Search PubMed⌕ Search

Biomedical subjects

G Hogg

Publications and source records attributed to G Hogg.

28 records · Page 2Linked to original sources
PubMed1996

Acyclovir for the prevention and treatment of varicella zoster in children, adolescents and pregnancy.

Varicella causes a mild, self-limiting childhood disease that may reactivate years later as shingles. In immunocompromised patients with altered cell mediated immunity, and rarely in healthy individuals, varicella results in a life-threatening infection. The antiviral drug, acyclovir, substantially reduces the mortality and risk of severe disease in these groups of patients. Early commencement of acyclovir is recommended for children with both varicella and altered cell mediated immunity, newborns during the first 2 weeks of life, preterm infants in the neonatal nursery, and severe varicella or shingles (including ocular zoster) in any patient, as well as during pregnancy. Acyclovir may be considered in children with serious cardiopulmonary disease or chronic skin disorders where varicella may exacerbate the underlying disease or increase the risk of secondary bacterial sepsis. Acyclovir, however, is not recommended for healthy individuals without severe disease, as a prophylactic agent against varicella, for asthmatics receiving aerosolized or low-dose oral steroids and/or as treatment of the post-varicella syndromes. When acyclovir is prescribed it should be given intravenously to those with severe disease, those at risk of dissemination and in children younger than 2 years of age.

Acyclovir↗
PubMed1995

Increasing severity of invasive group A streptococcal disease in Australia: clinical and molecular epidemiological features and identification of a new virulent M-nontypeable clone.

We conducted a 12-year review of all cases of group A streptococcal (GAS) bacteremia that were seen at Royal Children's Hospital in Melbourne, Australia, from 1982 through 1993. Forty-two cases were identified. There was a trend towards increased incidence of infections, as well as a clear increase in their severity, during the study period; more previously healthy children were affected during the last 6 years of the study (80% of cases) than during the first 6 years (47% of cases), and more complications occurred during the latter period than during the former (40% vs. 20%, respectively, with an 88% complication rate over the last 12 months). Seventy-four GAS isolates (41 invasive, 23 noninvasive, and 10 indeterminate) were analyzed. An M type 1 clone that was positive for the pyrogenic exotoxin A gene (speA) and that has been found to cause invasive disease in the Northern Hemisphere was most frequent among invasive isolates. Molecular typing also identified a genetically distinct strain that was virulent, mucoid, and M nontypable. Invasive GAS disease in Melbourne has become increasingly aggressive. Newer typing methods should be used in conjunction with traditional serotyping in order to maintain epidemiological surveillance of virulent strains.

Adolescent↗
PubMed1994

Slim pickings.

Explore the source record for details and available documents.

Community Participation↗
PubMed1994

Competing for patients: understanding consumer evaluation of primary care.

The introduction of a competitive market into primary care means that general practitioners must consider the way in which their patients evaluate the service which they receive. Reports the results of an exploratory study carried out in Scotland to investigate the evaluative strategies used by patients in assessing the service they receive. Identifies six particular dimensions of the care process which have implications for GPs protecting their existing patient lists and in understanding how to attract new patients. Suggests through its results that while communicating certain features of the service to potential patients is relatively straightforward, the experiential nature of primary care services leads to a reliance on word-of-mouth communication which depends on ensuring that existing patients are satisfied.

Economic Competition↗
PubMed1994

Surveillance for Bordetella pertussis infection in Victoria.

Our aims were to describe the epidemiology of Bordetella pertussis infection in Victoria during the last decade and to evaluate surveillance of B. pertussis by comparing notifications with laboratory isolations and hospital diagnoses. Whooping cough was once a leading cause of childhood morbidity and mortality but there was a dramatic reduction in the 1940s because of immunisation. During the last two decades, controversy about the vaccine's toxicity has resulted in waning immunisation rates and outbreaks of the disease. The notification system in Victoria has undergone changes which make interpretation of surveillance data difficult. We compared notifications of B. pertussis with laboratory data from the Royal Children's Hospital and hospital separations with B. pertussis from all hospitals in Victoria. The latter sources revealed epidemic years of infection in 1982, 1985 and 1989. This was not apparent from notifications alone and highlights the importance of using multiple sources of surveillance data. We also found a higher rate of notification from Geelong than rural Victoria and metropolitan Melbourne. The fluctuating incidence of B. pertussis infection in the last decade may reflect changing immunisation practices. Unfounded fears that pertussis vaccine causes serious neurological sequelae have inappropriately influenced individual practice and legislation. The increased notification of B. pertussis in the early 1980s may have reflected the omission of the fourth dose of pertussis vaccine from the Australian schedule in 1979. Surveillance data should be used not only for descriptive epidemiology, but for public health action, and efforts should be made to ensure that immunisation rates remain high.

Child↗
PubMed1994

Uninformed choice.

The United Kingdom recently reformed its health service to promote consumer choice of a provider. The authors investigate the evaluative strategies patients use for their present primary care provider as a precursor to determining future choice criteria. However, this information has only limited value since health care providers still cannot market their services. The policy changes have introduced structural reforms but are not addressing some of the practical constraints to choice in this market.

Choice Behavior↗
PubMed1992

Mucormycosis of the neonatal gut: a "new" disease or a variant of necrotizing enterocolitis?

Mucormycosis is an opportunistic infection that has been mainly described in adults with preexisting disease affecting immune status, eg, diabetes, leukemia, lymphoma, and renal failure on peritoneal dialysis. Few cases have been described in neonates. The presentation of mucormycosis as a cause of neonatal necrotizing enterocolitis is an unusual phenomenon. Three fatal cases of mucormycosis of the gut in premature infants in the period 1990 to 1991 are described. It is not clear whether this should be considered a separate disease or a variant of necrotizing enterocolitis. All three patients died soon after laparotomy from septic shock and the histological diagnosis of mucormycosis was made too late for effective chemotherapy.

Enterocolitis↗
PubMed1992

Insulin resistance, diabetes, and risk markers for ischaemic heart disease in Asian men and non-Asian in Bradford.

OBJECTIVE: To examine the hypothesis, in a community not studied before, that insulin resistance associated with centralised adiposity is the mechanism underlying the predisposition of Asian immigrant communities to both ischaemic heart disease and diabetes mellitus. DESIGN: Cross sectional study within one socioeconomic stratum. SETTING: Two factories in the textile sector in Bradford, West Yorkshire. SUBJECTS: Male manual workers of Asian (110) and non-Asian origin (156) aged 20-65 years. RESULTS: Diabetes was almost three times more prevalent in the Asian group. Two hours after an oral glucose load Asian men had double the serum insulin concentrations of non-Asian men (p < 0.0001). Asian men also had significantly lower concentrations of plasma total cholesterol (p < 0.03), high density lipoprotein cholesterol (HDL) (HDL2, p < 0.0001; HDL3, p < 0.0001), and apolipoprotein AI (p < 0.0001). Fasting plasma triglyceride concentrations were slightly higher (p = 0.072) in the Asian men; thus the ratio of triglyceride cholesterol was higher (p = 0.006). The inter-relation between serum insulin and plasma lipid concentrations indicated metabolic differences between the ethnic groups. Insulin concentrations were associated with cholesterol concentrations in the Asian men only and there was a lack of association between triglyceride, low density lipoprotein cholesterol, and HDL cholesterol in this group. The risk marker profile in the Asian men was therefore quite different to that of their non-Asian counterparts and was associated with a greater tendency to centralised adiposity. CONCLUSION: These data support the insulin resistance hypothesis and thus have important implications for strategies for the prevention of heart disease in Asian communities in the United Kingdom.

Adult↗