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Biomedical subjects

H Maguire

Publications and source records attributed to H Maguire.

At least 37 records · Page 2Linked to original sources
PubMed1998

Effects of resorbable membrane placement and human osteogenic protein-1 on hard tissue healing after periradicular surgery in cats.

Periradicular surgeries were performed on the maxillary cuspid teeth of twelve cats. Before reapproximation of the surgical flaps, eight of the osteotomies were covered with a resorbable membrane and eight were filled with human osteogenic protein-1 (hOP-1) on a collagen carrier. The remaining eight sites received no further treatment and served as controls. The animals were euthanized after 12 wk, and the specimens were examined histomorphometrically for the presence or absence of osseous regeneration, inflammation, and cementum formation on the root ends. The results showed that the sites treated with the membrane exhibited significantly more inflammation adjacent to the resected root ends (p < 0.05), and that the use of the membrane had no statistically significant effect on osseous healing or new cementum formation. The use of hOP-1 was associated with a significant decrease in the thickness of new cementum formed on the resected root ends (p < 0.05), but had no statistically significant effect on osseous healing or degree of inflammation. Based on these results, it seems that neither the use of hOP-1 nor resorbable membranes have a positive effect on periradicular tissue healing in endodontic surgery.

Absorbable Implants↗
PubMed1998

Predominant enteroviral serotypes causing meningitis.

All enteroviral reports to the Public Health Laboratory Service from 1975 to 1994 which had been proved by culture were analysed. Of the 40,366 isolates, 5741 reports (14%) were from cultures of cerebrospinal fluid. The groups and serotypes accounting for the largest number of cerebrospinal fluid isolates were A9, E7, E9, E11, E19, and E30, accounting for 70% of all cultured isolates of cerebrospinal fluid. It may be possible to prevent most cases of viral meningitis in the UK with the development of an enteroviral vaccine.

Adolescent↗
PubMed1998

Is food poisoning a clinical or a laboratory diagnosis? A survey of local authority practices in the south Thames region.

An audit of South Thames infectious disease surveillance systems in 1995 revealed large inconsistencies between the numbers of food poisoning records held on local databases and the numbers of food poisoning notifications reported to the Office for National Statistics (ONS), then called the Office of Population Censuses and Surveys. In March 1996 a questionnaire sent to each local authority in South Thames asked what action was usually taken when a laboratory report of cryptosporidium, campylobacter, salmonella, or giardia was received unsupported by a notification of food poisoning. All 51 local authorities responded to the questionnaire. Forty-eight reported salmonella to ONS, 38 reported cryptosporidium, 38 campylobacter, and 37 giardia. Some local authorities considered whether a food or water source was evident or suspected before reporting. Patterns of notification varied between geographical areas. Differences between local authorities' interpretations of the requirement to report to ONS the isolations of food poisoning organisms from patients make it difficult to analyse food poisoning statistics. We would recommend the adoption of a simple approach, in which laboratory reports and notifications are reconciled locally. A case should be reported to ONS only if the doctor who notified or arranged for an examination of stool suspected food or waterborne transmission initially.

Disease Notification↗
PubMed1997

Lone parent families are an independent risk factor for lower rates of childhood immunisation in London.

The aim of this study was to determine associations between indicators of social deprivation and the uptake of primary immunisation in London. Correlation coefficients were calculated between immunisation coverage in London for each of the 28 inner and outer London district health authorities in November 1991 and a range of possible explanatory variables from small area statistics data from the November 1991 census. The proportions of children under 5 years of age, lone parent families, unemployed members of the workforce, domestic overcrowding, ethnic minorities, and unskilled workforce were correlated significantly with the coverage of primary immunisation for third dose diphtheria (D3) and pertussis (P3) at 12 months. A significant correlation with measles, mumps, and rubella (MMR) at 24 months existed only for lone parent families. Multiple linear regression weighted by population size was used to identify independent predictors of variation in immunisation cover. The proportion of lone parent families in each district health authority was the only significant independent risk factor consistently associated with variation in immunisation coverage for D3, P3, and MMR. The proportion of lone parent families explained 42% of the variation in coverage for D3 in November 1991. This study has identified lone parenthood as an important independent risk factor in London for failure to complete immunisation.

Adult↗
PubMed1996

Outbreaks of infectious intestinal disease in schools and nurseries in England and Wales 1992 to 1994.

We present data on outbreaks of infectious intestinal disease in schools and nurseries obtained from the surveillance scheme of all general outbreaks of infectious intestinal disease in England and Wales reported to the PHLS Communicable Disease Surveillance Centre between 1992 and 1994. A minimum set of data was received for 1280 outbreaks, 95 of which (7%) arose in schools and nurseries. The commonest pathogens were salmonellas, Shigella sonnei, and small round structured viruses. The mode of transmission was described as mainly from person to person in 55 outbreaks and mainly foodborne in 30. The mean attack rate was 30% and median duration was 10 days. The attack rate and duration varied with the pathogen involved. Forty-five of the 3118 people reported to have been ill were admitted to hospital. Outbreaks in schools and nurseries are common. Attack rates are high and such outbreaks are often prolonged. Effective infection control policies and appropriate training of staff are needed. Good local systems for surveillance can help identify outbreaks quickly and allow control measures to be applied early.

Adolescent↗
PubMed1996

Methicillin-resistant Staphylococcus aureus: investigation of a hospital outbreak using a case-control study.

A retrospective case-control study of 50 MRSA-positive patients was carried out during an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) at an acute general hospital in London. Controls were randomly selected from MRSA-negative patients admitted during the outbreak period. Risk factors investigated included length of admission prior to screening, number of ward changes, main diagnosis, extent of staff contact, pressure sores, surgical and other invasive procedures and antibiotic treatment. Outcome variables examined were rates of infection (versus colonization) with MRSA and mortality. Patients with MRSA were in hospital longer before microbiological specimens were taken and moved wards more often than controls. In a logistic regression analysis, length of stay in hospital, pressure sores, physiotherapy and surgical procedures were associated with a significantly increased risk of acquiring MRSA. Odds ratios (and 95% confidence intervals) for having acquired MRSA were: 8.3 (1.02-71.43) if a patient had pressure sores; 3.7 (1.10-12.5) if they received physiotherapy; and 3.2 (1.82-10.0) if they underwent surgical procedures. The rate of clinical infection amongst patients with this strain of MRSA was 26% and included life-threatening infections such as septicaemia, underlining the potential virulence of MRSA. Surgery and physiotherapy may have been markers of debility. Physiotherapy was probably a marker of increased rates of contact with all hospital staff, and high standards of hand hygiene should be promoted amongst all staff as the most important factor in controlling an outbreak of MRSA. Good bed management is essential for hospital infection control.

Aged↗
PubMed1995

Tuberculosis in London: a review, and an account of the work of the London Consultants in Communicable Disease Control Group Working Party.

Tuberculosis (TB) has been recorded in London for centuries but reports have declined over the last 100 years, with a 10-fold decrease between 1948 and 1987. However, from 1987-1993 notifications of TB in London rose by 34%, compared with 15% nationally. This rise, together with concerns about undernotification and the emergence of multi-drug resistance in New York, led to establishment of a London Consultants in Communicable Disease Control Working Party on TB to review current surveillance data. Notifications to the Office of Population Censuses and Surveys from the London Boroughs declined by approximately 6.5% per year from 1982-1987. If this had continued until 1993 there would have been 3579 fewer notifications than actually received. The proportion of cases in the 15-44 age group rose markedly in males. The proportion of notifications in those aged 65 and above was higher in the Thames Regions outside London, where the total TB notifications declined by 3.5% over the same period. Recommendations were made to improve TB surveillance in London; and a city-wide surveillance function was established in 1994 to collate and monitor data on TB.

Adolescent↗
PubMed1995

Neuromuscular complications of bone marrow transplantation.

Six children are reported with neuromuscular complications of allogenic bone marrow transplantation. Myositis occurred in 4, chronic inflammatory demyelinating neuropathy in 1, and myasthenia gravis in 1. Chronic graft-versus-host disease was present in 3. The onset following bone marrow transplant may be delayed.

Biopsy↗
PubMed1994

Piccadilly Circus legionnaires' disease outbreak.

BACKGROUND: An outbreak of legionnaires' disease occurred in central London in January and February 1989. An Infection Control Committee was established to investigate the outbreak and institute control measures. The objective of this paper is to describe the investigation and control of the outbreak. METHODS: An epidemiological survey and case-control study were carried out. The subjects were cases of community acquired pneumonia associated with central London with onset of illness in January and February 1989. RESULTS: Thirty-three confirmed cases, including five deaths, and ten suspected cases, including three deaths, were identified with dates of onset from 1 January to 11 February. A clustering of visits by cases to the vicinity of Piccadilly Circus was noted, and a case-control study demonstrated a strong association between illness and visits to this area in the two weeks before onset of symptoms. The causative organism, Legionella pneumophila serogroup 1, was isolated from six patients. Legionella pneumophila of the same serogroup was isolated from water samples from five wet cooling systems (cooling towers) in the area under investigation, but in only two systems was the organism indistinguishable by subtyping from the patients' strains. Many of the cooling towers examined were inadequately maintained, including one of the two above a building adjacent to Piccadilly Circus from which a strain indistinguishable from the outbreak strain was isolated. All cooling towers in the area were shut down until inspected, and only allowed to restart after appropriate maintenance had been instigated. CONCLUSIONS: This outbreak showed the continuing risk of legionnaires' disease posed by wet cooling systems, including cooling towers, and highlighted the need to assess this risk so that appropriate maintenance is carried out. Regulations have recently been introduced, under the Health and Safety at Work Act, requiring notification of all wet cooling systems to the local authority to facilitate the investigation of outbreaks of legionnaires' disease.

Adolescent↗
PubMed1993

A multidisciplinary investigation of a cluster of deaths on a paediatric intensive care unit.

During late December 1989 and early January 1990, a cluster of six unexplained deaths occurred on a paediatric intensive care unit (PICU) among children with congenital heart disease who had undergone cardiac surgical procedures. The children were all aged three years or less. In each case death was preceded by an unexpected increase in ventilatory pressure requirement followed by the development of a similar pulmonary shadowing on chest radiography. The radiological abnormality was felt to be consistent with a pneumonitis associated with some small airway disease. The clustering of these deaths, occurring in a similar unusual manner, was felt to constitute an outbreak warranting investigation. An Incident Committee was established to plan and manage a large multidisciplinary investigation during which the unit was temporarily closed. Following extensive investigation no bacterium, virus, fungus or other pathogen, toxic agent, or any other explanation for the cluster of deaths could be found. The possibility that the cluster occurred by chance remains although this was felt to be unlikely.

Cause of Death↗
PubMed1993

An outbreak of Salmonella mikawasima associated with doner kebabs.

During October 1992 an increase in the number of isolates of Salmonella mikawasima, a rare serotype, was noted including a cluster of nine cases in the South West Thames region. A case control study was conducted and univariate analysis showed a statistical association between illness and eating at take-away A for cases compared with household controls (P = 0.003) and with neighbourhood controls (P = 0.0245). Cases were also more likely to have eaten kebabs than were controls or average take-away A customers, implicating doner kebabs as the most likely vehicle of infection. Plasmid profile analysis of the nine cases' isolates showed them to be indistinguishable and to be characterized by a single plasmid of approximately 60 MDa. The original source of the Salmonella mikawasima contamination was not determined, but food preparation practices for kebabs at take-away A were insufficient to protect against illness if contaminated. This outbreak was only recognized because of the unusual serotype, but could be an indication of a more widespread problem with doner kebabs.

Adolescent↗
PubMed1992

The epidemiology and control of hepatitis A.

Hepatitis A virus (HAV) infection is endemic in developing countries and remains a public health problem elsewhere. A total of 7430 cases was notified in England and Wales in 1991. Children and young adults were most frequently affected. Risk factors include travel to countries of high endemicity, contact with an infected person and shellfish consumption. Person-to-person spread is common within families, closely knit communities and schools (especially nurseries). The provision of safe water and sanitary disposal of faeces are prerequisites for control of HAV throughout the world. In developed countries, human normal immunoglobulin (HNIG) is used for post-exposure prophylaxis and is given to those travelling abroad prior to possible exposure. Recommendations for the use of hepatitis A vaccine have have recently been made but it is expensive. Further studies on risk factors for infection, and on the efficacy of hepatitis A vaccine in outbreak control, are needed.

Adolescent↗