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Biomedical subjects

J Parry

Publications and source records attributed to J Parry.

At least 19 recordsLinked to original sources
PubMed2001

Volumes of cancer surgery for breast, colorectal and ovarian cancer 1992-97: Is there evidence of increasing sub-specialization by surgeons?

The 'Calman-Hine Report' (1995) recommended that cancer surgery should be limited to 'high-volume' consultants. Through an analysis of 5 years of Hospital Episode Statistics for the West Midlands region (1992-1997), we have investigated whether there is evidence of increasing numbers of patients with breast, colorectal or ovarian cancer being treated by high throughput, i.e. sub-specialist surgeons, who carry out more than a threshold level of primary cancer resections annually. The proportion of cases treated by the high-volume breast, colorectal and ovarian cancer surgeons increased annually during the 5 years. The absolute number of consultant firms who undertook breast cancer resections reduced during the 5 years; but the number doing colorectal and ovarian surgery increased. Throughout the 5 years, half of the ovarian cancer resections were carried out by consultant firms who did very few procedures - less than 5 of these procedures annually. The relatively high case-load, the elective nature of breast cancer surgery and an early policy change have undoubtedly facilitated the move towards sub-specialization. The weaker trends for colorectal and ovarian cancer surgery suggest continued monitoring is required to ensure that there is a reduction in the proportion of people treated by surgeons who undertake few cancer resections annually.

Breast Neoplasms↗
PubMed2001

A report of an outbreak of Shigellosis in a primary school in Staffordshire.

This paper describes the management of an outbreak of Shigellosis, reported in the national media, in a village school in Staffordshire. The issues encountered by the outbreak team during the management of this incident have re-affirmed the need for public and environmental health departments to work closely with educational bodies to develop clear and consistent action plans for the management of communicable disease outbreaks. The management of communicable disease in schools, the workplace and other settings should be addressed, possibly as a component of local health improvement plans.

Child↗
PubMed2001

Investigation of mineral waters and soft drinks in relation to dental erosion.

A range of still and sparkling mineral waters were assessed for their erosive potential together with comparator soft drinks using in vitro dissolution assays with extracted human teeth and powdered hydroxyapatite. Dissolution levels with all of the mineral waters were very low and for several still waters were undetectable. Sparkling mineral waters showed slightly greater dissolution than still waters, but levels remained low and were of the order of one hundred times less than the comparator soft drinks. De-gassing of a sparkling mineral water reduced its dissolution, but the total levels were still relatively low suggesting that carbonation of drinks may not be an important factor per se in respect of erosive potential. The complex and heterogeneous mineral compositions of mineral waters could influence the dissolution equilibrium of apatite in enamel and controlled addition of several ions to ultrapure deionized water was investigated. Calcium ions led to the greatest reduction in hydroxyapatite dissolution, but their effects were moderated by other ions including magnesium and sulphate. Thus, mineral waters appear to offer a safe alternative to more erosive acidic beverages and their complex mineral ion compositions may positively influence any dissolution processes at the tooth surface.

Apatites↗
PubMed2001

Creutzfeldt-Jakob syndrome presenting as epilepsia partialis continua.

Creutzfeldt-Jakob disease (CJD) is an uncommon rapidly progressive neurological disorder which can have protean clinical presentations. We report an autopsy-proven case of CJD presenting initially as epilepsia partialis continua but then developing the typical clinical features of CJD over several weeks. CJD should be considered in the differential diagnosis of new onset epilepsia partialis continua in adults.

Aged↗
PubMed2001

Identifying 'non-medical' datasets to monitor community health and well-being.

BACKGROUND: The aim of the study was to identify 'non-medical' datasets holding routinely collected information that might be used to measure and monitor the wider determinants of community health and well-being. METHODS: An expert panel discussion, involving public health and environmental health academics and professionals with expertise in a variety of backgrounds (including environmental health, housing, transport, community safety, public health, primary and secondary care), and interrogation of the Office for National Statistics database were carried out for the West Midlands region. The aim was to identify routinely collected 'non-medical' datasets containing information on the following factors: physical environment, crime, housing and homelessness, social services, socio-economic environment including employment, lifestyles, education, leisure and culture, transport and accidents. RESULTS: Fifty-six datasets were identified. Although 43 (77 per cent) were collected at least annually, few (17; 30 per cent) held data that were disaggregated and routinely available at the sub-local authority level. CONCLUSIONS: This study has identified a number of datasets that hold information relevant to health. However, no single dataset is likely to provide information on all dimensions of health and the determinants of health, and local agencies should consider carefully the strengths and weaknesses of each. Through the development of inter-sectoral working and multi-agency involvement at the local level there is now considerable scope to improve the quality of many of these datasets and to promote their use in the measurement and monitoring of community health.

Accidents↗
PubMed2000

The public health applications of unlinked anonymous seroprevalence monitoring for HIV in the United Kingdom.

BACKGROUND: In order to monitor the epidemiology of human immunodeficiency virus (HIV), integrated national programmes of unlinked anonymous (blinded) HIV sero-surveys have taken place in the UK since 1990. METHODS: The programmes comprise multi-centre surveys primarily using specimens gathered routinely for screening groups of patients. All specimens are irreversibly unlinked from patient identifiers before being tested. RESULTS: The surveys have met their prime aim of providing at low cost minimally biased estimates of current HIV prevalence and trends in sentinel populations. The surveys have remained acceptable to professionals and the public, being successfully implemented without breech of their founding principles. The findings have had major public health applications, have influenced HIV policy and funding, been used for monitoring the spread of HIV, for targeting and evaluating health promotion and improving projections of severe HIV disease. The surveys have detected substantial prevalence rises and under-diagnosis of HIV which would otherwise have been unrecognised. The programmes' value is being increased by sub-typing HIV-1 isolates, capturing additional demographic information to detect spread among minority groups. The same specimens are used for monitoring other infections (initially hepatitis A, B and C). CONCLUSIONS: Monitoring HIV and other infections through unlinked anonymous HIV surveillance has become an integral essential part of national HIV and AIDS surveillance. Although it has unique applications the value of unlinked anonymous surveillance is maximized when used in conjunction with behavioural data, information from HIV and AIDS reporting, and behavioural data and surveillance for other sexually transmitted infections.

Confidentiality↗
PubMed2000

Tetanus.

Explore the source record for details and available documents.

Adolescent↗
PubMed1998

Induction of tissue transglutaminase by dexamethasone: its correlation to receptor number and transglutaminase-mediated cell death in a series of malignant hamster fibrosarcomas.

Treatment of the hamster fibrosarcoma cell lines (Met B, D and E) and BHK-21 hamster fibroblast cells with the glucocorticoid dexamethasone led to a powerful dose-dependent mRNA-synthesis-dependent increase in transglutaminase activity, which can be correlated with dexamethasone-responsive receptor numbers in each cell line. Increasing the number of dexamethasone-responsive receptors by transfection of cells with the HG1 glucocorticoid receptor protein caused an increase in transglutaminase activity that was proportional to the level of transfected receptor. In all experiments the levels of the tissue transglutaminase-mediated detergent-insoluble bodies was found to be comparable with increases in transglutaminase activity. Despite an increase in detergent-insoluble body formation, an increase in apoptosis as measured by DNA fragmentation was not found. Incubation of cells with the non-toxic competitive transglutaminase substrate fluorescein cadaverine led to the incorporation of this fluorescent amine into cellular proteins when cells were damaged after exposure to trypsin during cell passage. These cross-linked proteins containing fluorescein cadaverine were shown to be present in the detergent-insoluble bodies, indicating that the origin of these bodies is via activation of tissue transglutaminase after cell damage by trypsinization rather than apoptosis per se, since Met B cells expressing the bcl-2 cDNA were not protected from detergent-insoluble body formation. We describe a novel mechanism of cell death related to tissue transglutaminase expression and cell damage.

Animals↗