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Biomedical subjects

F Johnstone

Publications and source records attributed to F Johnstone.

14 recordsLinked to original sources

Local surveillance of influenza in the United Kingdom: from sentinel general practices to sentinel cities?

Surveillance of influenza in England and Wales utilises a disparate geographical network of general practices to provide clinical data in the form of weekly consultation rates for influenza and 'influenza-like illness'. This network accurately detects and monitors seasonal influenza activity at national and supra-regional levels. Localised regional and sub-regional epidemics are less easily detected. We describe a localised epidemic of influenza affecting a deprived urban community in the North West of England that was detected by a close knit network of general practices participating in the surveillance of communicable diseases as part of a primary care health needs assessment initiative.

Adolescent↗

Methicillin-resistant Staphylococcus aureus in a finger felon.

Methicillin-resistant Staphylococcus aureus is an increasingly prevalent nosocomial pathogen that presents therapeutic challenges. We report an incidence of methicillin-resistant S aureus in a felon. The biochemical and clinical characteristics of methicillin-resistant S aureus are reviewed. The alarming increase of this organism in various types of infections demands the attention of all surgeons and emphasizes the importance of early surgical drainage and culture of pus in all cases of infection. (J Hand Surg 2000; 25A:173-175.

Abscess↗

The incidence and prevalence of HIV infection among childbearing women living in Edinburgh city, 1982-1995.

OBJECTIVE: To track the complete course of the HIV epidemic among women from the city of Edinburgh who delivered babies during 1982-1995. METHODS: The performance of the modified Serodia HIV test on dried blood spots from archived neonatal metabolic screening cards stored for up to 11 years was evaluated by testing 221 cards from neonates whose mothers' HIV infection status was already known (100 HIV-positive, 121 HIV-negative). Unlinked anonymous HIV testing of cards from neonates born during 1982-1989 was then performed and the resulting prevalence data were combined with existing data from 1990-1995. Maximum and minimum limits of HIV incidence among women during the 36-month period prior to delivery were calculated using data held on a clinical database of HIV-infected pregnant women that had been generated under strict conditions of confidentiality; these data included the date of the woman's first HIV-positive and, if available, last HIV-negative specimen. RESULTS: The evaluation revealed a sensitivity of 91%, not clearly related to storage time, and a specificity of 100%. HIV infection first entered Edinburgh's childbearing population during the early 1980s with prevalence peaking at 0.4% in 1986 and then decreasing to 0.1% in 1995; a similar incidence profile was seen during this period. Since 1986, the first full year that HIV testing was available, 78% of all infections were known during the pregnancy, 13% were identified retrospectively, and only 10% (10 cases) remain unaccounted for. For infected cases during 1984-1987, 78% were injecting drug users (IDU) and only 22% acquired their infection sexually; this distribution had reversed by 1992-1995. CONCLUSION: HIV testing of neonatal metabolic screening cards stored for up to 11 years can yield results of sufficient accuracy for epidemiological purposes. There has been a substantial decline in the prevalence and incidence of HIV since the mid-1980s. Although new infections are still occurring, the numbers are small. The decline may largely be explained by the impact of preventive measures on the spread of HIV amongst IDU, and thus from IDU to their sexual partners.

Cohort Studies↗

Socio-economic factors associated with HIV infection in pregnant women.

The HIV epidemic in women in Edinburgh has characteristics which enable a total population study. We studied retrospectively all women with a known history of injection drug use or with a seropositive drug-using partner in a five year period from 1985-1990. We sought to quantitate lifestyle and environmental factors associated with HIV infection in pregnant women and to test two hypotheses: that infected women would have more adverse socio-economic features, and that there would be a change in these factors with time. There were 244 pregnant women in the study. They were slightly younger than all Edinburgh City women and much less likely to be married. They were much more likely to live in areas of multiple housing deprivation. Only 16% of women, and 28% of partners, were in paid employment; 90% of women smoked and 76% had a history of injection drug use. Some 28% of previous children were in the care of another, often a relative, 8% of women had a recent prison admission, and 58% of those tested had antibodies to Hepatitis B. Univariate analysis showed that none of these factors was significantly different in HIV seropositive women except for prison admission, previous infection with Hepatitis B, which probably all related to type of drug use. Linear logistic regression suggested two other variables which distinguished between groups, but because these are composite, and dependent on incomplete data, this must be interpreted with caution. The same overall associations were found when only women with a history of injection drug use were considered. There was no statistically significant change in these factors with time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Self poisoning.

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Antidotes↗

Acute poisoning.

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Humans↗

Glycosylated haemoglobin concentrations in mothers of large babies.

Mothers who have big babies may have had abnormal glucose tolerance during pregnancy. Glycosylated haemoglobin (HbA1) concentrations were measured on the first or second day after delivery in 50 women who had had babies weighing over the 95th centile for gestational age and in 50 women who had had normal-sized babies (controls). Nine of the mothers of big babies but only one of the controls had an HbA1 concentration above the normal range. All the women had normal glucose tolerance and HbA1 concentrations six weeks after delivery. Measuring HbA1 concentration in the first two days after delivery in mothers of large babies may identify gestational diabetics.

Birth Weight↗

Familial trends in low birth weight.

The reproductive performance of sisters and sisters-in-law of 185 women who had delivered "light-for-dates" and "premature expulsion" low birth weight infants was studied. Percentile birth weights were compared taking into account length of gestation, fetal sex, and the height, weight, parity, and smoking habits of the mother. Sisters of women who had delivered light-for-dates babies had lighter babies than the general population, their sisters-in-law, or the sisters of women in the premature expulsion group. These other groups, however, had the expected distribution of percentile birth weights. Data on familial trends in smoking habits and unknown gestation are also presented. The results are consistent with the theory that the mother's own intrauterine experience affects her reproductive performance but could also be explained by shared family learning experience of as yet unidentified microsocial factors related to pregnancy performance.

Birth Weight↗