant results were confirmed by separate primers in 40 of 48 specimens for N. gonorrhoeae, in 11 of 12 specimens for C. trachomatis, and in 31 of 32 specimens for T. vaginalis. Tampons tested by PCR provide an acceptable and sensitive method for detection of STDs in women living in remote areas.

Animals↗
PubMed1997

Epidemiology of genital warts in England and Wales: 1971 to 1994.

OBJECTIVE: To describe the epidemiology of genital warts in England and Wales over the period 1971 to 1994. METHOD: Retrospective study of available statistics. RESULTS: The rate of attendance for genital warts increased by 390% and 594% for men and women respectively between 1971 and 1994. Most of this increase occurred between 1980 and 1986. From 1986 to 1991 virtually no change occurred, but since 1992 the rate of attendance has risen by 15%. The ratio of male to female cases has declined steadily from 1.85 in 1971 to 1.34 in 1994. Rates of attendance for first attack in men were highest in the 20 to 24 year age group whereas for women it peaked in those aged 16 to 24 years. Regional data indicate that the rate of attendance has increased consistently over England and Wales during this period. CONCLUSIONS: Rates of genital warts have risen substantially over the past 25 years. If these are a reflection of changes in sexual behaviour then the rise since 1992 is of considerable concern particularly for the incidence of cervical cancer in the coming decades.

Adolescent↗
PubMed1997

Cryptosporidiosis in patients with AIDS.

Cases of cryptosporidiosis in patients with the acquired immunodeficiency syndrome (AIDS) residing in Melbourne over a 6-year period (1990-1995) are described. During this period 85 cases occurred, while 979 new AIDS diagnoses were notified. Over this period temporal clustering in cryptosporidial detection was evident (P=0.007), but the pattern was not statistically associated with the season, rainfall (P=0.88), mean average maximal temperature (P=0.15) or mean average minimal temperature. Further studies should identify these risk factors and provide an opportunity to prevent this devastating disease.

AIDS-Related Opportunistic Infections↗
PubMed1996

The effect of an accelerated immunisation schedule on pertussis in England and Wales.

Notifications of pertussis in England and Wales have fallen dramatically from 65 810 during the epidemic year of 1982 to 3963 cases during the epidemic year of 1994, as vaccine coverage has risen. The incidence of pertussis has declined in all ages, including babies under 3 months of age who would have been at risk of disease from older siblings vaccinated under the accelerated schedule introduced in 1990 if immunity induced as result of this schedule had been short lived. To document the efficacy of the current whole cell vaccine under the accelerated schedule an enhanced surveillance scheme based on laboratory confirmed cases of pertussis was set up in 1994. Three deaths occurred in infants with confirmed pertussis, all of whom were under 8 weeks of age and unvaccinated. The overall vaccine efficacy for those over 6 months and under 5 years of age was 94%. This estimate may be inflated, as a number of biases could lead to the underascertainment of cases in vaccinated children, but it is similar to previous estimates obtained for children of the same age vaccinated under the 3, 5, and 10 month schedule. Vaccine efficacy was 89% for children aged over 5 and under 15 years. The enhanced surveillance scheme will enable us to monitor the duration of protection under the accelerated schedule and evaluate the continuing impact of pertussis infection.

Adolescent↗
PubMed1996

The organisms reported to cause infective myocarditis and pericarditis in England and Wales.

It is difficult to acquire an overall perspective of the range of organisms responsible for infective myocarditis or pericarditis, and their relative importance, as most studies have involved only case reports or case series of a single organism. This study analyses reports to the Communicable Disease Surveillance Centre, of the Public Health Laboratory Service. Reports where myocarditis or pericarditis was included as the main clinical features between 1990 and 1993 were studied. Between 1990 and 1993, 368 cases of myocarditis and/or pericarditis were reported to CDSC. Viruses were reported to cause 253 (69%) cases, bacteria were responsible for 49 (13%) cases, mycoplasma for 32 (9%) cases, chlamydia for 16 (4%) cases and Mycobacterium tuberculosis for nine (2%) cases. Infection with coxsackie B virus was most frequently associated with a mixed picture of myo/pericarditis, whereas influenzae virus was associated with pericarditis or myocarditis alone. This information will provide clinicians with details of the more likely pathogens responsible for these conditions.

England↗
PubMed1996

Conjugate meningococcal serogroup A and C vaccine: reactogenicity and immunogenicity in United Kingdom infants.

The reactogenicity and immunogenicity of a serogroup A and C meningococcal polysaccharide-CRM197 conjugate vaccine was evaluated in 58 infants who received three doses at 2, 3, and 4 months of age. The conjugate vaccine produced few systemic side effects, and local reactions were significantly less common than those produced by the routine vaccinations. The prevaccination geometric mean titers (GMTs) of A and C polysaccharide antibodies were, respectively, 2.8 and 0.6 microg/mL, rising to 21.5 and 38.5 microg/mL by 1 month after the third dose (age 5 months) and falling to 3.1 and 2.2 mircog/mL by 14 months of age. Prevaccination serum bactericidal titers against 2 serogroup C meningococci strains were <1/4 in 49 of 52 infants, rising to a GMT of 1/3082 at 1 month after the third dose and falling by age 14 months to a GMT of 1/10. Thus, this meningococcal conjugate vaccine proved to be safe and immunogenic, inducing high levels of anti-C polysaccharide antibodies that were bactericidal in young infants.

Antibodies, Bacterial↗
PubMed1996

Varicella-zoster virus epidemiology--a changing scene?

Chickenpox is a relatively mild disease in healthy children but may be life threatening in immuno-suppressed patents, neonates, and normal adults, especially smokers-for whom the risk of varicella pneumonia is high. The epidemiology of chickenpox appears to be changing: There has been an unexplained upward shift in the age distribution of cases over the last 20 years. This is reflected by increased consultations for chickenpox in general practices and more deaths in England and Wales. On the basis of hospital admissions for chickenpox in young adults, there is evidence of a similar trend in the United States. This epidemiologic change has important consequences for future mortality rates and for risk of infection in health care workers and pregnant women. The potential use of the varicella vaccine should be considered as a measure to reduce the risk of nosocomial transmission in view of the possible changing epidemiology of varicella.

Adolescent↗
PubMed1996

AIDS defining diseases in the UK: the impact of PCP prophylaxis and twelve years of change.

We examined all reports of adult AIDS cases made to the 2 national surveillance centres in the UK for changes in AIDS defining conditions between January 1982 and September 1994. Differences and changes among persons diagnosed since January 1988 who had and had not been aware of their HIV infection prior to their AIDS diagnosis were of particular interest. Pneumocystis carinii pneumonia (PCP) is the AIDS defining disease most often reported at the initial AIDS diagnosis. Its proportion of all AIDS cases has increased significantly between January 1982 and December 1987 and decreased markedly thereafter. Since January 1988 a significant decrease in the proportion of cases diagnosed with cryptosporidial infection was also observed while increases were observed in the proportion of cases diagnosed with: HIV wasting (chi(1)(2) = 5.56) PML (chi(1)(2) = 19.47), mycobacterium avium complex (chi(1)(2) = 35.76) and pulmonary tuberculosis (chi(1)(2) = 144.0). For cases diagnosed between January 1988 and September 1994, PCP was more likely to be diagnosed in patients previously unaware of their HIV infection (P < 0.01) as was extrapulmonary TB (P < 0.01). In contrast, the following diseases were more likely to be diagnosed in patients already aware of their HIV infection prior to the diagnosis of AIDS: oesophageal candidiasis (P < 0.001), HIV wasting (P = 0.07), mycobacterium avium complex (P = 0.0001), cytomegalovirus disease (P < 0.001), HIV encephalopathy (P = 0.0009) and cryptosporidial infection (P = 0.02). Prophylaxis and anti-retroviral therapy appear to have had a significant impact on the temporal changes of the most frequently diagnosed AIDS diseases. While PCP prophylaxis has substantially reduced the likelihood of a PCP diagnosis at AIDS, the corresponding increase in other opportunistic infections suggests that there may be a need for improved prophylaxis for these conditions.

AIDS Dementia Complex↗
PubMed1995

Observational study of effect of intrauterine transfusions on outcome of fetal hydrops after parvovirus B19 infection.

The role of intrauterine transfusion for fetal hydrops arising from maternal paravirus B19 infection is unclear. 66 cases of fetal hydrops arising from B19 infection were reported in England and Wales between June, 1992, and September, 1994. In 29 cases the fetus was dead at the time of the first abnormal ultrasound or a therapeutic abortion as performed; 12 of the 38 alive at the first abnormal scan received intrauterine transfusions and 3 of the 12 died. 26 did not receive intrauterine transfusions and 13 died. After adjustment for the severity of the hydrops as assessed by the ultrasound and for gestational age, the odds of death among those who received an intrauterine transfusion was significantly less than among those who did not (odds ratio 0.14, 95% CI 0.02-0.96). These findings suggest that intrauterine transfusion will benefit some fetuses with hydrops arising from parvovirus B19 infection.

Adult↗
PubMed1995

Risk factors for the development of amoxycillin-clavulanic acid associated jaundice.

OBJECTIVES: To identify risk factors for the development of amoxycillin-clavulanic acid associated jaundice. DESIGN: Retrospective case-control study. Cases were selected from those reported to the Adverse Drug Reactions Advisory Committee from the time of introduction of amoxycillin-clavulanic acid to Australia in 1986 until December 1993. SUBJECTS: Thirty-four cases, defined as individuals who developed jaundice within eight weeks of starting amoxycillin-clavulanic acid, with a biochemical picture of cholestasis, normal calibre bile ducts and no other recognised causes of jaundice or recent use of other hepatotoxic drugs, were selected. For each case, four controls who had been prescribed amoxycillin-clavulanic acid without developing jaundice were randomly selected from the patient register of the prescribing doctor. RESULTS: Increasing age was a risk factor for amoxycillin-clavulanic acid associated jaundice; patients over 55 years had an odds ratio of 16.1 (95% confidence interval [CI], 2.9-88.9) compared with patients less than 30 years. Men had an odds ratio of 2.5 (95% CI, 1.1-5.4) compared with women, although the proportion of men in the study group was larger than in the reported cases overall. History of serious medical illness, drug dose, route and duration of therapy, other medications, smoking and previous drug allergies or use of amoxycillin-clavulanic acid were not significantly associated with jaundice. CONCLUSIONS: Because of the higher risk of jaundice with increasing age, the risk-benefit ratio of amoxycillin-clavulanic acid should be carefully considered in older patients. Further assessment is necessary to clarify the association between jaundice and male sex.

Adult↗
PubMed1995

Antibody responses and symptoms after DTP and either tetanus or diphtheria Haemophilus influenzae type B conjugate vaccines given for primary immunisation by separate or mixed injection.

The safety and immunogenicity of two conjugate Haemophilus influenzae type B (Hib) vaccines administered either mixed with, or in separate limbs to, a whole-cell DTP vaccine, was compared in infants vaccinated at 2, 3 and 4 months of age. Antibody titres to purified polyribosylribitol phosphate, diphtheria, and to pertussis antigens between infants who received the Hib and DPT vaccines in separate limbs or in the same limbs were similar (P > 0.1) while antibody titres to tetanus toxoid were higher in the later group (P < 0.05). This study demonstrated that both Hib vaccines can be mixed with whole-cell DTP vaccine without reducing immunogenicity of either vaccine or increasing the incidence of adverse reactions.

Antibodies, Viral↗