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Biomedical subjects

J M Parkin

Publications and source records attributed to J M Parkin.

At least 19 recordsLinked to original sources
PubMed1991

Insulin dependent diabetes in childhood and material deprivation in northern England, 1977-86.

OBJECTIVE: To determine the incidence of insulin dependent diabetes in the Northern region of England in children less than 16 years old in the period 1977 to 1986 and to relate the incidence data to an index of deprivation. DESIGN: Retrospective analysis of hospital case records identified from the regional health authority's computer; validation of the primary source with hospital clinic registers and community paediatric registers. SETTING: Northern region, excluding South Cumbria District Health Authority (659,300 children under 16 in 1981). PATIENTS: All children diagnosed with insulin dependent diabetes before the age of 16 and resident in the region at time of diagnosis. MAIN OUTCOME MEASURES: Incidence rates for the 10 year period and analysis of incidence rates within categories of deprivation. RESULTS: 919 incident cases were identified. The validation procedure covered 54% of all cases identified and gave 95% completeness of ascertainment. The average annual incidence over the 10 year period was 14.8/100,000 for girls and 13.4/100,000 for boys. The annual incidence for the most and least deprived areas of the region was 18.7/100,000 (95% confidence interval 16.2 to 21.5) for boys and 7/100,000 (5.6 to 8.8) for girls. There was a highly significant trend (p less than 0.001) of decreasing incidence with decreasing level of deprivation. CONCLUSIONS: In the north of England the incidence of childhood diabetes is related to material deprivation.

Adolescent↗
PubMed1991

Defective Candida opsonin and procidin function in patients with recurrent pyogenic infection: a common immunodeficiency.

Polymorphonuclear cell function tests were performed in 340 patients with recurrent unexplained infections. Serum-dependent defects in phagocytosis and intracellular killing of Candida albicans (Candida opsonin and procidin defects) were specifically associated with susceptibility to recurrent pyogenic infections, Candida opsonin defects occurring in 12.7% and Candida procidin defects in 20.8% of patients compared with 3.7% of healthy controls. Saccharomyces cerevisiae opsonin deficiencies were also found frequently in patients with recurrent infections, being present in 18.2% compared with 7.4% controls, although not specifically in those with pyogenic infection.

Adolescent↗
PubMed1990

Recognising failure to thrive in early childhood.

The maximum weight centile achieved by a child between 4 and 8 weeks of age was found to be a better predictor of the centile at 12 months than the birth weight centile. Children whose weight deviated two or more major centiles below this maximum weight centile for a month or more showed significant anthropometric differences during the second year of life from those who showed no such deviation. It is suggested that this leads to a logical and practical definition of failure to thrive.

Aging↗
PubMed1990

Performance appraisal and career counselling for senior house officers.

A pilot scheme of appraisal and career counselling for senior house officers (SHOs) in the Northern region has been undertaken. There were two sets of guidelines for the conduct of these interviews, one was a list of topics and the other a modification of the Manchester rating scale. All appraisal interviews were evaluated separately by the participating SHOs and consultants. There was strong concordance between these evaluations irrespective of the format chosen. Almost all participants considered that the interviews were useful, resulted in a fair assessment of performance, and fulfilled the stated aims of the scheme.

Attitude of Health Personnel↗
PubMed1989

Cytomegalovirus and the acquired immunodeficiency syndrome.

The acquired immunodeficiency syndrome (AIDS) is complex in nature with one major aetiological factor but with numerous other agents exploiting the immune incompetence. Cytomegaloviruses (CMV) form a little-defined group of viruses which naturally persist in man and respond readily to the relaxation in immune surveillance. A role for CMV and other herpesviruses in potentiating the underlying infection with human immune deficiency virus (HIV) cannot be totally excluded but CMV is well established as a major opportunist in AIDS. They are considered responsible for a range of diseases in AIDS patients including retinitis, gastrointestinal disease, pneumonitis and, less frequently, encephalitis. The pyrophosphate analogue foscarnet (phosphonoformate) and the deoxyguanosine analogue ganciclovir have both been used to treat CMV infections in AIDS patients. Results of uncontrolled studies have indicated efficacy with both drugs but the work with ganciclovir is particularly encouraging. This communication provides a review of CMV infections in AIDS patients with special reference to the experiences to-date in the use of ganciclovir and foscarnet.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Do education groups help diabetics and their parents?

The importance of education in the management of diabetes is recognised but has rarely been assessed in children. In a longitudinal controlled study we have examined the effect of a programme of education on the knowledge, diet, and concentration of glycated haemoglobin A1c in a group of diabetics. The programme took the form of two packages of education each consisting of four weekly meetings, in which small groups of parents and older children were led in a discussion of different aspects of diabetes. Only one of the 119 families who began the study failed to complete it. Family knowledge about diabetes improved as a result of the programme, although this was poorly retained in the fathers. A trend to improvement in several aspects of diet was noted but did not reach significance. A significant fall in glycated haemoglobin A1c was apparent seven months after the education in children aged 11 years and over. Those whose initial control was poor improved most. We conclude that such meetings should be considered as a useful adjunct to regular diabetic clinics.

Adolescent↗
PubMed1989

Cytomegalovirus infection in gastrointestinal tracts of patients infected with HIV-1 or AIDS.

All gastrointestinal tract biopsy specimens from 190 patients positive for HIV-1 or with AIDS were reviewed to assess the prevalence of cytomegalovirus (CMV) infection, morphology of infected cells, and the associated histopathological features. Eighteen patients (10 (7.7%) of 129 HIV antibody positive and eight (13.1%) of 61 with AIDS) had CMV identified in 35 biopsy specimens from the following sites: oesophagus (n = 3); stomach (n = 6); small intestine (n = 4); colorectum (n = 18) and perianal area (n = 4). Eleven patients had CMV alone as the potential cause of symptoms and in seven there were coexistent pathogens or Kaposi's sarcoma. The appearance and type of infected cells at different sites was highly variable. Immunocytochemical techniques and electron microscopic examination were performed to confirm the presence of CMV antigen and CMV virus particles and to exclude the possibility of an adenovirus producing similar cytopathic changes. It is important to recognise the different morphological forms of infected cells, and the use of immunocytochemical techniques is recommended in patients at risk for CMV or in whom CMV infection is suspected.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Children with diabetes mellitus: perception of their behavioural problems by parents and teachers.

The behaviour of 127 children with diabetes mellitus aged 8-16 years was assessed by their parents and teachers using a well established screening device and compared to that of 51 non-diabetic children. Twenty five per cent of the diabetics were perceived by their parents to be disturbed compared to only 14% of the controls. The proportion perceived to be disturbed by their teachers was similar in the two groups but more diabetics than controls were perceived by both parents and teachers to be disturbed. No relationship was found between the extent of the behaviour problems recorded and the control of the diabetes, as measured by glycosylated haemoglobin, the child's age, the child's age at diagnosis or the duration of the diabetes. However, the children with the younger parents at diagnosis tended to be perceived by their parents as having more behaviour problems, as were the diabetics from families facing the most social problems. The families more knowledgeable about diabetes were less likely to have disturbed children.

Adolescent↗
PubMed1988

Training programme for senior registrars in community paediatrics.

Consultant paediatricians with a special interest in community child health are being appointed in many parts of the United Kingdom but there are few training posts or programmes for this specialty. A training programme for senior registrars in the northern region that three doctors have completed and in which six doctors are currently engaged is presented.

Child Health Services↗
PubMed1988

Dietary variation in diabetics.

The day to day variation in the energy and carbohydrate intake of 168 children with diabetes on Tyneside and Teesside was less than that of 405 non-diabetic children. It was, however, still considerable, the average range of carbohydrate intake over three days being 51 g. The variation in carbohydrate intake was not related to diabetic control nor to the families' knowledge of diabetes. Compliance with the dietary prescription deteriorated during the day. These findings support a qualitative approach to the dietary prescriptions for diabetics.

Adolescent↗
PubMed1987

Atopic manifestations in the acquired immune deficiency syndrome: response to recombinant interferon gamma.

Six patients with the acquired immune deficiency syndrome (AIDS) had exacerbations or recurrences of previously quiescent atopic disease when they developed immunodeficiency. Four developed a different atopic illness from that suffered previously. Atopic symptoms developed within three months after the patients developed AIDS or during prodromal illness. Two of the patients were treated with recombinant interferon gamma: both showed a striking improvement in symptoms and cellular immunity. These results indicate that cellular immunity, through interferon gamma, may have a role in regulating atopic disease.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Association of different allelic forms of group specific component with susceptibility to and clinical manifestation of human immunodeficiency virus infection.

The distribution of phenotypes of the group specific component (Gc) was examined in 203 homosexuals at risk of infection or infected by the human immunodeficiency virus and compared with that in 50 randomly selected homosexuals and 122 healthy male heterosexual seronegative controls. 30.2% of patients with the acquired immunodeficiency syndrome (AIDS) were homozygous for Gc 1 fast (Gc 1f) compared with 0.8% of controls (p less than 0.0001); patients with other clinical manifestations of HIV infection were also more likely than controls to have Gc 1f. By contrast, seronegative symptomless homosexual contacts of AIDS patients (AH-p) lacked this phenotype but were more likely than controls to be homozygous for Gc 2 (25% vs 9%, p less than 0.05). AIDS patients lacked the homozygous Gc 2 phenotype altogether. A chi 2 trend test showed that progression to AIDS had a strong positive association with the Gc 1f allele (p less than 0.0001) and a negative one with Gc 2 (p less than 0.05). It is proposed that Gc may be involved in viral entry into host cells, the ease of which varies with different allelic forms of Gc, according to their sialic acid content.

AIDS-Related Complex↗