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Biomedical subjects

J Todd

Publications and source records attributed to J Todd.

At least 199 records · Page 11Linked to original sources
PubMed1965

Nucleoside incorporation into strain L cells: inhibition by pleuropneumonia-like organisms.

Contamination of Strain L cell cultures by pleuropneumonia-like organismtis (PPLO) resulted in a complete inhibition of the incorporation of tritiated thymnidine and uridine. Contanminated cultures were characterized by a concentration of PPLO along the margins of the cells and in the intercellular-spaces of the cultures. Autoracliograins of PPLO-contaminated cultures were characterized by exposed silver grains over the margins of the cells. Kanamnycin was efjective in the elimination of PPLO and the restoration of nucleoside incorporation.

Autoradiography↗
PubMedDate not supplied

Population incidence and segregation ratios in the Martin-Bell syndrome.

A clinical and cytogenetic study of children attending schools for the educationally handicapped has been carried out in the City of Coventry. As a result of this an estimate of the population incidence of the Martin-Bell syndrome among schoolchildren has been made. Among school-boys the incidence of mental retardation due to the fra (X) was found to be 0.73 per 1000 and among schoolgirls 0.48 per 1000. The overall prevalence is 0.61 per 1000. Genetic and cytogenetic analysis of 14 families ascertained in an unbiased manner showed that the expected 50% ratio of affected to unaffected relatives was disturbed, the possible result of a segregation distortion.

Child↗
PubMedDate not supplied

The distribution of birth weights in Gambian women who received malaria chemoprophylaxis during their first pregnancy and in control women.

The distribution of birth weights among the infants of 172 Gambian primigravidae who had received chemoprophylaxis with Maloprim (pyrimethamine+dapsone) during pregnancy was compared with that of the infants of 149 primigravidae who had received placebo. Administration of chemoprophylaxis led to a reduction in the prevalence of low birth weight babies and to an increase in the median birth weight. However, these changes were not accompanied by a comparable increase in the prevalence of high birth weight babies. The perinatal mortality rate was lower, although not significantly so, among the babies of women who had received chemoprophylaxis. Thus, no evidence was found to support the view that administration of chemoprophylaxis might increase the risks of delivery by causing cephalo/pelvic disproportion.

Antimalarials↗
PubMedDate not supplied

The effects of iron supplementation during pregnancy, given by traditional birth attendants, on the prevalence of anaemia and malaria.

A randomized, double-blind, placebo-controlled community-based trial of oral iron supplementation (200 mg ferrous sulphate daily) administered to multigravid pregnant women by traditional birth attendants (TBAs) was carried out in a rural area of The Gambia. Iron supplementation led to a significant reduction in the prevalence of anaemia and of iron deficiency. Iron supplementation was not accompanied by increased susceptibility to malaria infection; there was no difference in the prevalence and severity of peripheral blood or placental malaria infection between the 2 groups of women. The birth weight of children born to women who received iron prophylaxis was increased by an average of 56 g. It is concluded that oral iron prophylaxis can be successfully delivered through TBAs integrated into a primary health care programme. This simple intervention can produce significant beneficial effects on the health of the mother without inducing increased susceptibility to malaria and has the potential for reducing perinatal mortality by increasing birth weight.

Adult↗
PubMedDate not supplied

Malaria prevalence is inversely related to vector density in The Gambia, West Africa.

Baseline epidemiological and entomological studies were conducted in 5 different areas of The Gambia before the introduction of a national malaria control programme, the objective of which was to treat all the bed nets belonging to people living in primary health care villages with insecticide. All malariometric indices used (parasite density, parasite rates, splenomegaly, and packed cell volume) indicated that malaria transmission was more intense in the east of the country than elsewhere. High transmission in the east was associated with a high sporozoite rate but not with the greatest vector abundance; the lowest malaria prevalence rates were found in villages which were close to very productive breeding sites of Anopheles gambiae s.l. Bed net usage was strongly correlated with vector density and the highest malaria rates were found in villages where bed net usage was relatively low. These results suggest that in The Gambia malaria prevalence rates are reduced where nuisance biting by mosquitoes is sufficient to encourage the population to protect themselves with bed nets.

Animals↗
PubMedDate not supplied

Can malaria chemoprophylaxis be restricted to first pregnancies?

The harmful effects of malaria are most pronounced during first pregnancies and chemoprophylaxis is most effective when given at this time. However, restriction of chemoprophylaxis to first pregnancies might lead to enhanced susceptibility to malaria during second pregnancies. We have investigated this possibility by studying the outcome of second pregnancies in 165 Gambian women who had received either malaria chemoprophylaxis with Maloprim or placebo during their first pregnancy. Many of these primigravidae did not present until the third trimester of pregnancy so that some are likely to have experienced a malaria infection before they started medication. The prevalence of malaria infection of the blood and of the placenta during second pregnancies was similar in women who had received chemoprophylaxis during their first pregnancy and in those who had not, and the mean birth weights of babies born to women in each group were almost identical. Thus, in areas where the epidemiology of malaria is similar to that of The Gambia and where most women present relatively late in pregnancy, it may be possible to restrict malaria chemoprophylaxis to first pregnancies with consequent savings in cost and a reduction in drug pressure on Plasmodium falciparum.

Antimalarials↗
PubMedDate not supplied

The response to iron supplementation of pregnant women with the haemoglobin genotype AA or AS.

The influence of haemoglobin genotype on the response to iron supplementation was studied in a randomized, double blind, placebo-controlled trial involving 497 multigravid pregnant women from a rural area of The Gambia. Women were randomly allocated to receive either oral iron (60mg elemental iron per day) or placebo. At 36 weeks of pregnancy, women who had received oral iron during pregnancy had higher mean haemoglobin, packed cell volume, plasma iron and ferritin levels than did women who received placebo. Iron supplementation of pregnant women with the AA haemoglobin genotype also resulted in increases in the packed cell volume (PCV) and haemoglobin level measured after delivery, and in the birth weight of the infant. However, in AS women PCV and haemoglobin level at delivery were lower in the supplemented group and supplementation was also associated with reduced birth weights. In malaria endemic areas, pregnant women with the haemoglobin genotype AS may not benefit from iron supplementation during pregnancy.

Adolescent↗
PubMedDate not supplied

Cost-effectiveness of improved treatment services for sexually transmitted diseases in preventing HIV-1 infection in Mwanza Region, Tanzania.

BACKGROUND: A community-randomised trial was undertaken to assess the impact, cost, and cost-effectiveness of averting HIV-1 infection through improved management of sexually transmitted diseases (STDs) by primary-health-care workers in Mwanza Region, Tanzania. METHODS: The impact of improved treatment services for STDs on HIV-1 incidence was assessed by comparison of six intervention communities with six matched communities. We followed up a random cohort of 12,537 adults aged 15-54 years for 2 years to record incidence of HIV-1 infection. The total and incremental costs of the intervention were estimated (ingredients approach) and used to calculate the total cost per case treated, the incremental cost per HIV-1 infection averted, and the incremental cost per disability-adjusted life-year (DALY) saved. FINDINGS: During 2 years of follow-up, 11,632 cases of STDs were treated in the intervention health units. The baseline prevalence of HIV-1 infection was 4%. The incidence of HIV-1 infection during the 2 years was 1.16% in the intervention communities and 1.86% in the comparison communities. An estimated 252 HIV-1 infections were averted each year. The total annual cost of the intervention was US$59,060 (1993 prices), equivalent to $0.39 per head of population served. The cost for STD case treated was $10.15, of which the drug cost was $2.11. The incremental annual cost of the intervention was $54,839, equivalent to $217.62 per HIV-1 infection averted and $10.33 per DALY saved (based on Tanzanian life expectancy) or $9.45 per DALY saved (based on the assumptions of the World Development Report). In a sensitivity analysis of factors influencing cost-effectiveness, cost per DALY saved ranged from $2.51 to $47.86. INTERPRETATION: Improved management of STDs in rural health units reduced the incidence of HIV-1 infection in the general population by about 40%. The estimated cost-effectiveness of this intervention ($10 per DALY) compares favourably with that of, for example, childhood immunisation programmes ($12-17 per DALY). Cost-effectiveness should be further improved when the intervention is applied on a larger scale. Resources should be made available for this highly cost-effective HIV control strategy.

Adolescent↗
PubMedDate not supplied

Welfare reform: advocacy and intervention in the health care setting.

Welfare reform has drastically altered the lives of poor families in the US. In its wake, many former recipients are not receiving whatever transitional benefits and other safeguards to which they remain entitled under federal and state laws. Families are losing access to Medicaid and are not receiving the child care assistance or Food Stamps for which they continue to be eligible. Ill-served by stringent time limits and work requirements, lack of child care assistance, and lack of training and educational opportunities for the development of skills that will lead to better jobs, families need help to navigate the complexities of the new welfare system. Boston Medical Center's Department of Pediatrics has instituted a welfare screening project to educate families about their rights under welfare reform and assist them in advocating for themselves and their children.

Adult↗
PubMedDate not supplied

Optokinetic suppression of aberrant vestibular reactions: an observation.

It has long been known that optokinetic nystagmus may be modified by vestibular inputs. We have suppressed an aberrant vestibular response and associated gastrointestinal sensations by use of an optokinetic stimulus simultaneous to the positional stimulus in a patient with paroxysmal positional vertigo. This single subject study utilized several optokinetic conditions, and patterned its stimulus presentations to control for visual fixation and vestibular habituation. Objective recordings of eye movements (ENG) were made simultaneously with subjective evaluation of "dizziness" on a simple magnitude estimation scale.

Adult↗
PubMedDate not supplied

Peripherally inserted central catheters and their use in i.v. therapy.

Peripherally inserted central catheters (PICCs) can adequately and safely meet the needs of patients who require short- to long-term therapy in many clinical settings. Moreover, PICCs have been successfully used in the delivery of i.v. therapy in the patient's home. There is evidence available which indicates that a PICC can minimize the trauma to patients who undergo multiple, repeated cannulations. PICCs can also reduce catheter-related risks such as thrombophlebitis, infection and insertion-related complications. The use of PICCs has been shown to be clinically effective as well as cost-effective. In many centres nurses are leading developments in IV therapy. In order to ensure that high quality, clinically effective patient care is developed, patients must undergo thorough assessment before device selection.

Catheterization, Central Venous↗
PubMedDate not supplied

Health care futures. Part 2: The future of physician executives? Panel discussion.

What is the future of health care in America? This is Part 2 of The Physician Executive panel discussion that explores the future of health care in America. To narrow this ambitious focus somewhat, the future is defined as five to 10 years hence. In Part 1, which was published in the May/June issue, Russell C. Coile, Jr., Barbara LeTourneau, MD, MBA, FACPE, James Reinertsen, MD, Uwe Reinhardt, PhD, Marshall Ruffin, MD, MPH, MBA, FACPE, and David Vogel, MS, shared their opinions about what the future holds in managed care, information technology, and biotechnology. In Part 2, Susan Cejka, Barbara LeTourneau, MD, MBA, FACPE, John Henry Pfifferling, PhD, Uwe Reinhardt, PhD, and James Todd, MD, share their views on the future of medical education and physician executives.

Communication↗