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Biomedical subjects

J Carnie

Publications and source records attributed to J Carnie.

30 records · Page 2Linked to original sources
PubMed1997

Hepatitis B immunisation coverage of infants born to chronic carrier mothers in Victoria.

Infants born to HBsAg- (hepatitis B surface antigen) carrier mothers are highly likely to become chronic hepatitis B (HB) carriers themselves unless their status is recognised at birth and they are immunised with three doses of HB vaccine, the first within 48 hours of birth, concurrent with hepatitis B immune globulin (HBIG). This study was designed to determine how many infants born in Victoria to carrier mothers completed three doses of HB vaccine. We sent the names of all infants of HBsAg-carrier mothers notified in Victoria between 1.7.91 and 30.6.92 to the appropriate local government immunisation providers and requested information on how many doses of HB vaccine, DTP (diphtheria-tetanus-pertussis) or CDT (combined diphtheria-tetanus), and OPV (oral polio vaccine) they had received. The HBsAg-carrier prevalence of women giving birth in Victoria in 1991-92 was at least 0.52%. Of the 336 infants notified, 239 (71.1%) were recorded in local government records. Of these 239, 90.8% received at least two doses and 80.8% received at least three doses of hepatitis B vaccine. There was no significant difference in the number who received three doses of HB vaccine compared with three doses of DTP or CDT vaccine. Of the entire cohort of 336, only 57.4% were documented as being completely immunised against hepatitis B. HB immunisation coverage for these infants needs to be improved. The high rate of loss to follow-up, especially between the maternity hospital and the community, is disturbing. Mechanisms for intensive prospective follow-up of these infants should be developed to prevent loss to follow-up and to encourage full immunisation against HB. Improving HB immunisation coverage of infants in high HBsAg-prevalence ethnic groups and introduction of universal infant HB immunisation may lead to increased coverage of infants of carriers by serving as back-up mechanisms for those lost to follow-up.

Carrier State↗
PubMed1997

Immunising the population. Are we succeeding?

While diseases such as diphtheria and poliomyelitis have disappeared in this country, other vaccine preventable diseases such as measles, pertussis and rubella are quite common and result in epidemics from time to time. There are some groups in the community with particularly low coverage with specific vaccines and they need extra attention. Immunisation providers need to identify the barriers to achieving high coverage rates and adopt measures to overcome these barriers.

Adolescent↗
PubMed1993

Opposite response to starvation of Trp/LNAA ratio in lean and obese Zucker rats.

Total blood and plasma free amino acids and plasma urea levels were studied in fed and 24 h fasted Zucker rats. In fed animals there were no differences between obese and lean rats in the overall essential and non essential blood free amino acids. However, starvation reduced blood amino acid levels in the obese animals compared to the lean group, mainly due to changes in the plasma compartment. The reduction of available amino acids from plasma in the obese rats during starvation affected most of the amino acids, including the branched chain amino acids, which showed higher levels in the fed situation than in lean rats. Of particular interest is the opposite response to starvation in lean and obese Zucker rats concerning the plasma ratio of tryptophan (Trp) to the large neutral amino acids (LNAA) which could be implicated in the alteration of food intake and energy expenditure characteristic of obesity.

Amino Acids↗
PubMed1992

Influenza surveillance in general practice.

This paper describes a survey of influenza conducted in general practice from July to October 1990. The study demonstrates how interested general practitioners can be involved in community based surveillance for the early detection of influenza outbreaks.

Adolescent↗
PubMed1991

Altered blood amino acid distribution in genetically obese mice.

The present study was undertaken to determine whether the alteration in amino acid distribution between the plasma and cellular compartment of the blood, previously described in dietary-obese rats, also occurs in genetically obese mice. The blood concentration of individual amino acids and its distribution between plasma and cells of lean and genetically obese mice (ob/ob) have been measured. The results demonstrated that genetically obese mice showed a decrease (55%, P = 0.0489) of free amino acids in the blood cells. Most amino acids were affected and among the most noteworthy characteristics was the observation that the reduction in concentration was more pronounced for the total concentration of the essential amino acids which was reduced by 76% (P = 0.0112) compared to cells of lean mice. These results suggest that an altered amino acid distribution between plasma and blood cells is a consequence of both diet-induced and genetic obesities.

Amino Acids↗
PubMed1986

A pre-induction test dose for suxamethonium.

A two-part experimental and clinical study was conducted to determine the effects of administration of a pre-induction dose of suxamethonium, and to see whether the symptoms produced could form the basis of a test dose, to determine sensitivity to suxamethonium prior to administration of a full intubation dose. Suxamethonium was shown to produce distinctive clinical features characterised by signs of both extraocular muscle contraction and paresis, manifest by symptoms of eye and eyelid heaviness without generalised paresis. The dose response was determined in individuals with normal plasma cholinesterase, to a test dose of suxamethonium chloride of between 20 and 1 micrograms/kg. Individuals with abnormal plasma cholinesterase were shown to exhibit sensitivity to these low doses and were easily distinguished from those with normal enzyme. A protocol is suggested which can conveniently establish, prior to induction, those individuals with a reduced ability to hydrolyse suxamethonium.

Adolescent↗
PubMed1985

Clinical anaesthetic knowledge amongst surgical house staff.

Knowledge of common anaesthetic drugs, techniques and complications amongst junior surgical staff at a typical district general hospital is assessed. The implications for patient care are discussed and suggestions made for improved education.

Anesthesiology↗
PubMed1984

An analysis of thirty years of contributions to the British anaesthetic literature (1953-1982).

A thirty-year review of the two major British anaesthetic journals, Anaesthesia and the British Journal of Anaesthesia, was undertaken. Overseas contributors accounted for 30% of the total articles published, with North America providing the greatest proportion. The remainder of the contributions came from the United Kingdom. The British contributions were analysed for content and origin. The North West Thames Region with 9%, contributed the single largest percentage of the British articles. There was a marked difference in the Regional contributions, not invariably linked to the size of the Authority or the number of University Departments. Over the thirty-year period there was a progressive increase in the number of published articles and an increase in the proportion of overseas contributors.

Anesthesiology↗
PubMed1982

Continuous suxamethonium infusion for microlaryngeal surgery.

The suxamethonium infusion requirements to maintain a 100% neuromuscular block in patients undergoing microlaryngeal surgery were determined. Anaesthesia was maintained with halothane and the neuromuscular block monitored with a peripheral nerve stimulator delivering train-of-four stimuli. Suxamethonium requirements varied directly with time in a linear manner and the onset and recovery time of the block increased with time. No difficulties in recovery were observed when the duration of infusion was less than l h, even when the nature of the block had altered to the non-depolarizing type. A good correlation was observed between neuromuscular block as indicated by peripheral nerve stimulation and laryngeal muscle paralysis.

Adult↗
PubMed1981

Treatment of chronic heart failure with pirbuterol: acute haemodynamic responses.

Fifty-nine patients with severe chronic heart failure were given pirbuterol, a beta agonist with vasodilator and positive inotropic properties. The acute haemodynamic responses to both single (20 patients) and incremental doses (39 patients) were measured. Pirbuterol increased cardiac index and reduced left ventricular filling pressure and systemic vascular resistance with only small changes in heart rate and blood pressure. Maximal effects were observed at an average of 170 minutes after a single oral dose of pirbuterol. In the incremental dose studies the plasma pirbuterol concentration was found to increase with increasing doses and was related to the magnitude of the haemodynamic response. Pirbuterol was well tolerated, and no drug-related side effects were recorded. Oral pirbuterol clearly improved pump performance in these patients, the haemodynamic changes being consistent with vasodilatation as the dominant mechanism rather than a direct inotropic effect.

Administration, Oral↗
PubMed1981

Veno-venous extra-corporeal membrane oxygenation.

A case of post-traumatic respiratory insufficiency is presented in whom a prolonged period of veno-venous membrane oxygenation was utilised in an effort to provide life support and allow resolution of pulmonary damage. Stabilisation of respiratory function was achieved. Withdrawal of support was required because of surgical haemorrhage while the patient was fully heparinised. Respiratory function deteriorated and the patient died 4 days after discontinuing membrane oxygenation. The procedure was undertaken in the Intensive Care Unit of a District General Hospital where cardiopulmonary bypass facilities are not normally available.

Adolescent↗