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Biomedical subjects

L Thornton

Publications and source records attributed to L Thornton.

At least 37 records · Page 2Linked to original sources
PubMed1995

An outbreak of hepatitis A among Irish haemophiliacs.

BACKGROUND: An outbreak of hepatitis A (HAV) occurred in 1992 in Irish haemophilia A patients treated with high purity solvent-detergent (SD) treated factor VIII. Similar outbreaks were reported in Italy, Germany and Belgium. The aim of this study was to investigate the outbreak, and to test the hypothesis that it was caused by exposure to SD-treated factor VIII. METHODS: A case-control study was started in early 1993. Haemophilia A cases with acute HAV (n = 29) were compared with haemophilia A controls for exposure to SD-treated factor VIII and other environmental factors. Details of factor VIII usage were obtained from the National Haemophilia Register and environmental data were obtained by a telephone-administered questionnaire. The response rate was approximately 90%. RESULTS: The incidence of acute HAV infection among haemophilia A patients exceeded the notified national incidence of HAV by a factor of approximately 300. The incidence was higher in younger patients and those with more severe bleeding disorders. Contact with hepatitis, with children, and exposure to factor VIII were associated with increased risk. The association with factor VIII was the strongest risk factor after controlling for other factors (odds ratio = 27.6, 95% confidence interval [CI] 6.5-117.3). A dose-response effect was demonstrated. CONCLUSIONS: Although person-to-person transmission is likely to have caused a few of the cases, the results of our investigation suggest that the major contributing factor was exposure to certain batches of SD-treated factor VIII.

Adolescent↗
PubMed1994

Investigation of an outbreak of hepatitis A in Irish haemophilia A patients.

Since 1990, Irish haemophilia A patients have been treated with solvent-detergent(SD)-treated virally inactivated high-purity factor VIII concentrate prepared from plasma from Irish voluntary non-remunerated donors. In 1992, 13 haemophilia A patients developed clinical hepatitis A and a further 17 patients showed serological evidence of recent infection by hepatitis A. All but 3 of these patients had had recent exposure to SD-treated product. A case-control study is underway to determine whether these cases represent transmission through product or environmentally acquired hepatitis A.

Blood Component Transfusion↗
PubMed1993

The epidemiology of rubella in the Republic of Ireland.

The trend in notified cases of rubella in the Republic of Ireland from 1950 to 1990 has been downward, with a mean interval of four years between peak periods. Vaccine uptake and antenatal immunity levelled out in the 1980s at 85% and 87%, respectively. One hundred and six cases of congenital rubella were recorded between 1975 and 1990, 66 being reported by paediatricians. The fact that cases of congenital rubella still occur highlights the need for a continued and aggressive immunisation policy, up-to-date and cohort-based data on vaccine uptake, and the introduction of a congenital rubella register.

Humans↗
PubMed1993

The problems of tracing a geographically widespread outbreak of salmonellosis from a commonly eaten food: Salmonella typhimurium DT193 in north west England and north Wales in 1991.

Geographically widespread outbreaks involving commonly isolated organisms and where the vehicles of infection are commonly eaten foodstuffs pose particular difficulties at a technical and organizational level. An outbreak of Salmonella typhimurium infection, affecting 39 people, spread over a wide area in North West England and North Wales in April and May 1991, was detected thanks to the practice of sending specimens to the national reference laboratory where phage typing and characterizing of antibiotic resistance patterns enabled the identification of a cluster of distinctive isolates (S. typhimurium DT193 resistant to sulphonamides, trimethoprim and furazolidone). An investigation, involving twenty environmental health departments in addition to health authorities and the Public Health Laboratory Service, showed an association between the illness and eating loose sliced cooked ham (P = 0.004). Detailed tracing of the chain of supply of the ham showed this to be particularly cooked ham originating from a single small local producer (P = 0.00003). Further investigation of that producer revealed that a batch of ham distributed on one day in early April was undercooked due to a malfunction in cooking equipment.

Adolescent↗
PubMed1991

Evaluation of a taurine containing amino acid solution in parenteral nutrition.

Vaminolact, an amino acid solution containing taurine, was given to 15 sick newborn babies. They were compared with a group of 10 babies who received a solution that did not contain taurine (Vamin glucose). Efficacy and safety were evaluated by monitoring plasma amino acid patterns, growth patterns, nitrogen balance, and biochemical and haematological profiles. No serious abnormalities in amino acid concentrations were found. After an initial fall the taurine concentration recovered more rapidly in those receiving the taurine supplement, though this difference was not significant. Phenylalanine concentrations were within the reference range in the group receiving Vaminolact, and were significantly lower than in the group receiving Vamin glucose. Metabolic acidosis, which occurred in several subjects in each group, was not a serious problem. Liver function tests remained satisfactory. Nitrogen retention was greater among those receiving Vaminolact than in the control group. Vaminolact is a safe and effective amino acid solution for use in critically ill babies.

Amino Acids↗
PubMed1990

Prader-Willi syndrome in New Zealand: a survey of 36 affected people.

The Prader-Willi syndrome consists of infantile hypotonia, failure to thrive, hypogonadism and developmental delay. It was first described in 1956. Later in life hypotonia improves. Between the age of two and four obesity becomes noticeable and between six and ten there is uncontrollable behaviour. A survey has been carried out of the 36 known cases in New Zealand and the pattern of the disease is similar to that elsewhere. In most cases the diagnosis was not established until between the ages of six and 10 when the obesity was marked and uncontrolled behaviour a problem. Early control of the obesity is helpful.

Adolescent↗
PubMed1990

Narcotic addiction: the expectant mother and her baby.

In a retrospective study of the period 1982-1985, the records of 29 narcotic-addicted mothers and their 42 babies were reviewed. All mothers were from socially deprived backgrounds, had a poor record of ante-natal attendance and had frequent admissions to hospital. Thirteen mothers had a past history of hepatitis B and four were HBsAg positive. The babies had significantly lower mean gestational age and mean birth weight than the control group. Features of withdrawal were recorded in 84% of babies where a history was available. A high incidence of twins (10.5%) was also observed. Testing for HIV antibody in more recent cases has revealed positive results in seven mothers and three babies; one infant has since died from acquired immune deficiency syndrome.

Adolescent↗
PubMedDate not supplied

Influences on breast feeding initiation and duration.

The study objectives were to establish the prevalence of breast feeding at birth, at four and twelve weeks after birth and describe the factors associated with its initiation and duration. The study population consisted of all babies born in May 1993 (n = 162) to mothers resident in Kildare. The response rate was 145/162 (89 percent). Mothers were visited within fourteen days of the birth. Breast feeding mothers were re-visited when the baby was four to six weeks old and at twelve to fourteen weeks. Interviews were conducted using an interviewer administered questionnaire. Fifty-five mothers (38%) chose to breast feed at birth. Twelve (8%) had stopped by the first, ten (7%) by the second and fourteen (10%) by the third visit. Higher social class and maternal grandmother having breast fed were significantly associated with initiation (p < 0.05 and p < 0.0005 respectively). Smokers and non-working mothers were significantly less likely to breast feed and smokers had a significantly shorter duration of breast feeding but these associations disappeared on social class adjustment.

Adolescent↗
PubMedDate not supplied

Blood-borne infections in Dublin's opiate users.

BACKGROUND: Injecting drug users are at high risk of acquiring blood-borne infections. Ireland has had a harm reduction policy of methadone maintenance and needle exchange since 1992. AIM: To estimate prevalence of hepatitis B, hepatitis C and HIV infection and appropriate uptake of hepatitis B vaccine in methadone attendees and to make recommendations for a simple record-based surveillance system. METHOD: Retrospective study of 138 client records for evidence of laboratory tests or test results for blood-borne viruses and appropriate immunisation against hepatitis B. RESULTS: A total of 60% of clients had evidence of one or more laboratory tests in their notes. Of those tested for individual viruses, 5.1% were positive for hepatitis B surface antigen, 78.8% had antibodies to hepatitis C and 16.7% were HIV positive. Nearly two-thirds of clients had no evidence of vaccination or information on prior immunity in their records. CONCLUSIONS: A standardised written protocol for screening for blood-borne viruses and for immunisation against hepatitis B in methadone service attendees was clearly needed, and was subsequently introduced by the Eastern Region Health Authority.

HIV Infections↗