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Biomedical subjects

J Dearlove

Publications and source records attributed to J Dearlove.

At least 19 recordsLinked to original sources
PubMed1999

A controlled trial of parent initiated and conventional preschool health surveillance using personal child health records.

OBJECTIVES: A comparison of parent initiated preschool surveillance, using personal child health records, with the then current system of child health surveillance using child health records. DESIGN: Prospective, controlled trial with randomisation of five general practices into two groups. SETTING: Five general practices, a well baby clinic, and an orthoptic clinic at Yeovil District Hospital. SUBJECTS: 538 babies born between 1 April 1992 and 1 November 1994, from within the five general practices. MAIN OUTCOME MEASURES: The number of screenable abnormalities in the two groups that were missed in the first 3 years of a baby's life. RESULTS: 163 babies from the parent initiated preschool surveillance group and 107 from the conventional group completed the study. Although all the mothers from the parent initiated preschool surveillance group understood the concept of parent initiated surveillance, 117 stated their health visitor had made their appointments. Only 45 mothers made their own appointments. The abnormality rates were: 12 of 163 and eight of 107 at 1 year and nine of 163 and six of 107 at 3 years. No medically important conditions were missed. Most mothers did not want to make their own appointments because it was inconvenient. The system was unpopular with health visitors. CONCLUSION: Parent initiated preschool surveillance is as safe as the current system. Implementing the idea involved a small change in work practice and a large change conceptually for some of the primary health care team. It was not adopted in east Somerset.

Appointments and Schedules↗
PubMed1992

Thiamin and vitamin B6 intakes and erythrocyte transketolase and aminotransferase activities in morbidly obese females before and after gastroplasty.

To assess the need for postoperative vitamin supplements, intakes and nutritional status of thiamin (B1) and vitamin B6 were studied in 18 female gastroplasty patients who received a placebo or different levels of supplemental vitamins. Postoperative erythrocyte transketolase basal (BA) and thiamin pyrophosphate-stimulated (SA) activities and activity coefficients (AC) correlated significantly with B1 intake. Despite a decrease in apotransketolase, low thiamin intakes were associated with increased AC values during the first 3 months. With return to low B1 intakes following repletion during month 4, the AC values remained normal with low total activities. Both alanine (EALT) and aspartate (EAST) aminotransferase apoenzyme levels declined and AC values increased significantly during the first 3 months. Although the EALT-indices were more sensitive to changes in B6 intake than the EAST-indices, the EASTBA and SA correlated most consistently with the intake. Postoperative dietary intakes of both vitamins were inadequate for maintenance of normal activities of these erythrocyte enzymes. Although B1 intake of greater than or equal to 1.0 mg/day was adequate for maintenance of normal thiamin status in most subjects of this study, supplementation with greater than or equal to 1.5 mg/day is prudent even though it may not prevent the early postoperative loss of apotransketolase. Vitamin B6 intake at the current recommended dietary allowance (1.6 mg) was not adequate to maintain coenzyme saturation of the erythrocyte aminotransferases. Marginal intake of other nutrients may have affected the utilization of both thiamin and vitamin B6.

Adult↗
PubMed1990

How good is general practice developmental screening?

All developmental screening in Somerset is performed by general practitioners and health visitors. A retrospective review of a cohort of 1504 7 year old children living in semirural Somerset found that the development assessment by a health visitor at age 3 1/2 years had a sensitivity of 45% for identifying the 103 children with special educational needs, whereas the sensitivity of the preschool examination by a general practitioner was 56%. There was no relation between results of preschool developmental assessment and later reading ability. Of the 23 children in special schools, 22 had been identified independently of the developmental screening programme before starting school. Intervention was started at a mean age of 1 year 5 months (range 2 months to 3 years) for children with severe learning difficulties, and 3 years 9 months (2 years 3 months to 6 years 6 months) for children with moderate learning difficulties. The preschool medical examination revealed fairly minor medical problems: 29 of 81 children referred for specialist opinions were shown to be medically normal, and for only seven of the medically abnormal children was information about their conditions given to their teachers. In Somerset screening the development of all children at predetermined ages has not been very useful.

Age Factors↗
PubMed1990

Riboflavin intakes and status of morbidly obese females during the first postoperative year following gastroplasty.

Eighteen women participated in a prospective study to assess the need for supplemental riboflavin after gastroplasty. Three groups of five patients received either a placebo or 0.6 or 1.2 mg riboflavin daily for up to 12 months, except during months 4 and 7 when all participants were given a "one-a-day" supplement containing 1.7 mg riboflavin. Dietary intakes of riboflavin decreased from 1.43 +/- 0.17 mg before the operation to 0.70 +/- 0.07 mg at 3 months, and then increased to 1.02 +/- 0.17 mg by 6 months. Even at 12 months, only 33% of the subjects had dietary intakes greater than or equal to 1.2 mg. All those with total intakes less than or equal to 1.7 mg at 3 months had impaired riboflavin status, as indicated by an erythrocyte gluthatione reductase activity coefficient greater than 1.40 and an erythrocyte riboflavin concentration less than 372 nmol/L. In contrast, 62% of the same subjects had urinary riboflavin excretion in the acceptable range. Supplemental intake of 1.7 mg riboflavin appeared to prevent tissue depletion in all subjects.

Adult↗
PubMed1988

Retinal/macular pigmentation in conjunction with ring 14 chromosome.

A number of constant features can be ascribed to patients who have a ring 14 chromosome. Recent publications have described pigmentation of the retinal/macular area of the eye and suggested that it may also be a constant feature of the syndrome. We describe a patient who has a ring 14 with a terminal deletion but no retinal pigmentation and compare our case with other informative cases. We suggest that a region on chromosome 14 proximal to q32.2 may be involved in controlling these changes.

Child, Preschool↗
PubMed1988

Endoscopic measurement of gastric mucosal blood flow by laser Doppler velocimetry: effect of chronic esophageal variceal sclerosis.

A technique of endoscopic measurement of gastric mucosal blood flow using laser Doppler velocimetry was described. The technique was validated in the laboratory by performing endoscopic measurement of gastric mucosal blood flow in the dog simultaneously with application of a second probe at open operation, utilizing the same laser Doppler flowmeter. Probe pressure causing minor dimpling (less than 20 gm/cm2) was found to cause insignificant alteration of mucosal blood flow. Criteria were developed to aid separation of artifacts introduced by probe motion. A conversion factor was established for converting the readout of the instrument (Hertz x 10(2] into ml/100g/min by synchronously measuring mucosal blood flow by hydrogen gas clearance technique and laser Doppler velocimetry in the gastric and duodenal mucosa. In patients with portal hypertension gastric mucosal blood flow was determined before and after sclerotherapy, and compared to the gastric mucosal blood flow in subjects without portal hypertension. Gastric mucosal blood flow was elevated in portal hypertensives, but sclerotherapy did not appear to cause changes in blood flow. Endoscopic mucosal blood flow measurement is non-invasive, practical and of potential value in clinical investigation of gastrointestinal pathophysiology.

Animals↗
PubMed1988

The sources of recurrent hemorrhage during long-term sclerotherapy.

The sources of recurrent hemorrhage during long-term sclerotherapy undertaken by a single surgeon were studied prospectively in a consecutive series of 53 patients for a period of 2 to 6 years. Recurrent hemorrhage, defined as upper gastrointestinal bleeding requiring transfusion or hospitalization or both, in the course of chronic sclerotherapy was investigated aggressively by means of endoscopy and the findings archived with videotape recording. In 24 patients 51 episodes of recurrent hemorrhage developed in the entire series. On the basis of endoscopic findings and serial comparison of videotape recordings, the most common source of recurrent hemorrhage was the original varices, which accounted for rebleeding in 18 patients. The risk of such bleeding was highest in the first month, diminishing thereafter until total variceal eradication. Rebleeding after eradication of varices was always from sources other than varices, as regenerated vessels were small and infrequent and never the source of bleeding. Continued sclerotherapy ultimately achieved total variceal eradication in 15 of 18 patients with variceal rebleeding. Sclerotherapy alone was successful in eradicating all varices in a total of 38 patients in this series, the mean time required being 13 +/- 4.1 months. Rebleeding from sources not amenable to sclerotherapy was treated with porto-azygos disconnection (6 patients) or distal splenorenal shunts (3 patients). There were 12 deaths: four attributed to hemorrhage (3 after surgery), five from liver failure, and three late deaths from causes not due to liver disease. Recurrent hemorrhage per se during the course of sclerotherapy may not be taken as a sign of treatment failure but must be vigorously investigated, since findings profoundly affect management and outcome.

Blood Transfusion↗
PubMed1983

Clinical range of neonatal rotavirus gastroenteritis.

A baby admitted to a special care baby unit with profuse watery diarrhoea was found to have a rotavirus infection. A total of 196 babies were admitted to the unit over the next year. Routine stool samples were taken weekly from all babies and additional samples were taken from all babies who developed clinical signs suggesting sepsis. A total of 76 babies excreted rotavirus; 32 of these developed a diarrhoeal illness, 12 of whom were severely ill with bloody diarrhoea and abdominal distension; and two had perforations. The smaller, sicker babies who stayed in hospital longer were more likely to acquire infection; colostrum did not confer protection against rotavirus or symptomatic infection. The outbreak of rotavirus declined independently of the measures taken to eradicate it. Our findings suggest that neonatal rotavirus infection may occasionally cause severe gastrointestinal problems.

Cross Infection↗
PubMed1982

Ignoring the obvious: doctors' wives as patients.

There is a widely held belief among doctors and nurses that when a colleague is in hospital, if anything can go wrong during the course of his illness it invariably will. To investigate this belief, we studied prospectively a group of pregnant doctors and doctors' wives, comparing the number of obstetric, paediatric, and psychiatric complications with those in two control groups of similar social class, race, and parity. These were teachers and lecturers and a group of State registered nurses. The occurrence of obstetric and paediatric problems was similar in the three groups. Psychiatric problems, however, were more common among teachers and lecturers (p less than 0.001); this difference was due to the way the nurses on the postnatal wards failed to report mild psychiatric problems among doctors' wives to their colleagues. This difference was not related to the amount of preferential treatment that doctors and doctors' wives received while in hospital.

England↗
PubMedDate not supplied

An anachronistic treatment for asthma.

Dry cupping is an ancient practice that died out in England over a hundred years ago. In certain cultures it survives and if not recognised can lead to a little diagnostic confusion.

Adolescent↗