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Biomedical subjects

G E Urquhart

Publications and source records attributed to G E Urquhart.

At least 19 recordsLinked to original sources
PubMed1993

Ophthalmic disease in patients with unrecognized HIV infection.

HIV disease has a long and relatively asymptomatic incubation period before the onset of AIDS. The ophthalmic manifestations of AIDS are well recognized. Little is known of the incidence or range of ophthalmic disease seen in the latent period of HIV disease. A retrospective analysis of 125 case notes of HIV 1 antibody positive patients was undertaken. Of these, 15 (12%) had previously attended the ophthalmic department, at which stage their HIV status was unknown. Eight patients were diagnosed as being HIV positive within twelve months of attending the ophthalmic department. There was a predominance of ophthalmic infections, as opposed to trauma which is the commonest cause for ophthalmic casualty referral. Some of the ophthalmic presentations seen were the initial presenting sign of HIV disease. There were also cases of serious trauma and a mixture of other ophthalmic diseases. We discuss these ophthalmic findings and their relevance to HIV disease.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Prevalence of HIV among childbearing women and women having termination of pregnancy: multidisciplinary steering group study.

OBJECTIVE: To determine the prevalence of HIV among pregnant women, in particular those whose behaviour or that of their partners put them at "low risk" of infection. DESIGN: Voluntary named or anonymous HIV testing of pregnant women during 21 months (November 1988 to July 1990). SUBJECTS AND SETTING: All women who planned to continue their pregnancy and attended clinics serving the antenatal populations of Edinburgh and Dundee. All women admitted for termination of pregnancy to gynaecology wards serving the pregnant populations of Dundee and outlying rural areas. MAIN OUTCOME MEASURES: Period prevalence of HIV antibody positivity. RESULTS: 91% of antenatal clinic attenders and 97% of women having termination of pregnancy agreed to HIV testing on a named or anonymous basis. HIV period prevalences for antenatal clinic attenders and women having termination of pregnancy tested in Dundee were 0.13% and 0.85% respectively, and for antenatal clinic attenders tested in Edinburgh 0.26%. For those at "low risk" rates for antenatal clinic attenders and women having termination of pregnancy in Dundee were 0.11% and 0.13%, and for antenatal clinic attenders in Edinburgh 0.02%. In Dundee HIV prevalence among women having a termination of pregnancy (0.85%) was significantly greater than that among antenatal clinic attenders (0.13%). CONCLUSIONS: HIV infection is undoubtedly occurring among women at "low risk," and it is clear that a policy of selective testing of those at only "high risk" is inadequate for pregnant women living in areas of high prevalence such as Edinburgh and Dundee. Moreover, when studying pregnant populations in such areas there is the need to include those having a termination of pregnancy.

Abortion, Induced↗
PubMed1990

Prevalence of HIV antibody and pregnancy in Tayside, 1984-9: background to screening.

OBJECTIVE: To determine age specific prevalence of HIV antibody, incidence of pregnancy, and likelihood of detection and correct assignment to risk category by antenatal screening of women known to be positive for HIV antibody, from 1984 to 1989. DESIGN: Retrospective analysis of reproductive history and risk behaviour of women positive for HIV antibody and prediction of detection by screening on the basis of blood group samples, Guthrie tests, and rubella tests. SETTING: City of Dundee, where the prevalence of HIV is high, since the appearance of HIV in 1984, predominantly among heterosexual intravenous drug users. PATIENTS: All (61) women known to be positive for HIV antibody who had had clinically indicated tests, for whom case notes were available for 60. MAIN OUTCOME MEASURES: Risk assessment according to case notes and reported to the laboratory, incidence of infection, geographical location, age, date of positive test result, and reproductive history. RESULTS: With 61 infected women the overall minimum prevalence among women within the city of Dundee was 0.67/1000 and 2.9/1000 among women in their third decade. Of the 60 women whose reproductive history was available, 35 had 57 pregnancies, 36 of which occurred after seroconversion was known to have taken place, representing 8.7% of the total number of affected pregnancies reported for the United Kingdom. If antenatal screening for HIV had been performed between 1984 and 1989 it could not have detected positivity for HIV antibody in 25 (42%) women who had no pregnancies during this time. Among the remaining 35 women, screening samples taken for blood grouping could have identified a maximum of 34 (57%), samples taken to check rubella susceptibility a maximum of 22 (37%), and blood spots on Guthrie cards a maximum of 19 (32%). Retesting would have occurred in 14 women 33 times with samples taken for blood grouping, but three and four women would have been tested twice using samples taken for rubella testing and Guthrie cards respectively. Anonymous screening would have been unable to determine risk category as a history of intravenous drug use was known in 47 (79%) women before testing but this was increased by a further 5 (8%) who admitted to it after the test result was known. CONCLUSION: Interpreting the results of antenatal screening programmes will be complex and will underestimate overall prevalence of HIV antibody among women; this will be exaggerated by strategies based on anonymous testing with Guthrie cards or on samples taken for rubella testing, which do not include women who have had an earlier loss of pregnancy. Only open testing with consent will permit satisfactory attribution to

Acquired Immunodeficiency Syndrome↗
PubMed1989

Eight year study of viral isolates from cot deaths in Glasgow.

Over an eight year period 21 different viral strains excluding polioviruses were isolated in 44 (19%) of 237 cot deaths. The percentage of viral positive cases was significantly greater in over 16 week age groups and in cultures obtained less than 24 hours after death.

Age Factors↗
PubMed1987

Unresponsiveness to skin testing with bacterial antigens in patients with haemophilia A not apparently infected with human immunodeficiency virus (HIV).

Unresponsiveness to skin testing with PPD and tetanus toxoid was commonly seen in patients with haemophilia A but not infected with human immunodeficiency virus but was uncommon in controls. Vaccination history indicated that the unresponsive patients had not been immunised in childhood. Other tests of immune competence (skin tests with other antigens, lymphocyte stimulation with mitogens and antigens, and viral serology) showed that the haemophilia A patients had an adequate response to pathogens to which they had been exposed. Five of 12 such patients had a mild T4 lymphopenia, and this may have been related to parenteral administration of large quantities of protein.

Adolescent↗
PubMed1985

Rubella: immunity and vaccination in schoolgirls.

Of 191 schoolgirls, 128 volunteered to take part in a feasibility study of serotesting before and after rubella vaccination, and all responded to RA 27/3 vaccine. Had the serum samples been taken by a fingerprick method the number of volunteers would probably have increased considerably. A change in policy for rubella vaccination to testing both before and after vaccination would cost no more than the existing policy, would ensure primary response, and would differentiate those women who were protected by the vaccine from those with antibody to wild virus.

Adolescent↗
PubMed1984

A survey of coxsackie A16 virus antibodies in human sera.

A comparison of neutralizing and immunofluorescent (IF) IgG antibody tests in 18 sera from 10 cases of hand, foot and mouth disease (HFMD) showed a variety of responses but all sera taken more than one week after infection had both neutralizing and IF IgG antibodies. A survey of IF IgG antibody in 80 paediatric and 80 adult non-HFMD case sera gave antibody detection rates of 47.5% and 11.3% respectively. This difference could be attributed to a decline in IF IgG antibody with time after infection. Three point nine per cent of 26 sera from possible adult carditis cases had IF antibody suggesting that coxsackie A16 virus was not a common cause of adult carditis. Forty-eight point three per cent of 29 sera from cases of spontaneous abortion had detectable IF antibody, a rate similar to the paediatric sera and significantly greater than that in adult male (7.9%) and other adult female (13%) sera tested. This interesting observation requires further study.

Abortion, Spontaneous↗
PubMed1982

Effect of rubella vaccination programme in schools on rubella immunity in a general practice population.

Between November 1979 and January 1980 all patients aged 13-21 years who attended a general practice in Glasgow were tested for their immunity against rubella (single radial haemolysis test). All of the women in the sample should have been vaccinated at 13 as part of the rubella vaccination programme, which began in Glasgow in 1971. The programme excludes boys. Of the 77 females and 64 male patients studied, nine (11.7%) and 10 (15.6%), respectively, were susceptible to the infection. For only 34 women was evidence of vaccination documented in the practice records, and three of those either had failed to seroconvert or had antibody below detectable values. Overall there was no significant differences between the proportion of men and women who were susceptible to the disease. The rubella vaccination programme had clearly failed to reduce the number of susceptible women in this practice. Hence the immune state of all girls should be checked at about 15 years of age, so that as many as possible may be rendered immune before they leave school.

Adolescent↗
PubMed1978

Trial of high-titre human rubella immunoglobulin.

To test the efficacy of passive antibody for protecting susceptible pregnant women who have been exposed to rubella high-titre human rubella immunoglobulin (HRI) was given to 20 seronegative male adult volunteers simultaneously with rubella vaccine. After receiving the intramuscular injections of HRI (750 mg of IgG) and vaccine (10(3 . 92) median tissue culture dose, Wistar RA27/3 subcutaneously) eight of the 20 volunteers failed to show seroconversion. Antibody responses--and thus presumably viraemia--in the remaining 12 volunteers were delayed and reduced when compared with those in 19 volunteers given the vaccine alone. No significant responses occurred in volunteers given only HRI. We conclude that HRI may be of value for seronegative pregnant women who come into contact with clinical rubella, particularly when termination is likely to be refused.

Antibodies, Viral↗