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Biomedical subjects

C M Connors

Publications and source records attributed to C M Connors.

5 recordsLinked to original sources

Universal hepatitis B vaccination: hospital factors influencing first-dose uptake for neonates in Darwin.

A universal neonatal hepatitis B vaccination program was introduced in the Northern Territory in 1990. We compared live births with vaccine usage to determine the uptake of the first dose of hepatitis B vaccine under this new policy and to identify hospital factors that influenced this rate. Attitudes and vaccine administration practices were determined through interviews, using standard questions with midwifery and paediatric nursing staff at both hospitals. Hepatitis B vaccines dispensed at Hospital A indicated a 96 per cent coverage of neonates in 1993 and 93 per cent in 1994. Vaccination at Hospital B indicated 71 per cent coverage in 1993 and 77 per cent in 1994. Differences in vaccine uptake appeared to be influenced by the use of standing drug orders, the nursing staff's attitudes and knowledge, and misinformation among health professionals. Education programs for health professionals and parents need to be established before the introduction of a universal hepatitis B vaccination policy for it to be well accepted. Standing orders for hepatitis B vaccine in postnatal wards allow nursing staff to promote it and thus maximise coverage rates.

Attitude to Health↗

Histocompatibility antigens in primary biliary cirrhosis.

HLA-A, -B, and -DR antigens were examined in 71 patients with primary biliary cirrhosis (PBC) enrolled in a randomized, double-blind trial of colchicine versus placebo. All patients had typical laboratory and histological features of PBC, except that six had a negative test for antimitochondrial antibody. Frequencies of these antigens were compared with the international Caucasian panel of the Eighth International Workshop and with a local Caucasian panel. Antigen frequencies were compared using the chi 2 test, with a correction for the number of antigens tested. The PBC patients had a significant excess of DR4 (29 of 70 typed, or 41.1%) compared to the international (804 of 3811, or 21.1%, corrected p value less than 0.05) but not the local panel (47 or 129, or 36.4%). Of PBC patients, 52.9% had only one DR antigen identified, compared to 67.5% for the international panel and 49.6% for the local panel. In past studies, the HLA antigen most strongly correlated with PBC was DR8, but this was not included in our panel of antisera. However, no significant relationship between HLA and PBC was found among the antigens screened.

Colchicine↗

Increased incidence of hypothyroidism in primary biliary cirrhosis.

We examined the thyroid status of 58 patients with primary biliary cirrhosis (PBC) using total serum thyroxin, thyroid hormone binding ratio, free thyroxin index, serum TSH, antithyroglobulin, and antimicrosomal antibodies. Seven patients were known to be hypothyroid prior to the diagnosis of PBC. Six additional patients were found to have biochemical evidence of hypothyroidism. The prevalence of hypothyroidism was 12% if we include only those six PBC patients with newly diagnosed hypothyroidism or 22% if we include all 13 patients. Five of the 58 patients had evidence for an elevation of thyroid hormone binding capacity. Three hypothyroid patients had normal total thyroxins with low thyroid hormone binding ratios. Two euthyroid patients had elevated total T4s with low thyroid hormone binding ratio and normal FTI. The prevalence of positive antimicrosomal antibodies was 34%, including 11 euthyroid PBC patients. The prevalence of positive antithyroglobulin antibodies was 20% including five euthyroid patients. There was no association between HLA DR3 or DR5 and the patients with hypothyroidism and/or antithyroid antibodies. Because fatigue, lethargy, and anorexia as well as hypercholesterolemia are common features of both hypothyroidism and PBC, patients with PBC should be screened for evidence of thyroid dysfunction. Thyroid disease may precede the diagnosis of PBC by several years. Therefore, the development of cholestatic liver disease in a patient with known autoimmune thyroiditis should arouse suspicion of PBC.

Autoantibodies↗