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Biomedical subjects

P R Gully

Publications and source records attributed to P R Gully.

At least 19 recordsLinked to original sources
PubMed1997

Hepatitis C.

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Canada↗
PubMed1997

Hepatitis B.

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Canada↗
PubMed1995

Selective risk group strategies in North America.

Policies for hepatitis B immunization in Canada and the USA evolved from 1982 and culminated in recommendations for universal vaccination in both countries in 1991. In policies developed between 1982 and 1985 there were clear national recommendations for the immunization of selected risk groups, e.g. healthcare workers, recipients of multiple blood products, infants of HBsAg-positive mothers and those at high risk for sexual transmission. By 1988, both countries had policies for prenatal screening. It is evident that most vaccine was delivered to healthcare workers and that the epidemiology of the disease did not change as a result of selective strategies. However it is very important, for the foreseeable future, to continue selective immunization programmes in addition to a universal strategy in order to protect those presently at risk.

Canada↗
PubMed1995

How well do family physicians manage sexually transmitted diseases?

OBJECTIVE: To identify gaps in knowledge about sexually transmitted diseases (STDs) and evaluate practice. DESIGN: We compared how 49 family physicians managed 249 episodes of STDs with the recommendations of the 1988-1989 Canadian STD management guidelines. (The study took place before revised guidelines were distributed in late 1992.) SETTING: Family physicians' practices throughout Canada. PARTICIPANTS: Physicians recruited by the National Research System from among the members of the College of Family Physicians of Canada. These physicians had been in practice for a mean of 9 years; 43 were Certificants of the College. MAIN OUTCOME MEASURES: Family physicians' self-reported episodes of sexually transmitted disease evaluated in light of current Canadian guidelines. RESULTS: Of the 249 episodes studied, 215 (86.3%) were treated effectively, and 34 (13.7%) were judged to have been treated ineffectively. Of the 215 effective treatments, 67 (31.2%) were not completely in agreement with current guidelines. CONCLUSION: Experienced family physicians with postgraduate training usually manage STDs well. The number of ineffective treatments and effective treatments not following the 1988-1989 guidelines, especially for pelvic inflammatory disease, indicates that information on managing certain STDs and syndromes should be made available to all family physicians in a format that is easy to read and use.

Adolescent↗
PubMed1986

An outbreak of tuberculosis in a children's hospital.

A 3-year-old girl was admitted to a children's hospital; subsequently her mother was found to have pulmonary tuberculosis with smear-positive sputum. Of over 400 patients, their families and staff at risk in the hospital, 30 inpatients, three outpatients, two sibling visitors and one staff member became infected. A retrospective cohort study of exposed inpatients identified exposure duration, exposure proximity and primary diagnosis as independent predictors of infection risk. Children with neoplastic disease who were being treated with cytotoxic and immunosuppressive therapy with clotting factors were at a greater risk of developing clinical disease including disseminated infection. Altogether three generations of infected children and adults were diagnosed amongst community and hospital contacts in this extended outbreak. These findings support current recommendations for the follow-up of highly susceptible casual contacts of cases of pulmonary tuberculosis with smear-positive sputa.

Adult↗
PubMed1985

An outbreak of hepatitis A on a hospital ward.

An outbreak of hepatitis A has been recognised on a medical ward of a district general hospital. Eleven nurses and one patient were reported to have hepatitis over a period of 18 days in October, 1984. Specific tests for hepatitis A IgM were positive in all cases. Following extensive investigations, the outbreak was traced to a female patient who had recently returned from India and who was incontinent. Her serum, when tested subsequently, showed evidence of recent hepatitis A infection. The implications of this outbreak are discussed.

Adolescent↗
PubMed1983

Water-borne outbreak of campylobacter gastroenteritis.

An outbreak of gastroenteritis affecting 234 pupils and 23 staff at a boarding school occurred over a period of 8 weeks. Campylobacter spp. were isolated from pupils and staff, and from two samples of cold water taken from an open-topped storage tank which supplied predominantly unchlorinated water to the main school building. The two isolates from water were of the same serotype. This serotype was the commonest of the three serotypes of Campylobacter jejuni detected in isolates from pupils and staff. There was a highly significant association between consumption of water from the cold water storage tank and reported illness in staff. Attack rates in pupils corresponded closely with the extent of distribution of this water-supply to the main residential houses. Contamination of water by faecal material from birds or bats was the most likely source of infection.

Campylobacter Infections↗
PubMed1980

Protection against pertussis by immunisation.

Review of all 126 children admitted to the communicable diseases unit with whooping cough during the epidemic in 1978 showed that two had received two doses of triple vaccine and only one had had full primary immunisation against the disease. None of these three children suffered complications of the disease. Of the 123 children who had not been immunised against pertussis, however, 66 had had one or more complications. In Birmingham the dramatic decline in immunisation against pertussis has been accompanied by a fall in acceptance rates for diphtheria and tetanus immunization. Nevertheless, of the 62 children aged over 1 year in this series, 41 had been so immunised. These findings suggest that the apparently positive decision by parents to omit pertussis immunisation was misplaced, since immunisation does protect against the more serious complications of the disease. Furthermore, there is no firm evidence that pertussis immunisation of children without specific contraindications is associated with serious adverse reactions.

Child↗